Multidimensional Environmental Factors and Sleep Health for Aging Adults: A Focused Narrative Review.

The timing, amount, and quality of sleep are critical for an individual's health and quality of life. This paper provides a focused narrative review of the existing literature around multidimensional environments and sleep health for aging adults. Five electronic databases, Scopus, Web of Science, PubMed/Medline; EBSCOhost, PsycINFO (ProQuest), and Google Scholar yielded 54,502 total records.

Understanding Experience of Patients With Highly Infectious Diseases During Extended Isolation: A Design Perspective.

Objectives: This study aimed to develop a better understanding of the unique needs of patients with highly infectious diseases and their perceptions of being placed in isolation. We explore the subjective experiences of patients treated for Ebola in a biocontainment unit (BCU) and the healthcare personnel who cared for them.

Background: The 2014 Ebola outbreak and the COVID-19 pandemic have brought to focus some major challenges of caring for patients with serious infectious diseases.

Placing Users at the Center: Evaluating Exam Room Design for Improved User Experience.

Objective: This article proposes a method for evaluating the design affordances of primary care exam rooms from the perspectives of users using functional scenario (FS) analysis.

Goal: This study aims to develop quantifiable criteria and spatial metrics for evaluating how exam room design supports the needs of different users. These criteria and metrics can be used in the early stages of the design process to choose between alternatives.

Healthcare design to improve safe doffing of personal protective equipment for care of patients with COVID-19.

Objective: Understand how the built environment can affect safety and efficiency outcomes during doffing of personal protective equipment (PPE) in the context of coronavirus disease 2019 (COVID-19) patient care.

Study Design: We conducted (1) field observations and surveys administered to healthcare workers (HCWs) performing PPE doffing, (2) focus groups with HCWs and infection prevention experts, and (3) a with healthcare design experts.

Settings: This study was conducted in 4 inpatient units treating patients with COVID-19, in 3 hospitals of a single healthcare system.

Lighting the Patient Room of the Future: Evaluating Different Lighting Conditions From the Patient Perspective.

Objective: This study explores whether "future" lighting systems that provide greater control and opportunity for circadian synchronization are acceptable to participants in the role of patients.

Background: Tunable, dimmable light emitting diode systems provide multiple potential benefits for healthcare. They can provide significant energy savings, support circadian synchronization by varying the spectrum and intensity of light over the course of the day, address nighttime navigation needs, and provide user-friendly control.

Playful strategies to foster the well-being of pediatric cancer patients in the Brazilian Unified Health System: a design thinking approach.

Background: Cancer care can negatively impact children's subjective well-being. In this research, well-being refers to patients' self-perception and encompasses their hospital and care delivery assessment. Playful strategies can stimulate treatment compliance and have been used to provide psychosocial support and health education; they can involve gamification, virtual reality, robotics, and healthcare environments.

Designing for Effective and Safe Multidisciplinary Primary Care Teamwork: Using the Time of COVID-19 as a Case Study.

Effective medical teamwork can improve the effectiveness and experience of care for staff and patients, including safety. Healthcare organizations, and especially primary care clinics, have sought to improve medical teamwork through improved layout and design, moving staff into shared multidisciplinary team rooms. While co-locating staff has been shown to increase communication, successful designs balance four teamwork needs: face-to-face communications; situational awareness; heads-down work; perception of teamness.

Lighting the Patient Room of the Future: Evaluating Different Lighting Conditions for Performing Typical Nursing Tasks.

Purpose: This study explores how aspects of lighting in patient rooms are experienced and evaluated by nurses while performing simulated work under various lighting conditions. The lighting conditions studied represent design standards consistent with different environments of care-traditional, contemporary, and future.

Background: Recent advances in lighting research and technology create opportunities to use lighting in hospital rooms to improve everyday experience and provide researchers with opportunities to explore a new set of research questions about the effects of lighting on patients, guests, and staff.

The Representational Function of Clinic Design: Staff and Patient Perceptions of Teamwork.

Objective: This study empirically investigates the relationships between visibility attributes and both patients' and staff members' teamwork experiences.

Background: Teamwork among healthcare professionals is critical for the safety and quality of patient care. While a patient-centered, team-based care approach is promoted in primary care clinics, little is known about how clinic layouts can support the teamwork experiences of staff and patients in team-based primary clinics.

Spatial Influences on Team Awareness and Communication in Two Outpatient Clinics: a Multiple Methods Study.

Background: Healthcare organizations are moving their primary care teams out of private offices into shared workspaces for many reasons, including teamwork improvement and cost reduction.

Objective: Identify the specific aspects of layout and design that enable two fundamental processes of high-functioning teams: communication and situation awareness.

Design: This was a multi-method study employing qualitative interviews, floor plan analysis, observations, behavior mapping, and surveys.

A Conceptual Visibility Framework for Linking Spatial Metrics With Experience and Organizational Outcomes.

Visibility enables or prohibits healthcare professionals' ability to monitor, control, or manage situations in healthcare settings. Visibility has a significant impact on patient safety, including patient fall rates and mortality rates, and on the performance of healthcare professionals, including situational awareness and communication. This article provides a conceptual visibility framework synthesizing visibility analysis models, tools, and metrics.

Backstage Staff Communication: The Effects of Different Levels of Visual Exposure to Patients.

Objective: This article examines how visual exposure to patients predicts patient-related communication among staff members.

