Emergency departments (ED) face growing volume challenges related to gaps in community health services. These gaps contribute to increased ED use particularly by geriatric and pediatric age groups.
As a result, emergency departments must seek new ways to enhance speed, efficiency, and patient care. Here we share valuable insights on major shifts in hospital design that can help manage increasing volume and improve patient experience and outcomes.
Understanding the 3 Basic Categories for Improvement
According to a 2018 Facility Guidelines Institute (FGI) study, there are three basic categories that can negatively impact ED service:
- Flow: What design changes can help optimize patient flow through the stages of a typical emergency room visit?
- Capacity: How can designs become more flexible to accommodate volume surges as the trend for patients seeking basic care turn to emergency departments?
- Patient experience: What changes can be made to improve the patient’s “front-end” experience and help increase the speed of patient discharge?
Identifying the challenges contributing to these areas can help uncover design opportunities to improve emergency efficiency.
Overarching Design
Considering overlaps between these categories helps designers take an overarching approach to design. For example, flow and capacity both see improvement when front end screening and triage areas limit the number of patients entering the department for emergency level treatment. This can often be resolved by creating self-screening/check in kiosk areas for low acuity patients.
There is then an overlap between flow and patient experience. In order to provide a better level of care, a patient’s journey from arrival to their point of treatment must become smoother. The kiosk helps at the front end. However, adaptable spaces to deal with different emergency severity index (ESI) levels improve flow and experience. For example, designing areas with seats as opposed to beds can accommodate more level 3 to 5 patients, freeing up space for ESI level 1 and 2 patients requiring a hospital bed and/or emergency procedures.
Addressing Facility Specific Challenges
Each ED has its own list of challenges specific to local demographics, staff levels and experience, access to primary care and mental health facilities in the area, etc. Designers can identify specifics to find design solutions, such as:
- Kiosk screening for low acuity patients to help overcome the challenges of longer waits for check in and care
- Accommodating high volume by designing wider corridors to manage triage with “pop-up” treatment alcoves
- Improving privacy during busy times by creating flexible spaces that adapt to multi-acuity levels
- Improving overall patient care using modular/flexible treatment rooms that can quickly be adjusted for treatment or consults
- Creating ESI level specific areas to improve operational efficiency such as an ESI 1 & 2 area with doctor care and a level 3 to 5 area with behavioral care experts, nurse practitioners or registered nurses
- Dedicated behavioral health EDs with social workers, security, and observation rooms to improve patient care and staff/patient safety
Improving Speed and Efficiency
There are several modern approaches to design that can help improve efficiency, including:
- Logical paths: Creating clear, short paths throughout the ED help staff move quickly while improving patient safety and flow.
- Wayfinding: Effective wayfinding reduces unnecessary traffic, directs patients to registry kiosks, and helps reduce flow into the ED so staff can focus on treatment.
- Vertical and horizontal treatment rooms: Having more vertical space requires a smaller footprint than an ED consisting entirely of horizontal space. It also provides the right treatment area based on patient condition.
- Flexibility: Linear design, rolling partitions, modular movable components, and wheeled furnishings/equipment all contribute to ED adaptability that improves efficiency.
- Storage: In flexible design, standard, easy to access storage is critical to ensure equipment, medication and supplies are readily available when seconds count.
- Advanced materials: Exploring antimicrobial polymer composites for high touch surfaces can help control hospital acquired infections and reduce return ED visits.
Data Informed Design
The most effective ED design strategies leverage healthcare data to make informed decisions. Information such as patient outcomes, operational efficiencies, and staffing models help designers understand common challenges to craft patient-centric, efficient design.
Analyzing data based on typical processing times, wait times, how traffic moves through an ED, etc. contribute valuable insights that create ED efficiencies. However, data regarding common failures related to large scale crises such as COVID, SARs, atypical flu seasons, etc. also improve design planning for better day-to-day patient intake and flow.
Reimagining Waiting Rooms
The FGI study also suggested modern ED waiting areas should be reimagined to help reduce stress and improve patient experience. The “Starbucks meets resource center” approach to design is amenity-forward such as:
- Comfortable lounge style seating
- Pleasing colors and design elements
- Food service such as a café
- Computers for research
- Segmented private areas for family groups waiting to hear news about an admitted loved one
Aging baby boomers, chronic diseases related to increased longevity and gaps in healthcare will continue to increase ED crowding. However, these design trends will enhance speed, efficiency and care helping EDs adapt to growing volume.
Bring your vision to life with Apex.
Every emergency department design and build project has one ultimate goal – to build a space that perfectly aligns with patient needs while delivering optimum efficiency and compliance. When you choose Apex as your strategic partner, you are armed with deep expertise and a proven methodology to ensure your vision is realized to the highest standards. Click here to set up your consultation today.