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Pages: 5 - 12 Abstract: HERD: Health Environments Research & Design Journal, Volume 15, Issue 2, Page 5-12, April 2022.
Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-05-05T09:15:37Z DOI: 10.1177/19375867221092757 Issue No:Vol. 15, No. 2 (2022)
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Authors:D. Kirk Hamilton Pages: 13 - 21 Abstract: HERD: Health Environments Research & Design Journal, Volume 15, Issue 2, Page 13-21, April 2022.
Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-05-05T09:03:42Z DOI: 10.1177/19375867221082774 Issue No:Vol. 15, No. 2 (2022)
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Authors:Yifat Rom, Yuval Palgi, Michal Isaacson Pages: 22 - 42 Abstract: HERD: Health Environments Research & Design Journal, Volume 15, Issue 2, Page 22-42, April 2022. When planning long-term care facilities (LTCFs), architects strive to design buildings that support high well-being (WB) levels for those who live and work in them. To achieve this goal, architects must understand what defines WB in old age and how these qualities can be achieved through the designed physical layout. This task must be achieved while tackling additional challenges, such as considering the official planning guidelines, codes, and additional requests given by the client. During the planning process, architects use their subjective impressions by visiting similar institutions, their personal experience as architects, and their subjective assumptions on what residents and caregivers may consider desirable. Once built, there are a lack of methodological ways to evaluate an existing LTCF unit’s plan as a supportive tool for higher levels of WB. The current study aims to create a methodological tool to analyze LTCF units’ layout, giving scores to each plan based on five aspects of WB that they support. In our article, we demonstrate this methodology’s application on 40 plans of LTCFs, demonstrating its effectiveness. We believe that the approach presented in this article will contribute to furthering the quality of planning of LTCFs benefiting residents and caregivers alike. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-05-05T09:15:38Z DOI: 10.1177/19375867211064538 Issue No:Vol. 15, No. 2 (2022)
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Authors:Jingwei Zhao, Xinxin Wang; Master Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Aim:This study checked the effects of landscape types and complexity along path in urban green spaces on perceived restorativeness, so as to provide guidance for path landscape design.Background:Paths in urban green spaces are not only the connections between places but also places for visitors reducing mental stress and seeking psychological well-being. However, there is a lack of evidence-based research on the effects of landscape composition along the path on restorative quality, failing to provide a cohesive guideline for practice.Methods:Fourteen videos representing the popular path landscapes in urban green spaces were produced using computer software by adding or/and deleting elements and controlling environmental components. The restorative quality of these videos was measured by Short-version Revised Restoration Scale (SRRS). Statistical analysis was employed to treat the data and checked the effects of different landscape types and complexity on restorative quality.Results:(1) A significant difference in restorative quality between 14 path landscapes was found, comparatively, the path containing lawn or(and) forest was much better than that containing bamboo and waterscape, and bamboo was a negative predictor of restorative quality; (2) waterscape generally reduced the restorative quality of vegetated path landscape, especially when the landscape possessed higher restorative quality; (3) path landscape complexity had a weak influence on restorative quality.Conclusions:This study explains how path landscapes affect mental restoration of users, and these findings contribute to enhancing the restorative quality of urban green spaces and have applications for path landscape design. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-06-10T06:18:28Z DOI: 10.1177/19375867221104251
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Authors:William (Bill) Benbow Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Purpose:The purpose of this article is to review available literature for evidence-based impact of the built environment upon the prevention and management of COVID-19 with a view to emphasizing lessons learned for future infection control of pandemics.Background:This is urgently needed given the devastation brought upon long-term care residents worldwide. Long-term care (LTC) facilities face a battle to protect their residents. Previous studies of infection control design issues have focused generally on Fomites: that is, contaminated objects and surfaces. As COVID-19 has been shown to be largely spread through the air, this article will broaden the focus to include engineering controls that effect this type of transmission.Method:A literature search was conducted using key words such as long-term care facilities, built environment, COVID-19, infection control, and nursing homes.Results:Results were sorted using an engineering controls pyramid developed by the author to stratify approaches to LTC infrastructure. Basically, six elements were supported: ventilation, spatial separation, physical barriers, hand hygiene stations, resident room zones, and private rooms.Implications:Conclusions were that the built environment has a major impact on infection control that can be deleterious or beneficial. Substantial changes need to be made to protect the very vulnerable LTC population from future pandemics and infectious diseases. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-06-10T06:11:30Z DOI: 10.1177/19375867221101897
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Authors:Zorana Matić, Yeinn Oh, Lisa Lim, Craig Zimring Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:This article proposes a method for evaluating the design affordances of primary care exam rooms from the perspectives of users using functional scenario (FS) analysis.Goal:This study aims to develop quantifiable criteria and spatial metrics for evaluating how exam room design supports the needs of different users. These criteria and metrics can be used in the early stages of the design process to choose between alternatives.Background:The primary care exam room is an essential space in healthcare, as it is the first point of contact between the healthcare provider and the patient. However, there is a lack of rigorous evaluation metrics for exam room design that supports improved user experiences and better health outcomes.Method:A total of nine primary care exam rooms were analyzed using FS analysis. We identified three key user groups involved in the clinical examination process—providers, patients, and care partners—and translated their needs into FSs. We developed spatial metrics for each FS to quantify the extent to which the needs were spatially supported.Results:We developed 11 FSs in total: three from the providers’, five from the patients’, and three from the care partners’ perspectives. The results revealed possible design strategies for improved user experiences.Conclusions:We quantitatively measured the affordance of primary care exam room design for multiple stakeholders. We expect that the criteria and metrics presented in this article will improve the understanding of different users’ perspectives and provide new design guidance for improved user experiences. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-05-24T04:57:35Z DOI: 10.1177/19375867221101886
