'Mock EDs' help finalize design plans
'Mock EDs' help finalize design plans
Nurses offer suggestions before construction
In a warehouse owned by Fort Lauderdale, FL-based Broward Health, teams of nurses, physicians, and techs from the EDs at Coral Springs Medical Center and Imperial Point Medical Center, both in Fort Lauderdale, recently toured mock emergency treatment rooms as the final stage of preparation for construction of the new EDs at those Broward Health facilities.
"Our facilities built three rooms that were an exact replica of the designed rooms," says Mary Anne Usher, RN, MBA, BSN, manager of emergency services at Imperial Point. "The RNs and physicians were given three days to visit the mock rooms and provide suggestions on improvements to make the areas more user-friendly for staff and patients."
There were two days set aside so all the staff, day and night shifts, could view the rooms, says Rachelle Zahniser, RN, MSN, CEN, nurse manager of emergency and nursing administrative services at Coral Springs Medical Center.
Despite the fact that the design firm, Omaha, NE-based HDR, had involved the nurse managers and other staff members in the design process from day one and had used computers to create "virtual rooms," the input received after the tours indicated this step was necessary.
"A lot got taken care of just through [the virtual design]," notes Zahniser, "But once we got there, we recommended major changes for the placement of equipment in the room."
For those considerations, it was important to physically be in the rooms, she says. Zahniser; her team, which consisted of the pediatrics assistant nurse manager, two staff nurses, a technician and a secretary; and the physician group recommended placing items such as scopes and cardiac monitors on the opposite side of the room.
While Zahniser considers her team's recommendations to be "very minimal," Usher and her team recommended several alterations in the room plans. They included:
- making needle boxes more accessible;
- placing monitors in better view for the practitioner;
- adding windows to alcoves to create better visibility of the patients;
- repositioning the diagnostic panels;
- adding cabinetry to create additional storage space;
- installing additional electrical outlets;
- adding another computer on wheels.
In addition, says Usher, "a selection was made concerning the type and size of Steris exam light to be used, the headboard design was chosen, and a color scheme was decided on that consisted of warm but neutral tones."
Both nurse managers were gratified by the response to their suggestions. Usher says, "This was a remarkable experience. The design team listened to all our ideas and transferred them to the final draft."
Direct involvement
This collaboration was consistent with the involvement of the nurse managers throughout the process, says Zahniser.
"I had input on the selection of architects and design people. I sat in on the interviews and met the contractors," she says. "They met with us to find out what we wanted, such as rooms large enough for stretchers and for the family to visit." Family is allowed in the rooms at all times, Zahniser notes. The design team came back with several models, she adds.
Project is in three phases
The process at Coral Springs was a bit more challenging, because it will be a three-phase project. "We are building out into the parking lot and then gutting part of our existing ED, and then in the third phase we will gut the rest of the current ED," Zahniser explains. "They originally wanted two phases, but we explained we needed more beds than would be available that way."
At Imperial Point, the staff will move into a totally new facility. The Broward Health corporate office and the board of directors approved the project. An ED expansion task force was created and spearheaded by the nurse manager. It included Usher, the hospital CEO, the chief nursing officer, the CFO, the regional facilities manager, and the ED medical director.
The team met monthly with architectural, structural, and civil engineering teams to develop an ED that is user friendly to the physicians and employees, says Usher. The HDR project design team was open to all suggestions on how the staff wanted the ED flow to occur from start to finish, she says.
The new Imperial Point ED, will have a racetrack design, which allows for total visibility of each exam room, Usher says. The patient will enter the ED waiting room, be "quick-registered" by registration, and immediately taken to a patient room for triage assessment and treatment, she says. Registration will be placed at the nursing station to expedite registration and discharge, Usher says. "For our electronic documentation, laptops will be placed in specific patient rooms, in addition to the computers on wheels we presently utilize," she says. Radiology will be staffed 24/7 in the ED.
The nurse managers agree their involvement has made a big difference in the final design of the departments. "Without our involvement, you'd have a set of rooms that were not functional, not to mention missing quality and safety issues, like where crash carts should be placed," says Zahniser.
Usher says, "Without the input and suggestions from the clinical experts in the ED, you would have had nonclinical people choosing our design and determining how our patient flow would look."
In a warehouse owned by Fort Lauderdale, FL-based Broward Health, teams of nurses, physicians, and techs from the EDs at Coral Springs Medical Center and Imperial Point Medical Center, both in Fort Lauderdale, recently toured mock emergency treatment rooms as the final stage of preparation for construction of the new EDs at those Broward Health facilities.Subscribe Now for Access
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