1. PIEDMONT HOSPITAL ICUs A visit to the Red (Open Heart CCU), Green (NICU), and Blue Units (Med Surg.) with a comparison to a Regular Hospital Room Host: Patricia Black Group Members: Wanlin Xiang, Siming Mao, Ann Rogers, Kushal Waghmare

2. Red Open Heart (CCU) 10 rooms, 5 on each side of a central nursing station. Configured for maximum storage of supplies both within patient room and outside Sleeping discouraged (no family area) Quiet Ample ambulatory space for nurses

3. Green Neuro ICU Designed in the 70s in a circular plan, intended for maximum visibility Renovated recently to improve visibility and work: 10 rooms  8 Cited by Ms. Black as more problematic than rectangular layout due to difficulty in aligning rectilinear furniture Observed by team members: Less space for nurse alcoves More restricted ambulatory space Disorienting

4. Blue Med-Surg. Same layout as ICU red 10 rooms instead of 12

5. Regular Patient Room No Visibility Inboard toilet in the room Large window >> More natural light Difficult to renovate: Wiring embedded in concrete walls make rewiring difficult Expensive glass doors

6. Problems at Piedmont noted by Ms. Black Monitoring: Too many machines to nurse: “I’d rather be talking to them or washing their hair, etc.” – Charting: Too much time spent charting Charting often done long after observations are made Charting done on hands – Nurses don’t want to spend as much time in the room as Ms. Black wants them to. Family inclusion versus intrusion Technologies don’t “talk” to one another Building is land-locked, so expansion is difficult Noise of TVs

7. Problems our group will focus on: “Design for better visibility” 1.It is difficult and expensive to renovate existing designs – For ICUs (circle layout) – Non-ICUs being renovated to become ICUs

8. 2. The hospital desires to include families in the care process but they interrupt nurse workflow and make them uncomfortable to be observed (causing pain to the patient, e.g.)

9. 3. Nurses don’t get to spend as much time in direct contact with the patient as is desired 1.Because of charting difficulties 2.Because of the profusion of machines

10. Ideas for solutions Retrofit Visibility Reduction in the number of rooms ICU Green (Piedmont): Originally had 10 rooms, which were reduced to 8 Using Cameras, Mirrors Rectangular design of the unit Outboard toilets and less storage in the room More glass, more windows

11. Normalizing the round layout Bathroom Family Storage *Depends on available space

12. Ideas for Solutions: Family inclusion v. intrusion Headphones Lighted nametag color coded to indicate availability

13. Ideas for solutions: Patient face time and charting/routine tasks Exterior wall-mounted display with touch- screen representation of patient body Shoulder mounted audio recording device Automated Charting

14. Thank you