Feature Design
Lean Beginnings: Designing witH cHiLDren’s care in minD There are many reasons to initiate the design of a facility with a pre-design process that focuses on determining efficient work processes, from eliminating unnecessary square footage to decreasing staff inefficiencies and improving patient care. In paediatric units, however, healthcare staff has a singular commitment to and passion for their young patients. So it’s important to engage employees in a Lean pre-design process, which focuses on determining efficient work processes to maximize staff productivity and patient care. Using Lean design principles, HGA
helped the University of Minnesota Amplatz Children’s Hospital in Minneapolis, Minnesota - an innovative, world-class research and paediatric healthcare facility - devise workplace strategies that increase staff productivity and time spent with patients and families. HGA facilitated a fact-finding mission in which staff, clients and users provided their most valued criteria in a children’s hospital. The primary finding: Immediate access to a nurse. To determine the distances nurses walked
are usually very ill (they’re not just having their tonsils out or appendix removed). They may be ‘frequent flyers’, meaning their illness requires them to return to the paediatric unit on a regular basis. Nonetheless, they’re usually frightened of medical equipment and procedures. Whole families, from parents and siblings to grandparents, may be accompanying or even staying with the child during treatment. For these reasons, administrators and
designers of paediatric units must take into consideration the emotional and medical needs of children undergoing long-term care. Parents cope better with the anxiety of tending to a sick child when paediatric units incorporate comfortable, family-friendly areas in which they can work, relax and enjoy time together with their family. Here are four key design criteria being incorporated into well-planned and sensitively designed paediatric facilities around the world today.
during a typical shift, and to highlight ways to decrease those distances and increase staff efficiency, HGA initiated several Lean discovery processes. Nurses and other clinicians were followed during their shifts, and their paths were transcribed into visible floor patterns. Door counters recorded how many total times staff entered a room. Simple observation and interviews revealed the purposes of these visits. Using this data, HGA found the nurses
most frequently visited the medication room, then the nutrition room (which was also frequently visited by parents). To eliminate bottlenecks in the former, the team collaborated on the design of each care unit with three medication rooms located near the nursing stations. To decrease traffic in the nutrition room, they also collaborated with the design of two self-serve snack alcoves for parents to use. As a result, the time nurses needed to
retrieve medication decreased by nearly 50%, from 19 to 10 minutes. The distance staff members travel per day decreased from 3,768 feet to 1,925 feet. Now, during an eight- hour shift, nurses walk at least three miles less than they did in the former paediatric facility, resulting in improved patient care and increased staff productivity.
Hospital Build Issue 3 2011 47
IN SHORT
■ Using lean processes in the design of paediatric care facilities will help productivity and ultimately the patient experience
■ Administrators and designers of paediatric units must take in to consideration the emotional and medical needs of their young patients
■ Private rooms are increasingly important in paediatrics, and should include three zones for family, patient and caregiver
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