Designing a Family Friendly Unit: Investigating Relationships Between the Physical Environment and Family Presence Sheila J. Bosch, Ph.D. Director of Research, GS&P Young-Seon Choi, Doctoral Student, Georgia Tech Property of Gresham, Smith and Partners
Overview Background Research approach Preliminary findings
Social Support Emotional, informational, and tangible support 1 Normally received from people in a social network and family 2 Social support contacts limited it when person is hospitalized 3 Need for social support increases with changes such as an unexpected situation or stressful event 4 1 (Kahn & Anton cci 1980 ); 2 (McM rra 1998) 3 (Koi la Tarkka Tarkka Laippala & Pa nonen 1 (Kahn & Antonucci, 1980 ); 2 (McMurray, 1998); 3 (Koivula, Tarkka, Tarkka, Laippala, & Paunonen- Ilmonen, 2002); 4 (Tarkka, Paavilainen, Lehti, & Astedt-Kurki, 2003)
The Evidence: Designing Patient Well- being for Social Support Physical Environment???????? Social Support Family Presence and Interaction as Proxy Family Member Well-being
Research Project Overview Partially funded by AAHF grant Compares 2 ICU designs in same hospital re: family presence (proxy for social support)
Research Questions Is family presence greater when more generous space and accommodations are provided for family members? Does greater family presence increase family-patient interaction and/or family-staff interaction (i.e., family support) to patients?
Graphically speaking Physical Environmental Accommodations for Family Members Family distance to residence Patient acuity Family presence Present in room Present in unit Number of visitors Family presence Patient acuity Interactions Verbal Physical
Operational Definitions Family presence: observed visitors (may be family or friend) for each patient. Presence in patient room and also in unit recorded. Interaction: observed interactions (physical or verbal) between family members and patients, as well as staff members
Research Methods Behavior mapping: Tracking behavior over space and time, typically through observation, to help explain or predict behavior. Focus groups: Purposeful, guided discussion among a small group of individuals, led by a moderator, to elicit opinions, beliefs or perspectives.
Behavior Mapping 5 days in each unit 12 hours per day 4 observations per hour in each patient room and public area = 240 observations per patient room (18 rooms in each unit)
Study Site Tampa General Hospital Private, not-for-profit, teaching hospital Affiliated with University of South Florida Over 800 licensed acute care beds, 59 rehab Named in top 50 (US News & World Report) in 7 specialties
Bayshore Pavilion 340,000 sf addition 5 floors over garage Includes Emergency and trauma center (many ER One concepts) Neuroscience intensive care unit Cardiovascular center Combined gastroenterology/med-surg unit Women s center Pediatric unit
Units Studied Trauma ICU in older facility (2D) Neuro-ICU in Bayshore pavillion (5K) Staff perceived these patients as having similar acuity levelsl Each 18 beds 5K 2D
2D Trauma ICU Floor Plan 11,380 sf Pti Patient trooms Nurse Station Staff Related Area Nurse Station Public Family Area Family Related Area
Nurse Station 5K Neuro ICU floor plan Public Family Area 5K Neuro-ICU Floor Plan 18,574 sf Staff Related Area Family Related Area Nurse Station Patient Rooms Public Family Area
Distributed Work Stations 2D 5K
Central Work Stations 2D 5K
Patient Room Typology 2D 5K 218 sf 304 sf
Patient Rooms 2D 5K
Family Zones in Patient Rooms 2D 5K 20 sf 55 sf
Public Family Waiting Areas 2D 5K 270 total sf 1974 total sf
Lessons Learned Preliminary analysis suggests that providing more generous space and accommodations may increase family presence Maximize the number of different patients family observed Never underestimate the time required for IRB and hospital approvals Never collect this much data manually find money for PDAs
Questions? sheila_bosch@gspnet.com ys.choi@gatech.edu