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Authors:Jodi Sturge, Ferdi Starrenburg Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:The COVID-19 pandemic has impacted healthcare systems worldwide. Although this disease has primarily impacted general medicine intensive care units, other areas of healthcare including psychiatry were modified in response to corona measures to decrease the transmission of the disease. Reflecting on the modifications to the environment provides an opportunity to design psychiatric environments for future pandemics or other demands for healthcare.Background:The therapeutic environment of psychiatric wards was modified in Friesland, the Netherlands, in response to COVID-19. During this time, an interdisciplinary team met consistently to contribute to the preliminary design of a new psychiatric hospital.Methods:During the first 18 months of the pandemic, clinical reflections were made to describe the impact of COVID-19 on the psychiatric care environment. Architects have created a preliminary design of a new psychiatric hospital based on these reflections, monthly collaborative design discussions based on virtual mock-ups and evidence-based design based on theoretical concepts and research.Results and conclusions:This theoretical and reflective study describes how an inpatient psychiatric environment was restructured to manage infection during COVID-19. The therapeutic environment of the psychiatric ward and patient care changed drastically during COVID-19. The number of patients accessing care decreased, patient autonomy was restricted, and the function of designated behavioral support spaces changed to manage the risk of infection. However, these challenging times have provided an opportunity to reflect on theories and consider the design of new hospital environments that can be adapted in response to future pandemics or be restructured for different care functions. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-05-13T05:31:46Z DOI: 10.1177/19375867221098982
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Authors:Shabboo Valipoor, Hesamedin Hakimjavadi, Patrick M. Nobles Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Background:Emergency departments (EDs) have been struggling with overcrowding issues for years. Some spatial configurations have been proposed to improve ED performance in facing overcrowding. Despite similarities with mass casualty incidents (MCIs), when demand for care exceeds the capacity, little is documented about the application of the proposed configurations during MCIs to improve surge capacity.Objectives:We aimed to explore the potential of spatial configurations that have been proposed to handle ED overcrowding in daily operations so as to improve surge capacity during MCIs.Methods:Using an online Likert-scale survey, 11 spatial design strategies were rated by ED care teams in terms of their potential to improve surge capacity during MCIs.Results:Responses from 72 participants revealed that establishing an in-house lab was perceived as the most potential strategy, followed by rapid care area, internal waiting rooms, and in-house imaging. In contrast, separate entrance and exit doors, as well as decentralized nurse stations, were perceived as the least potential strategies but also exhibited the most variance in response. Respondents’ comments implied that their choice of in-house ancillary services was primarily to improve communication and to reduce turnaround time and risk of errors. Their choice of rapid care and internal waiting areas related to improved flexibility.Conclusions:Understanding clinicians’ perspectives on potentially effective spatial configurations aids in implementing balanced strategies to better equip EDs to handle overcrowding in daily operations and manage surges during MCIs. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-05-03T06:33:53Z DOI: 10.1177/19375867221096639
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Authors:Liv Gølnitz Hjorhöy, Thora Grothe Thomsen, Malene Beck Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objectives:To explore how nurses experience the physical environment when caring for hospitalized patients.Background:The physical environment as part of nursing is already an embedded understanding in the earliest nursing theory. In today’s hospitals, the impact of the physical environment is important for both patients and nurses. Patients’ well-being is linked to the physical environment, which can produce both negative and positive emotions. Nurses’ work environment is affected by the physical one, which affects practice, communication, and teamwork.Methods:This study used a qualitative design to explore nurses’ experiences of the physical environment in nursing. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Individual interviews were conducted with nine nurses working in somatic hospital units. Data collection, analysis, and interpretation consisted of individual semi-structured interviews and meaning condensation as described by Kvale and Brinkmann.Results:Three themes were identified: (1) providing a place to belong, (2) offering a protective sensory shield, and (3) balancing clinical needs with the patients’ personal needs.Conclusions:Involvement of the physical environment in nursing provides an opportunity for nurses to offer the hospitalized patient a place to belong. However, the physical environment is important for nurses to maintain accessibility with, and visualization of the patient. It is a careful balancing act carried out in practice without further verbalization in nursing. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-04-19T08:56:30Z DOI: 10.1177/19375867221092150
