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COVER STORY


more efficient and safe for patients and physicians.” Architects typically look more at


physical designs, sizes of the rooms and making the facility look pretty but not necessarily functional, Hagendorn says. “Nurses can provide insight on aspects of flow that may be easily over- looked. This can include the location of supply rooms, locker rooms, sterile versus non-sterile rooms, and rooms your tele-data and HVAC people need to access. Nurses can definitely have input on what will work best for patient efficiency and time management.” A nurse can make key contributions


regarding the design of individual rooms, Leger says. “For ORs, nurses know the good and bad places to put patient monitors, lighting fixtures, out- lets and on and off switches. They also know about equipment sizing require- ments and will be able to tell you if a room design does not make sense because of the location of the patient or the need to bring equipment in and out of the room.” The same theory applies to the


whole facility, he says. Nurses, Leventis says, will remind designers of the importance of ensur- ing that the nurse’s station has visibil- ity to all patient bays. They also will make sure that the design includes a sufficient number of electrical outlets for emergency equipment and the opti- mal location and number of OR cabi- nets to control traffic patterns. It is not unusual for features to be omitted during design that might not appear significant but can have a big impact on the patient experience, Hagen- dorn says. “A lot of changing rooms are left out of places. Patients can change behind curtains, but this is uncom- fortable. If you really want to do it the right way, patients should have a private changing room. Nurses are always trying to think of what is best for the patient.” This includes the design of wait- ing rooms, where a nurse’s under-


8 ASC FOCUS SEPTEMBER 2016


A nurse’s involvement will help you have better conversations with the medical staff about specialties or procedures that may be coming down the pike and should be taken into consideration as part of design.”


— Jared Leger, RN Arise Healthcare


standing of the patient population will come in handy, Leger says. “If you perform many gastroenterol- ogy or ophthalmology cases, you are likely to have a high throughput of patients, as opposed to a facility that predominantly performs orthopedics cases, where volume and through- put will be lower. If you are going to perform bariatrics cases, it is impor- tant to purchase the right-sized furni- ture for the lobby. Nurses can advise you of the different needs for a lobby based upon various specialties and the patient flow/timing perspective.” Leger notes that a nurse also can shed light on important future consider- ations. “I go into ASCs that are over- and under-built. You do not want to be one or the other. You want to have room for future expansion. A nurse’s involvement will help you have better conversations


with the medical staff about specialties or procedures that may be coming down the pike and should be taken into consid- eration as part of design.” Hagendorn adds, “Nurses can make recommendations about the optimal location for future ORs and patient beds, or more substantial changes, such as if the ASC wants to eventu- ally provide procedures requiring a 23-hour stay.”


Involve Nursing from the Get-Go The best time to involve nurses in designing a new space, Leventis advises, is during the design develop- ment phase. “Once construction docu- ments/plans are submitted to local and/ or state agencies for permitting,” she says, “changes are often not allowed without a full resubmission of plans.” Leger advises consulting with


nurses when the layout sketches are being prepared and space is being assigned for equipment, storage and more. “Once you have decided on a plan, but before you start construction or bidding on that plan, definitely have a nurse walk through it with patient flow in mind,” he adds. “If you are planning to add a specialty, you will definitely want a nurse’s feedback on OR and procedure room layout and equipment planning and storage.” Do not let the time it might take to


receive, evaluate and integrate nurse recommendations into your design be a deterrent from soliciting that advice, Hagendorn advises. When developers and designers rush to complete a project and fail to involve the necessary partici- pants, including nurses, it can have long- term negative effects—something she has experienced firsthand, she says. “Design must be a careful pro- cess from the very beginning through completion of the project,” Hagendorn says. “Nurses should be involved to the very end. You cannot afford to hurry up and open because you will defi- nitely pay for that down the road.”


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