There is a lot of room in the Kaiser Permanente’s The Sidney R. Garfield Health Care Innovation Center’s 37,000 square feet to test everything from robots for delivering supplies to walking desks that allow a person to use a treadmill during conference calls.
Some of the experiments that started in the center have made it into hospitals in California and others are still in the lab. These are five of the center’s most interesting hospital design projects.
Give me that dimmer switch
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About three years ago, Kaiser invited their members to join the doctors, nurses, pharmacists, technologists and architects on the innovation teams that test ideas for improving healthcare delivery.
“We also make sure to lie down in the hospital beds in our rooms to make sure we get the patient’s view,” business support manager Sherry Fry said during a recent tour of the center.
One change that came from assuming this prone perspective is giving control of the room’s lighting to the patient. By adding a couple new buttons to the remote that controls the hospital bed, the patient can dim the lights in the room and ease the sterile hospital glare without turning out the lights completely. This change was part of phase two of the center’s patient room design work.
“When our first revised room design was implemented in our new hospitals, the executive team was very happy with it but the innovation team wanted to do a second round of improvements,” Fry said. “The management team said the only way we could keep changing the design was if the changes were revenue neutral.” That’s where the new head wall came into the picture.
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Who knew head walls were innovative?
In version 1.0 of the hospital room, all the plugs on the head wall were raised to chest height so that nurses didn’t have to bend all the way down to the floor to plug in monitors. In version 2.0, the Garfield Center team worked with the vendor to create a prefabricated head wall, which meant the new rooms were quicker to assemble.
Better medication delivery system
In addition to improving the physical design of a hospital, the center also looks for improvements to work flow. One of the most successful projects involved the delivery of drugs to patients.
“We shadowed several nurses and found that when they were dispensing medicines to patients, they were interrupted an average of 27 times,” Fry said.
Part of the final solution included a sash for a nurse who was dispensing medicine.
“My favorite part of this project is that there is no on/off switch,'” Fry said. “You can see how the design evolved to end up with something that was easy to clean and easy to fold up and put away.”
The Garfield Center shared the Med Rite system with other hospital systems after a post-implementation survey showed a 40 percent to 60 percent reduction in medication errors, depending on the care setting.
Peace and quiet for fragile newborns
In addition to improving adult hospital rooms, the center is working on a new design for private NICU rooms with one bed instead of many. This design has not been rolled out yet.
The room includes a barn door that divides the space for more privacy, but allows doctors and nurses to quickly change the configuration if they need room to bring in equipment.
“The light and noise of a standard NICU has an impact on how quickly the babies heal,” Fry said. “Giving them a more quiet space helps with this and with family bonding as well.”
Fry said that the team redesigned the entire NICU area, which meant the changes were space neutral with some public areas changing to private space. Kaiser anticipates that the new room design would mean a shorter stay for newborns and fewer readmissions as well.
An important mobile med cart failure
Testing another medication project helped Kaiser avoid a costly mistake. A team was working on a new medication cart. Fry said the team almost went straight to a pilot in a live hospital without doing a test run in the center first.
“Someone on the team said, ‘You know we really should test it here first,'” Fry said.
Shortly after the test started, some of the same nurses who had initially proposed the design of the cart called a time-out.
“The cart was just too heavy and didn’t work in a care setting,” Fry said.
A few weeks later, Fry was telling this story during a tour of the center. One of the hospital executives turned pale as she described the flaws the team had found in the design of the cart.
“He said that his hospital had spent millions on the initial rollout and then lots more money retrofitting the carts,” she said. “They had the exact problems we had identified in our testing.”