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Authors:Thomas J. Davidson, Harald Waxenegger, Ismail Mohamed, Duncan S. McConnell, Penelope M. Sanderson Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objectives:To (1) develop a simulation software environment to conduct prehospital research during the COVID-19 pandemic on paramedics’ teamwork and use of mobile computing devices, and (2) establish its feasibility for use as a research and training tool.Background:Simulation-based research and training for prehospital environments has typically used live simulation, with highly realistic equipment and technology-enhanced manikins. However, such simulations are expensive, difficult to replicate, and require facilitators and participants to be at the same location. Although virtual simulation tools exist for prehospital care, it is unclear how best to use them for research and training.Methods:We present SPECTRa—Simulated Prehospital Emergency Care for Team Research—an online simulated prehospital environment that lets participants care concurrently for single or multiple patients remotely. Patient scenarios are designed using Laerdal’s SimDesigner. SPECTRa records data about scenario states and participants’ virtual interaction with the simulated patients. SPECTRa’s supporting environment records participants’ verbal communication and their visual and physical interactions with their interface and devices using Zoom conferencing and audiovisual recording. We discuss a pilot research implementation to assess SPECTRa’s feasibility.Results:SPECTRa allows researchers to systematically test small-team interaction in single- or multipatient care scenarios and assess the impact of mobile devices on participants’ assessment and care of patients. SPECTRa also supports pedagogical features that could allow prehospital educators to provide individual trainees or teams with online simulation training and evaluation.Conclusions:SPECTRa, an online tool for simulating prehospital patient care, shows potential for remote healthcare research and training. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-04-19T08:55:46Z DOI: 10.1177/19375867221090984
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Authors:Haoyue Yang, Matilin Rigsby, Xuemei Zhu, Chanam Lee, Marcia Ory Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Background:Long-term care facilities (LTCFs) with compact, group-living arrangements have become COVID-19 hot spots during the pandemic. Systematic research is needed to understand factors associated with COVID-19 infections in LTCFs and the inadvertent effects of preventive measures adopted by LTCFs.Objectives:This rapid review identifies factors associated with LTCF residents’ COVID-19 infections and the impacts of the pandemic and the corresponding preventive measures on residents’ mental health and behavioral problems.Methods:Following the preferred reporting items for systematic reviews and meta-analyses guidelines, we identified and reviewed relevant literature in Medline, PsycINFO, and AgeLine.Results:Thirty-seven articles were identified and reviewed, including 30 reporting factors associated with COVID-19 infections in LTCFs and seven reporting the impact of the pandemic and corresponding prevention measures on LTCF residents. Results revealed four domains of factors associated with COVID-19 infections: facility physical environments, resident characteristics, facility management and testing, and community factors. The pandemic and infection control measures increased residents’ depression, anxiety, loneliness, and behavioral problems (e.g., agitation, hallucinations). Residents without cognitive impairments were more vulnerable to these adverse effects.Conclusion and implications:LTCF managers/policymakers and healthcare designers can help mitigate COVID-19 infections by (1) providing additional resources to vulnerable LTCFs; (2) enhancing the training of personal protective equipment use and guideline compliance; and (3) investing in amenities, such as sinks, quarantine rooms, and outdoor spaces. Digital activities and accessible green spaces can mitigate mental health and behavior issues. Future LTCF design can benefit from flexible spaces, natural ventilation, and reducing crowding. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-04-12T09:12:49Z DOI: 10.1177/19375867221092149
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Authors:Anjali Joseph, David Neyens, Kevin Taaffe, Sara Bayramzadeh, Ken Catchpole Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:To describe the planning, development, and implementation of a structured video-based observational method that can be used to systematically examine and model the role of the physical environment within healthcare systems.Background:Direct observation methods are often used in healthcare to study complex healthcare systems. However, these observations often occur in real time, which predisposes the collected data to shortcomings such as time lags in recording of activities, overlooking events, or limiting the scope of information than can be collected. Video observation approaches eliminate many of these challenges and provide opportunities for researchers to understand and model the role of the physical environment.Methods:An approach to developing and implementing a structured video-based observational method to study and model complex health systems is presented.Results:A structured observational approach can be highly effective for collecting multiple layers of data necessary for understanding interactions between the physical environment and other systems components in healthcare settings. The proposed video-based observation method is effective in settings that have clearly defined environmental boundaries, limited number of people, are complex and fast-paced such as the OR, ED trauma rooms, and ICU rooms.Conclusions:Video-based observation is an effective complement to the traditional observational method for in-depth study of the built environment in health systems, enabling researchers to employ quantitative approaches to data collection and analysis, in addition to qualitative interpretations. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-04-11T09:08:40Z DOI: 10.1177/19375867221089271
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Authors:Suzanne J. Rose, Laurie Waggener, Sharon C. Kiely, Alan Hedge Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:A comparative study was undertaken to survey nurses working in an acute care nursing unit before and after moving to a new hospital to investigate the impact of a nursing unit designed utilizing Planetree build criteria.Background:The physical and emotional demands of frontline practitioners is a serious concern for patient safety and staff retention as the environmental design of nursing units can influence human errors from fatigue and interruption.Method:A pre-move survey was conducted with acute care nurses in a conventional design nursing unit who were moving to a new facility. After the move to the new hospital design, the same survey was readministered to obtain comparative performance information. Qualitative responses were analyzed for triangulation with survey responses. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Press Ganey scores were collected over a 5-year period.Results:There were statistically significant improvements for most of the survey questions, especially for work efficiency and productivity, the design of the patient room and of support spaces, the information systems, and the environmental conditions. There were statistically significant improvements in the HCHAPS and Press Ganey survey questions.Conclusions:The postoccupancy survey showed statistically significant improvements in most of the concerns highlighted in the pre-move survey and significant improvements in the workflow and overall satisfaction of nurses. Press Ganey results revealed all but five domains fell in the significantly improved category. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-04-07T01:45:20Z DOI: 10.1177/19375867221091318
