Safer, Green Designs
Success stories
Visit Green Corner to read success stories on green design and construction.
Design for safety resources
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Patient safety principles drive new hospital design
AHRQ Designing hospitals for safety
A free DVD from the Agency for Healthcare Research and Quality, "Transforming Hospitals: Designing for Safety and Quality”, reviews evidence-based hospital design and how it increases patient and staff satisfaction and safety, quality of care, employee retention, and results in a positive return on investment.
Key concepts of evidence-based design in a hospital include single-patient rooms, the use of noise reducing construction materials, easily accessible work stations, and improved layout for patients and staff. Patient safety issues addressed are falls, hospital-acquired infections, and medical errors. The cases of three hospitals that have incorporated evidence-based design elements in their construction and renovation are presented in a DVD that can be ordered from the AHRQ.gov website.
Governance Meeting 2008
Safe and Green Healthcare Design - What is the Return on Investment?
Blair L. Sadler JD Former President and CEO Rady Children's Hospital, San Diego and Vice Chair Center for Health Design and
Gina Pugliese, Vice President , Safety Institute, Premier healthcare alliance.
- Slides: Sadler and Pugliese
- Audio: Safe and Green Healthcare Design
St. Joseph, West Bend
A Wisconsin regional healthcare system has designed its new hospital to promote a culture of patient safety. West Bend, WI-based St. Joseph’s Community Hospital assembled a multi-departmental team of architects, patients, families, hospital staff, physicians and local citizens to design a hospital that would be safety driven from the ground up. The design, described in a special article from the Joint Commission Journal on Quality and Safety, includes standardized patient rooms, new technology that will help minimize falls, and patient care alcoves in each patient room. Additional design principles for the new facility include visibility of patients to staff, automation such as bar-coding of medications, and noise reduction. The hospital was designed to be adaptable and flexible and allow for future growth. It should be noted that this has been a developing process and today would include an “ICRA” as part of the process.
Webcast - Designing the 21st century hospital
A Webcast, "Designing the 21st Century Hospital: Serving Patients and Staff," is available from the Robert Wood Johnson Foundation (RWJF). The webcast features researchers, design professionals, and hospital leaders presenting and discussing how hospitals of the future should be built, organized, and managed to maximize patient safety and outcomes and improve staff performance and satisfaction. Featured are up-to-the-minute evidence-based design concepts for healthcare buildings. With an anticipated $20 billion in new hospital construction and major renovations projected annually for the next decade, the central question of the conference was how hospitals' physical design, operating systems, and "corporate culture" affect patients, staff, and hospitals' bottom line.
2006
Designing the 21st Century Hospital: Environmental Leadership for Healthier Patients and Facilities
The program, "Designing the 21st Century Hospital: Environmental Leadership for Healthier Patients and Facilities," was held on September 28-29, 2006, in Hasbrouck Heights, N.J.
Download a summary of all the presentations. An archived webcast record of the speakers' presentations and discussions as well as an article from the Wall Street Journal Article "Focuses on 'Green' Hospitals" is also available at this site. The article draws on issues discussed at a Foundation-sponsored meeting to examine ways to design eco-friendly facilities.
2004
- Download a summary of the proceedings: Designing the 21 Century Hospital
- Download a major presentation: The Role of the Physical environment
- Play the webcast 21st Century hospital design, select "Archives 2004," the webcast is dated June 7, 2004.
Resources addressing the built environment andd
patient safety
Evidence for innovation -Transforming children’s health through the physical environment. NACHRI –CHD Executive summary
Sadler BL, Joseph A. Evidence for innovation -Transforming children’s health through the physical environment. The National Association of Children’s Hospitals and Related Institutions. May, 2008.
Using Evidence-Based Environmental Design to Enhance Safety and Quality IHI-CHD
Sadler BL, Joseph A, Keller A, Rostenberg B. Using Evidence-Based Environmental Design to Enhance Safety and Quality. IHI Innovation Series White paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2009.
Sound control for improved outcomes in healthcare settings - CHD issues paper
17-page Issues paper by Anjali Joseph, Ph.D. and Roger Ulrich, Ph.D. The
Center for Health Design. January, 2007. Funded by the Robert Wood Johnson Foundation.
