5 Trends in Hospital Orthopedic Department Design

Laura Dyrda -  
New hospital constructions and renovations of orthopedic surgery departments have begun incorporating facility design aspects to enhance the patient experience and to facilitate a concerted effort to promote the healing process. John C. Schrott, III, president of IKM in Pittsburgh, discusses five major trends to the architectural design of orthopedic inpatient departments that are making a difference in the lives of the orthopedic patient.

1. Private patient rooms with natural views.
Over the past several years, inpatient hospital rooms for total joint replacement patients have migrated away from semi-private rooms to single-patient rooms. This is being promoted by a more actively engaged patient and their family members. Patients expressly have privacy concerns about  sharing a bathroom and television set with roommates. The stress of sharing with a stranger and the extra noise from the roommate's visitors can negatively affect the healing process. The design of new hospital renovations and buildings are focused on a more relaxing, hospitality like expression of finishes and furniture. This includes making efforts to have patient windows overlook a natural environment instead of a neighboring brick wall. "If you're a patient in your room and you look out a window at a meadow instead of a brick wall, your stress level is reduced, you request fewer pain killers, and your length of stay is decreased," says Mr. Schrott. "We as humans desire an inherent connection with nature and the outside work. Through that we tend to heal faster and are more comfortable in the process. Private rooms have advanced this cause as well."

2. Department feels more like a hotel than a hospital. Since orthopedic surgery is often elective, patients can take the time to find the surgeon and hospital that best suits them. "Baby boomers do their research and talk to their friends to find the best location and physician to mesh with who they are," says Mr. Schrott. To appear more attractive to these types of patients, some orthopedic departments are designing the inpatient rooms to look more like a hotel than a hospital. "Connection to nature, natural light and specific color schemes that go into hospitals now are much more prevalent in the field these days," says Mr. Schrott. "The building environment has an integral roll in supporting and enhancing the healing process."

3. Decentralization of nursing centers. Nurses on each floor have traditionally been placed in a centralized location to complete their paperwork. This location was often noisy, hectic, and the place where the staff tends to socialize. However, the recent trend has been toward decentralizing the nurses in the total joint replacement department so that the nursing staff's work location is closer to the patients. The closer proximity promotes nurse satisfaction because there are fewer steps to walk between the station and patients' rooms. It also promotes patient satisfaction because the waiting period for the nurse to respond to a call is shorter, and fewer patient falls occur because the patient understands that the  nurse is nearby. There is also less noise in the middle of the night when the nurses are spread among the patients, says Mr. Schrott, which can contribute to a faster recovery and better outcomes. The socialization aspect of the Nursing staff, which is a critical component for staff job satisfaction and retention, is moved into the staff lounge and other staff respite areas.

4. Physical therapy on the orthopedic unit
. Physical therapy and rehabilitation begins immediately for total joint replacement patients, which means they are going to the PT center while they are still relatively immobile. When the physical therapy department is far away from the orthopedic department, anxiety can build among the patients while they wait for an escort. "We are finding that in orthopedic inpatient units, there is a great advantage to having physical therapy on the unit proper," says Mr. Schrott. "Without the anxieties of a long wait or trek to physical therapy, the patient is free to become engaged and understand their role in rehabilitation.  It's part of their whole experience on the floor."

5. Design elements encourage camaraderie among patients.
Orthopedic surgeons often frontload the week with major joint replacement surgeries occurring on Mondays and Tuesdays. This is being driven by the physician's and hospital's desire to minimize work hours on the weekend, says Mr. Schrott. While this requires more patient rooms, having all the joint replacement patients at similar stages in the recovery process also creates a sense of camaraderie among each patient group. "If ten people are coming in to get their knees replaced, they all are experiencing the same thing and there is comfort in going through those trials together," says Mr. Schrott.

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