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Authors:Xiaodong Xuan, Xiaoxia Duan, Zihao Feng Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objectives:This study explores the specialized nursing requirements of different clinical departments and their influence on the design of nursing units, which ultimately improves the nursing staff’s efficiency and work experience.Background:Specialization of nursing work is important in the provision of quality of healthcare. Most of the research related to nursing units has focuses on general medical–surgical nursing units and has not differentiated between clinical departments.Method:This study was conducted in one inpatient building at a large general hospital in China. Survey data were collected from 11 clinical departments via questionnaire, and interviews were conducted in 10 of the clinical departments.Results:All 11 clinical departments had significant differences in their evaluations of and requirements for the arrangement of their physical space. Specialized requirements were found in three areas: nursing work processes, arrangement and needs of clinical spaces, and allocation of facilities and equipment.Conclusion:Evaluation of the specialized requirements of different clinical departments would contribute to the body of knowledge on nursing unit design and has a positive effect on the development and improvement of design theory. Suggestions for how the design of nursing units could be improved to support the specialized demands of different departments are provided. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-04-07T01:44:22Z DOI: 10.1177/19375867221089706
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Authors:Lisa Lim, Craig M. Zimring, Jennifer R. DuBose, Gary M. Fischer, Robert Stroebel Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:This article aims to illustrate the design considerations of team-based primary care clinics in response to the pandemic.Background:Due to COVID-19, physical distancing became a critical practice in our daily life, especially in healthcare settings where healthcare professionals must continue providing care to patients despite the manifold risks. Many healthcare facilities are implementing physical distancing in their clinic layouts, and healthcare professionals are adjusting their behaviors, so they can stay away from each other.Methods:A total of four team-based primary care clinics were studied to identify their lessons learned regarding safety measures and space usage during the pandemic.Results:The four team-based primary care clinics made changes to the clinic design (e.g., waiting areas, exam rooms, team workspaces), operational protocols (e.g., in-person huddles, social gatherings, staff work locations), and usage of spaces (e.g., outdoor spaces, utility rooms). Such changes enabled the implementation of safety measures during the pandemic. However, healthcare professionals also reported challenges regarding their team communication and coordination due to physical distancing and separation.Conclusions:Our findings suggest that the physical distancing may in fact contribute to less effective teamwork and patient care and negatively affect staff well-being. In this article, we ask healthcare system leaders and designers to continue supporting both safety and teamwork by paying attention to the flexibility and spatial relationships among healthcare professionals rather than fully sacrificing teamwork for safety. Also, now is the time when multidisciplinary collaborations are needed to establish and validate guidelines that can improve both factors. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-04-05T09:40:10Z DOI: 10.1177/19375867221091310
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Authors:Ruby Lipson-Smith, Rebecca McLaughlan Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:To provide a taxonomy of spatial observation methods that are commonly used in healthcare environments research and to describe their relative success.Background:Spatial observation is a valuable but resource intensive research method that is often used in healthcare environments research, but which frequently fails to deliver conclusive results. There is no existing catalog of the different spatial and behavioral observation methods that are used in healthcare design research and their benefits or limitations.Methods:The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Ten key databases were searched, and articles were screened by both authors.Results:Across 67 included studies, 79 observation methods were reported. We categorized those into four, distinct methodological approaches, outlining the benefits, limitations, and suitability of each for obtaining different types of results. Common limitations included difficulty generalizing to other contexts and a lack of detailed description during data collection which led to key environment variables not being recorded. More concrete conclusions were drawn when observation methods were combined with complimentary methods such as interview.Conclusions:The relative success of spatial observation studies is dependent on the fit of the method selected relative to the research question, approach, and healthcare setting; any complimentary methods delivered alongside it; and the analysis model employed. This article provides researchers with practical advice to guide the appropriate selection of spatial observation methods. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-31T11:55:59Z DOI: 10.1177/19375867221089702
