Traditional hospital structures and layouts were

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Traditional hospital structures and layouts were altered to better serve patients and to employ a process-focused Lean design. One example of the process-focused Lean design that encouraged a move away from traditional hospital design was observed in the location of the pharmacy and equipment depot. Typically, these frequently used services are on the first floor or basement of a hospital, but to reduce time and distance traveled, the new facility located these services in the middle of the hospital on the fourth floor. In some cases, the focus on serving the patient superseded staff desires. Serving the patient went beyond patient satisfaction. Another key consideration in approaching the design was the integration of evidence-based design into the planning of the building. Shifting from a traditional, large, one-room nursery layout to private patient rooms in the NICU is an example where the evidence showed potential benefits to the patient (e.g., reduced infections, individualized and cust omizable environments) and superseded the staff’s desires. The traditional nursery layout was more efficient for staff, since it allowed the nursing team to work together in one large room. Nonetheless, senior leaders made the decision to build private rooms using the evidence on hand and information from site visits to similar hospitals that used the proposed layout. The staff was asked for their input on the layout, but the decision to build private rooms was not changed. Other applications of evidence-based design were also evident: to reduce noise in the halls, LHC installed carpet in the main hallways. LHC also explored with their architecture firm the most effective products to prevent spread of infections. Sample rooms were built in the existing hospital for staff to experiment with and provide feedback. Based on feedback from the staff, a pocket door connecting adjacent NICU rooms was added to the design of the unit so that parents of twins could visit with both babies at once. Based on current safety design practices, LHC determined that each room should have a window onto the internal corridor, which would be visible from a nursing station so that nurses could observe patients better. However, the use of sample rooms and feedback from patients enabled designers to determine that this feature was not appropriate for postpartum rooms, because it reduced the mother’s privacy. Thus, the postpartum rooms were altered from the standard medical -surgical design to move the bathroom to the front of the room, even though it would impede clinical staff visibility from the hallway and nursing station. Process improvement/project selection. Teams from each clinical area identified areas for process improvement. Management engineers, Black Belts, and executives each reported a different number of processes across the hospital, with reports ranging from 60 200 processes.
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