How Hospital Design Saves Lives
"Design changes can cut infection rates, lower physician errors, improve staff performance, and make all the difference in delivering care."
This headline in Business Week, August 15, 2006, by Andrew Blum highlights
how the increasing use of evidence-based design in healthcare facilities,
integrating clinical and environmentally friendly data, has had a major impact
on patient and environmental safety. Go to:
Business Week (8/15/06)
Environmental design, worker safety and patient outcomes.
Organizational and environmental
factors that affect worker health and safety and patient outcomes
In American Journal of Infection Control. April 2002; (30) pp. 93-106.
Green building material alternatives
Green building: Alternatives to polyvinyl chloride (PVC) building materials for health care; Pub-33
This chart provides contact information and alternative materials for the products listed below:
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This publication is part of Going Green: A Resource Kit for Pollution Prevention in Health Care. Ver: October 6, 2008. Complete resource kit available at noharm.org.
Toxic chemicals in building materials- An overview for health care organizations
The 14 page Fact Sheet briefly describes the reasons for health concerns from the chemicals listed below and is useful for providing essential background when selecting safer, environmentally sustainable materials.
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The final summary provides a valuable "Green materials hierarchy for healthcare",
describing four criteria to consider during the selection process.
Evidence-based furniture design features -
A comprehensive plan and checklist
Furniture Design Features and Healthcare Outcomes - Eileen B Malone, RN MSN, MS, EDAC; Barbara A. Dellinger, MA, AAHID, IIDA, CID, EDAC published by the Center for Health Design. May 2011. As a component of a comprehensive plan to improve targeted healthcare outcomes, the "Evidence-Based Design Furniture Checklist" was created as a tool to facilitate the best healthcare furniture purchases across the facility life cycle. Furniture in this context includes the more common objects, such as chairs, sofas, tables, systems, and built-in furniture; it does not include the patient bed (which has become more equipment-like) or carts that support medical procedures.
Resilient flooring and chemical hazards
- 2009 - "Resilient Flooring & Chemical Hazards: A Comparative Analysis of Vinyl and Other Alternatives for Health Care"
from addresses resilient flooring, evaluating potential health impacts of vinyl flooring and the leading alternatives – synthetic rubber, polyolefin and linoleum
- currently in the health care marketplace. The study inventories chemicals incorporated as contents in each of the four material types or involved in their life cycle as feed-stocks, intermediary chemicals, or emissions. It then characterizes those chemicals using a chemical hazard-based framework that addresses:
- persistence & bioaccumulation;
- human toxicity; and
- human exposure
- 2010 - "Sustainable Resilient Flooring Choices for Hospitals: Perceptions and Experiences of Users, Specifiers and Installers" The study builds on the 2009 Health Care Research Collaborative paper, "Resilient Flooring & Chemical Hazards" The present study, involved hearing directly from users about their perceptions and experiences and used an online survey of and a series of interviews with architects, installers and facility managers to identify the key issues with resilient flooring materials and their installation prior to the development of the survey.
Sustainable Resilient Flooring
Surge capacity and building design - TJC; JCR
The Joint Commission (TJC) and its affiliate Joint Commission Resources (JCR) released a free web-based publication on surge hospitals in December, 2005. Surge hospitals are designed to assist the community in absorbing an overwhelming number of patients seeking care during emergencies, such as mass-casualty events or infectious disease outbreaks. Surge hospitals provide care when permanent facilities exhaust their capacity or cannot operate because of damage or other conditions This guide describes the different possibilities, such as shuttered hospitals, closed wards in existing hospitals, and mobile facilities, and the design considerations for each. It explores the challenges of planning for, establishing and operating surge hospitals, such as obtaining sufficient staff, supplies and equipment and providing safe care.
Minnesota Department of Health (MDH) "Airborne Infectious Disease Management Manual – Methods for Temporary Negative Pressure Isolation"
This user guide was written to assist hospitals in developing strategies for temporary negative pressure isolation and provides instruction on the use of equipment used for airborne infectious disease management. Preventative maintenance schedules and a sample log for measuring particle counts are included for performance improvement planning.
Surge Capacity - MERET- Minnesota Emergency Preparedness Education and Training
The MERET site has six modules including one on isolation and one on how to develop Temporary Negative Pressure rooms (TNP).