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Authors:Altug Kasali Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Aim:This article presents an opportunistic case with particular focus on instances from an extended procurement operation in which medical professionals run a proactive process involving the generation of layouts through distinct modes of representational practices without any actual collaboration with designers. The questions of inquiry involve an analysis on how the visualizations came into being and a discussion into the content of drawings that was shaped by individuals without any formal design education.Background:Although the literature introduces examples of genuine participation, particularly in healthcare design practices, the instances in which nondesigners demonstrate accomplished skills in spatial reasoning and representation are limited.Method:The research was formulated as a qualitative case study including a series of observations of the activities of the participants followed by interviews recorded at different locations. The investigation also focuses on the features of these authentic graphics which illustrate the intentions of the medical professionals concerning the function of spaces.Results:In this research, the participants went through a labor intensive and elaborate effort to produce “architectural representations” with the intention to convey their implicit professional expertise in the domain. The layouts were introduced to be the vital elements to visualize the implicit knowledge regarding the functioning of space.Conclusions:The productive and creative engagement of clinicians within this research makes the case for a multidisciplinary approach that reframes the limits and potential contributions of participants alongside drawings, which are exclusively claimed by and strategically employed by architects as negotiation devices within participatory design processes. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-29T08:43:33Z DOI: 10.1177/19375867221089707
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Authors:Parsa Aghaei, Sara Bayramzadeh, Sahar Ahmadpour Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:This study assessed the perception of people toward drive-through healthcare services, their willingness to use them, and the scope of services they would like to receive in a post-pandemic world.Background:The abrupt spread of COVID-19 urged healthcare facilities to adopt new infection-control measures. Drive-through testing facilities were implemented as one of the measures to minimize physical contact between healthcare workers and test-takers. Many studies describe drive-through models’ merits, but people’s opinions about them as a permanent attachment to healthcare facilities are unclear.Methods:An online survey was distributed through snowball sampling. The survey solicited feedback from adults who lived in the United States. The survey consisted of Likert-type and multiple-choice questions and was completed by176 eligible participants.Results:The use of drive-through pharmacies increased after the spread of COVID-19. Most people agreed drive-through healthcare services could be more convenient and safer to use. People prefer to have their vitals checked, and vaccinations received in a drive-through because of the improved infection-control matters and increased comfort; however, they are neutral about the level of privacy they have and the hygiene of drive-through healthcare settings.Conclusions:This study shows permanent drive-throughs offering medical services benefit people in times of crisis for the perceived infection control purposes and the improved convenience. A drive-through model can redefine the waiting experience and serve as a new safe triage system in urgent care centers. Drive-through urgent care centers can be adopted as a hybrid of telemedicine and in-person visits. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-28T08:45:07Z DOI: 10.1177/19375867221087360
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Authors:Qichao Ban, Min Lyu, Weijun Gao, Yulin Chen, Jiawei Yao Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Background:Natural views are an important design strategy for the application of ecological resources in built environments. Numerous clinical studies have indicated that views of nature—for example, plants—can effectively promote patient recovery by relieving their postoperative pains and negative emotions during hospitalization.Aims:This study demonstrates an intelligent method that develops algorithms of using collision detection techniques in Building Information Modeling to evaluate outdoor plant visibility for patients.Methods:These algorithms are digitized into a Revit plug-in program, which can be viewed as a design-aided tool for architects with the purpose of informing healthcare environment design in the decision-making process.Results:Its acceptability and effectiveness are evaluated based on the consultations in beta tests.Conclusions:It is believed that this method can improve the work efficiency of evaluating natural views in wards and help architects implement an informed design of built environments for better health performance. All findings in this study can contribute to the development of computational intelligence and social sustainability in the near future. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-28T08:44:07Z DOI: 10.1177/19375867221084220
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Authors:Sauli Karvonen, Markku Eskola, Aki Haukilahti, Timo Porkkala Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:The objective of this study is present how a patient movement-based patient-flow analysis is performed for planning the new Heart Hospital of Tampere University Hospital and how patient transfer distances can be shortened by this method.Background:The Heart Hospital had served patients as a service line organization for years. However, the Heart Hospital layout rather looked like functional layout instead of service line layout because the units of the Heart Hospital have been spread out around the large university hospital campus.Method:The flow routes of patients treated over the course of 1 year were analyzed by information technology systems in the hospital planning phase. Then, the proximity ranking of the main functions of the Heart Hospital was made. Layout planning was performed based on the proximity ranking. Nine months after the opening of the new Heart Hospital, the distances between the various hospital functions were calculated for the old Heart Hospital and the new one.Results:In the old Heart Hospital, patients’ transfer distance was 5,654 km (3,513 miles), while the corresponding figure for the new Heart Hospital was 3,797 km (2,359 miles), which means the distance was reduced by 33%.Conclusion:The patient-flow analysis works as it generated substantially shorter patient transfer distances in the new Heart Hospital. Shorter distances have supported more fluent patient flows that, in turn, has contributed higher productivity and quality of care. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-28T08:42:52Z DOI: 10.1177/19375867221086199
