Shermineh Afsary, EDAC, PhD student, Graduate Research and Teaching Assistant, Department of Architecture, The University of Kansas, shery.afsary@ku.edu

Dr. Mahbub Rashid, Professor, PhD, AIA, Interim Dean of School, Associate Dean of Research and Graduate Studies, School of Architecture and design, University of Kansas, mrashid@ku.edu

Abstract

This research aims to study how visibility from caregivers’ station to patients’ spaces affects in-bed length of stay (in-bed LOS) in Emergency Room (ER) taking into account patient severity. The data was collected from one of the ER units of Regions Hospital in Minnesota, USA. This unit with fifteen beds is located close to the main entrance and treats high-acuity patients. Visibility can improve caregivers’ awareness to patients, themselves, and care settings. Previous studies have evaluated visibility in other healthcare units, but seldom in ERs. In addition, ER designs generally focus more on physical connections rather than visual connections. This research is significant because it focuses on a lack of study on visual connections in ERs, and it is hoped that it will lead to innovations in the layout of ERs. The methodology of this research is correlational study. Visual connectivity, integration and step depth from the caregivers’ station to patients’ rooms is analyzed, using space syntax techniques. In-bed LOS and patient severity or the emergency severity index (ESI) is extracted from the emergency department database. Spearman correlation coefficients are used to find out the relations of three attributes to in-bed LOS taking to the account of the ESI. In findings, no correlations were found between in-bed LOS and three visual attributes. The Emergency Severity Index (ESI) and in-bed LOS showed significantly strong inverse correlations, which after removing trauma rooms, it is improved. One limitation was that the dataset used for statistical analysis was for one ER unit. In future studies, a larger dataset may help improve statistical significance of correlations. Another limitation was that in-bed LOS used in this study was defined by the time a patient stayed in ER. It is not known if the patient was moved to other rooms and/or units or not.

Keywords: Evidence Based Design, Healthcare Design, Emergency Room, Visual Surveillance, Visibility, Nurse Efficiency, Patient Outcomes, ER Layout Configuration.