Team Lego: Project Proposals

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Team Lego Project Proposals

• Design of Pediatric Health Center of the Future
• Team Lego
• Lavanavarjit
• Youngseon Choi
• Randeep

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Principle and Problem one

• Principle Provide physical environment to foster
  social interaction and support for patients and
  families
• Problem Definition The current design of family
  area doesnt encourage interactions between other
  family members and leave out the important source
  of social support for families

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Problem one no interactions occurs between
other family members
The family area in Pediatric Intensive Care Unit
at MCG
The family area in 4th floor at MCG
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The Patient room at MCG Childrens hospital
Private bathroom
Chair
Full body length sofa
Private refrigerator
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Evidence one Families comforting one another

• Presence of other family members soothes family
  members emotional suffering by comforting one
  another in trauma resuscitation room (Morse and
  Pooler 2002).
• Family members who are familiar with surroundings
  gave the patient and other family members
• reassurance of the care (Ive worked with these
  guys they are good)
• encouragement (Dont worry she is heading in
  the right direction),
• information (The analgesic will be working
  soon)
• 
  (Morse
  and Pooler 2002)

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Evidence two family needs in ICU

• The considerable amount of studies identified
• 5 needs of families in the ICU settings
• information
• assurance
• support
• proximity
• comfort needs
• (Molter, 1987 Bouman, 1984 Daley, 1984
  Leske, 1986 Norris Grove, 1986 Price,
  Forrester, Murphy, Monaghan, 1991)

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Evidence three spatial needs for families

• The survey result collected from 155 nursing
  staff indicated needs of peaceful place for
  discussion for interaction between family members
  and nurses (Astedt-Kurki et al, 2001)
• 27 out of 48 family members commented on the
  need for improved physical space to have family
  discussion and conference with physicians
  (Abbott, 2001)
• Two of parameters considered to be important for
  ICU settings were 1) waiting room availability
  2) room availability for family information
  available (Azoulay, 2002)

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Evidence three proximity

• A private family area with a patient room meets
  this proximity need but it is also limiting the
  source of other needs such as informational,
  assurance, and support.
• Personal experience We did not want to be far
  from her, but to give her any kind of privacy or
  quiet. There was no place nearby to go. So we sat
  in the hallway outside her room.

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Project idea one Customized Pocket Family area

• To meet five needs of family members
• information
• assurance
• support
• proximity
• comfort needs
• To foster interaction between families of other
  patients
• Territoriality
• Security
• Personalization
• Frequency of encounter
• Interaction
• Social support informational and emotional

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Proximity
The childrens medical center of Dayton (2007
ICU design winner)
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Proximity always near their child
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Proximity
Territoriality, Security, Personalization

• Pocket family areas which are assigned to
  specific
• patient rooms near by
• Territoriality recognized as their spaces
• Security - easy to identify person who uses
• the area card access
• Personalization possible to bring their child
• own toys or belongings and to use as needed

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Proximity Territoriality, Security,
Personalization social interaction

• Frequency of family encounter - easy to
  encounter same family members and be familiar
  with each other
• Interaction between families
• Emotional and informational support from each
  other

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Steps

• Customize pocket family area
• acuity level of patients in units
• type of diseases in units
• Introduce technologies to meet family needs
• Come up with a proper size of pocket family area
• Come up with the layout of customized pocket
  family area

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Principle and Problem two

• Principle Provide caring, devoted, fast (reduced
  waiting time) service in the emergency department
• Problem Definition Design an Emergency Department
  that has
• Reduced waiting-time and congestion in ED
• Efficient patient hand-over from ambulance to ED
• Use technology and mobile telephony to reduce the
  time for diagnosis and improve the turn around
  time.

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Why focus on this problem?

• 50,000 annual patient visits
• Most of them are for non-urgent care
• Uninsured families turn to the Emergency
  Department for primary care
• Overwhelming rush during peak times
• Congestion leading to overflowing check-in area
  and cramped hallway
• Where is patient privacy in such chaotic
  environment?
• The current facility layout also impedes
  operational efficiency. In a pediatric healthcare
  setting, every second counts. Yet minutes and
  hours are wasted transporting children to areas
  that should be located side by side
• Sourcehttp//www.choa.org/Menus/Documents/Aboutus
  /hsoc/about_hughesspalding.pdf

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Focus Idea 1

• Reduce waiting time and create a healthy healing
  environment
• Evidence based design for ED R6
• Clinical practice guidelines for specialty care
  like asthma R1
• Improving service at Triage (Bottleneck in ED is
  Triage!)
• Team consulting in Triage R3
• Hypothesis A doctor and nurse team investigating
  patients can reduce the number of patient
  redirections in the ED ? Reduced waiting time and
  congestion
• Mini Registration in Triage R2

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Focus Idea 2

• Improve the patient handover at different stages
  through
• Strategic location of ambulance bay based on
  traffic
• Design of Ambulance bay to avoid congestion and
  bottle necks due to the incoming patient flow.
• Allocation of bed and preliminary setup of ED
  before arrival of patient based on the initial
  diagnosis done on the patient during transit.
• Efficient transfer of patients to Grady for
  advanced examination
• Use walkways like in airports
• Use some overhead vision glasses

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Focus Idea 3

• Improved technology enabled patient handover from
  ambulance to ED R4, R5, R7
• Transmission of Electronic ambulance record
  including vital sign information and ECG
• 94s vs 7min (accomplished by using computers and
  mobile wireless network available)
• We could try to transmit necessary info using
  cell phones

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References 1

• R1 Studdert J., Ramsden C., 2004. Introduction
  of standardized emergency department pediatric
  asthma clinical guidelines into a general
  metropolitan hospital. Accident and Emergency
  Nursing
• R2 Gorelick M., Yen K., Yun H., 2004. The Effect
  of In-Room Registration on Emergency Department
  Length of Stay. Annals of Emergency Medicine
• R3 F Subash, F Dunn, B McNicholl, J Marlow,
  2004. Team triage improves emergency department
  efficiency. Emergency Medicine Journal
• R4 V. Anantharaman, L. Han, 2001. Hospital and
  emergency ambulance link using IT to enhance
  emergency pre-hospital care. International
  Journal of Medical Informatics

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References 2

• R5 A Jenkin, N. A. Mitchell, S Cooper, 2007.
  Patient handover Time for a change? Accident and
  Emergency Nursing
• R6 W. B. Millard, 2007. The cost of KOI
  Evidence-Based design in emergency medical
  facilities. Annals of Emergency Medicine
• R7 Sotiris Pavlopoulos, Efthyvoulos Kyriacou,
  Alexis Berler, Spyros Dembeyiotis, and Dimitris
  Koutsouris A Novel Emergency Telemedicine
  System based on Wireless Communication
  TechnologyAMBULANCE

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Interesting Resources

• http//www.statcom.com/flash/loader.html (Patient
  flow simulator dashboard s/w)
• www.archnewsnow.com/features/Feature37.htm (River
  Region Medical Center in Vicksburg, Mississippi)