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Authors:Hannah-Kathrin Silja Viergutz, Michael Apple Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objectives:This article compares national standards for area measurements of healthcare facilities in four countries and examines the risks and differences that can arise when comparing building areas of healthcare facilities internationally.Background:In the planning and management of healthcare facilities, the utilization and comparison of building floor areas plays a major role. Differences in terminology, classification, and methodology help to reduce planning and cost risks when applied on a local and national level. The proper allocation of building floor space is vital in the design of room programs, determination of floor space, construction costs, and operating costs.Methods:Each of the four hospital area measurement standards is compared to discern similarities and differences.Results:Most countries use a three-tier system of hospital area measurement: building gross area, department gross area, and department net area. Few differences were found between country standards for department area, though the German standards do not fully address this tier. Variation is found in whether a country includes certain functions in the hospital area—such as research space, shell space, or central energy plants—which can have a significant impact on the overall hospital area.Conclusions:This article informs further development of individual country standards and highlights principles to consider for international hospital area comparison. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-17T06:46:18Z DOI: 10.1177/19375867221078838
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Authors:Lisa Björnson Skogström, Emma Vithal, Helle Wijk, Göran Lindahl, Marie Berg Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Aim:To explore women’s experiences of physical features in a birthing room designed to be adaptable to personal wishes and needs during labor and birth.Background:Childbirth is a central life event influenced by numerous factors, including the healthcare environment; however, there is insufficient knowledge on how the physical design affects women during birth.Methods:This study was part of a randomized controlled trial in the Room4Birth research project, including women randomized to receive care in a new birthing room designed with physical features changeable according to personal wishes. Data consisted of responses to two questions analyzed with descriptive statistics (n = 202) and semi-structured interviews analyzed for content (n = 19).Results:A total of 93.6% (n = 189) assessed the physical features in the birthing room as meaningful to a very high or high extent. The overall impression of the room was positive and exceeded women’s expectations. They felt welcomed and strengthened by the room, which shifted the focus to a more positive emotional state. The room differed from traditional hospital birthing rooms, contained familiar features that maintained integrity, and had space for companions. The variety of physical features was appreciated. Of nine listed physical features, the bathtub was ranked most important, followed by the projection of nature scenery, and dimmable lighting, but the room as a whole appeared most important.Conclusions:When planning and designing hospital-based birthing rooms, it is crucial to offer possibilities to adapt the room and physical features according to personal wishes. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-16T09:21:48Z DOI: 10.1177/19375867221077097
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Authors:Jacqueline Roos, Gemma Koppen, Dr. Tanja C. Vollmer, Dr. Marieke Van Schijndel-Speet, Dr. Yvette Dijkxhoorn Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objectives:To identify available literature on the impact of built environments on health, behavior, and quality of life of individuals with intellectual disabilities in long-term care. Additionally, we aimed to map the available literature, (re)frame the overall research situation in this area, and formulate recommendations.Background:Long-term care facilities in the Netherlands are planned without using knowledge from research regarding evidence-based design because it is unclear what evidence is available about the impact of long-term care built environments on individuals with intellectual disabilities receiving 24/7 care.Methods:Twelve scientific databases were searched for keyword combinations. After systematically screening 3,095 documents, 276 were included in the analysis.Results:There is an underrepresentation of research and publications in intellectual disabilities, compared to other user groups living in long-term care facilities. A total of 26 design components were found in all groups; as for intellectual disabilities, research was available on only seven of them. Community care, home-likeness, and variety seem to have a positive effect on health, behavior, and quality of life. There are conflicting results regarding the effects of house size.Conclusions:Although individuals with intellectual disabilities live in long-term care facilities, sometimes for life, little research has been conducted on the impact of the built environment on them. In the future, more empirical research should be conducted, addressing all aspects of quality of life and specific design components, with hypotheses based on needs assessments and the use of good research designs. This requires an investment of time and funding. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-14T10:04:22Z DOI: 10.1177/19375867221085040
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Authors:Ethan Siu Leung Cheung, Ada C. Mui Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objectives:This study examined the associations between home and community environmental factors and self-rated health (SRH) among older Canadians and how these associations vary by gender and living arrangements. Background: In social gerontology research, the psychosocial determinants of SRH have been widely investigated. Based on the environmental gerontology framework, this study examined the home and community environmental correlates of SRH.Method:The sample (aged 60 or older) was drawn from the 2018 Canadian Housing Survey (4,086 men living alone; 6,471 men living with others; 9,170 women living alone; 4,876 women living with others). Multiple regression analyses were used to examine the relationships between SRH and potential environmental correlates in a hierarchical model.Results:Findings show that older men and women living alone reported lower levels of SRH than those living with others. Regression findings show common and unique home and community environmental predictors of SRH by group. Common predictors of higher SRH were private housing residence, larger living space, satisfaction with dwelling, volunteering, no perceived need for community services, and community safety. Home maintenance needs predicted lower SRH among older men and women living with others; uninhabitable conditions predicted poor SRH among older men living with others and older women living alone.Conclusion:Results support the important effects of place in terms of home and community environments for older adults’ SRH, and associations differed by gender and living arrangements. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-11T08:57:02Z DOI: 10.1177/19375867221085603