Background: Communication among healthcare professionals private from patients, or backstage communication, is critical for staff teamwork and patient care. While patients and visitors are a core group of users in healthcare settings, not much attention has been given to how patients' presence impacts staff communication.

Design Strategies for Biocontainment Units to Reduce Risk During Doffing of High-level Personal Protective Equipment.

Background: Few data exist to guide the physical design of biocontainment units, particularly the doffing area. This can impact the contamination risk of healthcare workers (HCWs) during doffing of personal protective equipment (PPE).

Methods: In phase I of our study, we analyzed simulations of a standard patient care task with 56 trained HCWs focusing on doffing of high-level PPE.

Variability in the Duration and Thoroughness of Hand Hygiene.

We observed 354 hand hygiene instances across 41 healthcare workers doffing personal protective equipment at 4 hospital-based biocontainment units. We measured the duration and thoroughness of each hand hygiene instance. Both parameters varied substantially, with systematic differences between hospitals and differences between healthcare workers accounting for much of the variance.

Common Behaviors and Faults When Doffing Personal Protective Equipment for Patients With Serious Communicable Diseases.

Background: The safe removal of personal protective equipment (PPE) can limit transmission of serious communicable diseases, but this process poses challenges to healthcare workers (HCWs).

Methods: We observed 41 HCWs across 4 Ebola treatment centers in Georgia doffing PPE for simulated patients with serious communicable diseases. Using human factors methodologies, we obtained the details, sequences, and durations of doffing steps; identified the ways each step can fail (failure modes [FMs]); quantified the riskiness of FMs; and characterized the workload of doffing steps.

The impact of clinic design on teamwork development in primary care.

Background: Traditional clinic design supports a high-volume, hierarchical practice model. New design models are evolving to foster a high-functioning team delivery model.

Purpose: The goal of this study was to determine whether new design models, specifically colocation, improve care team development.

Measuring Interpersonal Visual Relationships in Healthcare Facilities: The Agent Visibility Model and SAVisualPower Tool.

Visibility has a significant impact on health-related outcomes and experiences of users in healthcare settings. Built environments determine interpersonal visual relationships between users and control their ability to see (or be seen by) others. Despite this importance, metrics that fully and precisely describe these interpersonal visual relationships are lacking.

Exploring the Relationships Between Patient Room Layout and Patient Satisfaction.

This retrospective, exploratory study examined 8,366 patient responses to surveys on patient satisfaction and patient room spatial layout in a large academic teaching hospital consisting of 17 nursing units and 382 patient rooms. This study included four spatial measures: average distance to the nurse station, room handedness, location of bed, and location of first encounter-and explored their statistical associations with two types of patient satisfaction surveys (Hospital Consumer Assessment of the Healthcare Provider and Systems and third party). The study had two phases: a preliminary study of 3,751 patient respondents in a limited diagnosis-related group (DRG) over 5 years and a general study of 4,615 patient respondents with a broader range of DRG's over 2 different years from the preliminary study.

Design strategies to improve healthcare worker safety in biocontainment units: learning from ebola preparedness.

Objective: To identify ways that the built environment may support or disrupt safe doffing of personal protective equipment (PPE) in biocontainment units (BCU).

Design: We observed interactions between healthcare workers (HCWs) and the built environment during 41 simulated PPE donning and doffing exercises.

Setting: The BCUs of 4 Ebola treatment facilities and 1 high-fidelity BCU mockup.

Assessing Viral Transfer During Doffing of Ebola-Level Personal Protective Equipment in a Biocontainment Unit.

Background: Personal protective equipment (PPE) protects healthcare workers (HCWs) caring for patients with Ebola virus disease (EVD), and PPE doffing is a critical point for preventing viral self-contamination. We assessed contamination of skin, gloves, and scrubs after doffing Ebola-level PPE contaminated with surrogate viruses: bacteriophages MS2 and Φ6.

Methods: In a medical biocontainment unit, HCWs (n = 10) experienced in EVD care donned and doffed PPE following unit protocols that incorporate trained observer guidance and alcohol-based hand rub (ABHR).

Human Factors Risk Analyses of a Doffing Protocol for Ebola-Level Personal Protective Equipment: Mapping Errors to Contamination.

Background: Doffing protocols for personal protective equipment (PPE) are critical for keeping healthcare workers (HCWs) safe during care of patients with Ebola virus disease. We assessed the relationship between errors and self-contamination during doffing.

Methods: Eleven HCWs experienced with doffing Ebola-level PPE participated in simulations in which HCWs donned PPE marked with surrogate viruses (ɸ6 and MS2), completed a clinical task, and were assessed for contamination after doffing.

Environmental Variables That Influence Patient Satisfaction: A Review of the Literature.

Patient's perception of care-referred to as patient satisfaction-is of great interest in the healthcare industry, as it becomes more directly tied to the revenue of the health system providers. The perception of care has now become important in addition to the actual health outcome of the patient. The known influencers for the patient perception of care are the patient's own characteristics as well as the quality of service received.

Design to Improve Visibility: Impact of Corridor Width and Unit Shape.

Objective: This study analyzes 10 intensive care units (ICUs) to understand the associations between design features of space layout and nurse-to-patient visibility parameters.

Background: Previous studies have explored how different hospital units vary in their visibility relations and how such varied visibility relations result in different nurse behaviors toward patients. However, more limited research has examined the specific design attributes of the layouts that determine the varied visibility relations in the unit.