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Authors:Akhilesh Kumar Upadhyay, Saroj Kumar Patnaik, T. Chandrasekhara, T. V. S. V. G. K. Tilak, Patel Kushagra, Surinder Singh Bhatia Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. During the COVID-19 pandemic, the total number of hospital beds in the National Capital Region (NCR) of Delhi was 54,321 (roughly 300 beds per one lakh population), which was inadequate for the patients. Therefore, the Indian government initiated the construction of a 1,000-bedded greenfield hangar-based hospital to bridge the healthcare gap. As a result, Intensive Care Unit (ICU) beds in the facility augmented the COVID-19 care ICU beds in the city by 11%. The authors were involved in the planning, developing, and initiating the functioning of 1,000-bedded Dedicated COVID-19 Hospital (DCH). The hospital was conceptualized, built, and operationalized in 12 days only. Lessons learned from this experience would be of benefit should similar situations arise in future. Coordinating structural designing early with the entire project team—from facility administrators and medical practitioners to architects, consultants, and contractors—can result in a structure that better matches the facility’s long-term needs and often saves construction time and costs. This article enumerates various challenges faced and the way they were addressed. This hangar-based hospital can be rapidly constructed and deployed on a massive scale. While structural integrity is essential, the planning team was particularly aware of the patient-centric modality of healthcare. Many modifications were carried out in the structure based on patient inputs. Informal discussions with discharged patients and relatives revealed that the human-centric approach was the mainstay of the therapy. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-10T10:04:16Z DOI: 10.1177/19375867221079942
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Authors:Natália Ransolin, Tarcisio Abreu Saurin, Carolina Melecardi Zani, Frances Rapport, Carlos Torres Formoso, Robyn Clay-Williams Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:The aim of this study was to develop built environment (BE) design knowledge to support resilient healthcare by systematically reviewing the evidence-based design (EBD) literature.Background:Although the EBD literature is vast, it has not made explicit its contribution to resilient healthcare, which is a key component of the highly complex health service.Method:This review followed the steps recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses method. After applying the inclusion and exclusion criteria, 43 journal papers were selected. The papers were analyzed in light of five guidelines for coping with complexity, allowing for the development of BE design knowledge that supports resilient healthcare.Results:The design knowledge compiled by the review was structured according to four levels of abstraction: five design-meta principles, corresponding to the five complexity guidelines, seven design principles, 21 design prescriptions, and 58 practical examples. The design knowledge emphasizes the interactions between the BE as physical infrastructure and the functions that it supports.Conclusions:The design knowledge is expected to be useful not only to architects but also to those involved in the functional design of health services as they interact with the BE. Furthermore, our proposal provides a knowledge template that can be continuously updated based on the experience of practitioners and academic research. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-02-16T09:09:52Z DOI: 10.1177/19375867221077469
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Authors:Xiaoyi Zhu, Mardelle McCuskey Shepley Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:This study investigated Chinese nurses’ preferences for (a) proximity of break areas, (b) functionality of break areas, (c) amenities, and (d) nature-related environmental features.Background:While nurses in China need support to adequately perform their jobs, little is known about how restorative spaces impact their mental and physical health.Methods:Data were collected through interviews (N = 12), survey questionnaires (N = 88), and visual assessments (N = 88) from nurses who worked in inpatient settings in China.Results:Nurses preferred the break room to be close to nursing stations; to have visual privacy from patients; and to provide space and facilities for drinking, taking naps, dining, and chatting with colleagues. Balconies and windows were shown to have a significant restorative effect. Well-designed break areas were perceived to have positive impacts on nurse perceived levels of well-being and increase nurses’ satisfaction levels with their work environment.Conclusion:The study outcomes emphasize the importance of restorative spaces for inpatient nurses and recommend including natural elements in the break rooms. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-02-15T09:34:18Z DOI: 10.1177/19375867221075837
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Authors:Ali Lakhani, Dan Waters, Salvatore Dema Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objectives:A methodology to assess the impact of involving end users in therapeutic activities to address the hospital physical environment is provided. The impact of participating in a recreational art creation program with the aim of developing an art installation on the immediate feelings of participants and their perception of the physical rehabilitation environment (PPRE) and motivation to participate in rehabilitation (MPR) is investigated.Background:Rehabilitation unit design has largely excluded the perspectives of end users with disability. Including their aesthetic design contributions moves beyond contemporary approaches where their perspectives are considered.Methods:A two-period, mixed-methods pre–post intervention design involving within and between group comparisons is proposed. During Period 1, program participants and nonparticipants completed admission (T1) and discharge (T2) surveys including PPRE and MPR measures developed by the authors. Surveys pre and post each art session were completed. The art installation will be implemented within unit corridors. Period 2 participants will complete a T1 survey and their physical environment perceptions compared to Period 1 participants.Results:Participating in the recreational art program significantly improved immediate levels of calmness, happiness, pain, and physical health. There is a positive relationship between environment perception and rehabilitation motivation.Conclusions:People with disability should be actively involved in healthcare environment design. Arts-based programs have relevance to people with neurological injury as it promotes essential sensory stimulation. The methodology and findings can encourage further work which involves end users in the design of healthcare environments and evaluates the impact of their involvement. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-01-18T09:37:11Z DOI: 10.1177/19375867211069297
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Authors:Thorben Simonsen, Jodi Sturge, Cameron Duff Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objectives:The purpose of this scoping review is to identify evidence on how characteristics of healing architecture in clinical contexts impact clinical practice and patient experiences. Based on these insights, we advance a more practice-based approach to the study of how healing architectures work.Background:The notion of “healing architecture” has recently emerged in discussions of the spatial organization of healthcare settings, particularly in the Nordic countries. This scoping review summarizes findings from seven articles which specifically describe how patients and staff experience characteristics of healing architecture.Methods:This scoping review was conducted using the framework developed by Arksey and O’Malley. We referred to the decision tool developed by Pollock et al. to confirm that this approach was the most appropriate evidence synthesis type to identify characteristics related to healing architecture and practice. To ensure the rigor of this review, we referred to the methodological guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews.Results:There are two main findings of the review. First, there is no common or operative definition of healing architecture used in the selected articles. Secondly, there is limited knowledge of how healing architecture shapes clinical and patient outcomes.Conclusions:We conclude that further research is needed into how healing architectures make a difference in everyday clinical practices, both to better inform the development of evidence-based designs in the future and to further elaborate criteria to guide postoccupancy evaluations of purpose-built sites. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-01-12T08:12:55Z DOI: 10.1177/19375867211072513
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Authors:Shan Jiang, David Allison, Andrew T. Duchowski Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Background:Navigating large hospitals can be very challenging due to the functional complexity as well as the evolving changes and expansions of such facilities. Hospital wayfinding issues could lead to stress, negative mood, and poor healthcare experience among patients, staff, and family members.Objectives:A survey-embedded experiment was conducted using immersive virtual environment (IVE) techniques to explore people’s wayfinding performance and their mood and spatial experience in hospital circulation spaces with or without visible greenspaces.Methods:Seventy-four participants were randomly assigned to either group to complete wayfinding tasks in a timed session. Participants’ wayfinding performances were interpreted using several indicators, including task completion, duration, walking distance, stop, sign-viewing, and route selection. Participants’ mood states and perceived environmental attractiveness and atmosphere were surveyed; their perceived levels of presence in the IVE hospitals were also reported.Results:The results revealed that participants performed better on high complexity wayfinding tasks in the IVE hospital with visible greenspaces, as indicated by less time consumed and shorter walking distance to find the correct destination, less frequent stops and sign viewing, and more efficient route selection. Participants also experienced enhanced mood states and favorable spatial experience and perceived aesthetics in the IVE hospital with visible greenspaces than the same environment without window views. IVE techniques could be an efficient tool to supplement environment-behavior studies with certain conditions noted.Conclusions:Hospital greenspaces located at key decision points could serve as landmarks that positively attract people’s attention, aid wayfinding, and improve their navigational experience. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-01-11T09:08:22Z DOI: 10.1177/19375867211067539
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Authors:Debbie Gregory First page: 43 Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print.
Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-03-14T10:06:00Z DOI: 10.1177/19375867221082780
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Authors:Rebecca McLaughlan, Kieran Richards, Ruby Lipson-Smith, Anna Collins, Jennifer Philip First page: 149 Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print. Objective:To contribute staff perspectives on the design of palliative care facilities to better align with the philosophy of palliative care, in support of patient, family, and staff well-being.Background:The receipt of palliative care differs from other inpatient experiences owing to its distinct philosophy of care, longer lengths of stay, a greater presence of family members, and more frequent end-of-life events. While research regarding the optimal design of palliative care environments recognizes these differences, this knowledge has been slow to exert change on the guidelines and procurement processes that determine the design solutions possible within these settings. Sustained research attention is required.Methods:An online survey, comprising a series of open-ended questions, elicited the perceptions of palliative care staff regarding the relationship between the physical environment and the distinct philosophy of palliative care.Results:Responses from 89 Australian-based palliative care professionals confirmed the high value that staff place on environments that offer privacy, homeliness, safety, and access to gardens to assist the delivery of optimum care.Conclusions:Our findings illustrate that the implications of privacy and homeliness extend far beyond the patient room and that homeliness is about more than an aesthetic of comfort. This highlights a broader capacity for design to better support the philosophy of palliative care. Importantly, the data reveal a key relationship between staff well-being and the environments in which they work; environments that are unable to match the quality of care that staff aspire to deliver can engender frustration and distress. Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-01-13T09:01:08Z DOI: 10.1177/19375867211059078
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Authors:Peter L. Bardwell First page: 365 Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print.
Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-02-15T09:36:29Z DOI: 10.1177/19375867221075487
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Authors:Kumar Ajit First page: 366 Abstract: HERD: Health Environments Research & Design Journal, Ahead of Print.
Citation: HERD: Health Environments Research & Design Journal PubDate: 2022-01-17T09:10:21Z DOI: 10.1177/19375867211073718