Herd-Health Environments Research & Design Journal最新文献

{"title":"Modeling the Dynamic Outcomes of Infection Prevention Behaviors in an ICU Environment.","authors":"Lisa Sundahl Platt, Arezoo Zeinali","doi":"10.1177/19375867251317234","DOIUrl":"https://doi.org/10.1177/19375867251317234","url":null,"abstract":"<p><p><b>Objective:</b> The research opportunity addressed in this study is in understanding how socio-technical system interactions within healthcare settings can be optimized to promote patient safety, particularly in the context of infection risk analysis during critical clinician-patient interactions and throughout the care delivery. <b>Background:</b> Preventing the risk of pathogen spread in healthcare environments that cause Hospital Acquired Infections (HAIs) is an ongoing challenge both in the U.S. and globally. In complex inpatient care delivery settings, variability in clinical staff's infection control behaviors, such as hand hygiene compliance, can hinder achievement of optimal HAI risk prevention objectives. <b>Method:</b> The authors employed Agent-based Modeling (ABM) in conjunction with the Theory of Planned Behavior (TPB) as a framework for evaluating the simulated results of safety behaviors like hand hygiene compliance impact both patient and overall environmental infectivity. <b>Results:</b> This study demonstrates that using a computational approach to evaluate operational factors in care delivery settings can effectively forecast the impact of human behaviors like hand hygiene compliance on patient safety and environmental infectivity levels. <b>Conclusion:</b> This approach provides valuable insights for designing and operating healthcare environments by highlighting the importance of integrating behavioral theories and computational modeling to improve infection control practices. <b>Application:</b> The implications of this study healthcare designers and hospital operations professionals suggest that applying ABM to evaluate physical design interventions within the care environment that bolster clinicians' Perceived Behavioral Control and their intentions to perform safe infection risk prevention practices offers a viable method for understanding and improving the design dynamics healthcare settings.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"19375867251317234"},"PeriodicalIF":1.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Design-Driven Approach Exploring Therapeutic Building-Nature Integration Strategies in Healthcare.","authors":"Liheng Zhu, Dan Hu, Sarah Javed Shah, Xiao Hu","doi":"10.1177/19375867251313990","DOIUrl":"https://doi.org/10.1177/19375867251313990","url":null,"abstract":"<p><p><b>Objectives:</b> This paper focuses on the three representative hospital projects conceived by Herzog & de Meuron, which transcend the conventional function of healing facilities by embracing a holistic conception of care. Through a thorough examination, complemented by illustrative drawings, it delves into the design strategies that set these projects apart from conventional practices observed in general hospital settings. <b>Background:</b> In response to the rising concerns about environmental sustainability and human well-being, architects, urban planners, and landscape designers are beginning to realize how crucial it is to use \"natural\" components in design. Particularly in healthcare institutions, carefully designed healing gardens like courtyards, with their appropriate spatial arrangement and material composition method, aim for high-quality spaces to promote health and well-being. <b>Methodology:</b> A qualitative study was conducted through design-driven evaluation, with photographic documentation, drawings, and sketches to show how these designs achieve therapeutic integration. The strategies were thoroughly analyzed from three main perspectives: context and space, garden and building, and material and environment. <b>Results:</b> The investigation demonstrates that key design elements for improving the healing effect of hospitals include nature integration, spatial sequence, daylight exposure, and material composition. Specifically, it involves incorporating nature through courtyards, allowing daylight to enter indoor spaces, using clear architectural markers for easy wayfinding, and applying tactile timber finishes both inside and outside the building. <b>Conclusions:</b> The research highlights significant strategies and approaches that establish a framework for designers and decision-makers to assess hospital health promotion aspects to guide future design projects.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"19375867251313990"},"PeriodicalIF":1.7,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Role of the Physical Environment on Communication Patterns in Emergency Departments During Caregiving for Pediatric Mental and Behavioral Health Patients.","authors":"Yueci Jiang, Anjali Joseph, Monica Gripko, Sahar Mihandoust, Heidi Zinzow, Lucinda Easler, Ann Dietrich","doi":"10.1177/19375867251317241","DOIUrl":"https://doi.org/10.1177/19375867251317241","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates how the physical environment influences communication dynamics among staff members, pediatric mental and behavioral health (MBH) patients, and their families in the emergency department (ED).</p><p><strong>Background: </strong>The United States faces a public health challenge as MBH conditions in school-age children contribute to an increasing number of ED visits. Effective communication plays a pivotal role in pediatric MBH caregiving, where challenges often arise due to the sensitive nature of these conditions.</p><p><strong>Methods: </strong>This qualitative study involved observations and semistructured interviews with 55 care providers across four hospital-based EDs in the southeastern United States.</p><p><strong>Results: </strong>Qualitative thematic analysis of the interviews identified physical environment impacts on communication at three scales: unit, staff workstation, and patient care space. This study identified aspects of the physical environment, such as proximity, visibility, crowding, and privacy as influential factors in communication patterns for the MBH care process in ED.</p><p><strong>Conclusions: </strong>The physical environment has an essential impact on communication patterns and care delivery for the increasing number of pediatric MBH patients in the ED.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"19375867251317241"},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are ICU Bedspaces Based in Evidence, and Do They Support Patient Sleep? A Narrative Review.","authors":"Oystein Tronstad, Irene Szollosi, Dylan Flaws, Barbara Zangerl, John F Fraser","doi":"10.1177/19375867251317239","DOIUrl":"https://doi.org/10.1177/19375867251317239","url":null,"abstract":"<p><p><b>Objective:</b> This narrative review summarizes some of the evidence guiding current intensive care unit (ICU) design, focussing on environmental factors impacting on sleep, and compares available evidence and recommendations to current ICU designs and builds. <b>Background:</b> The importance of sleep for recovery after illness is well known. However, hospitalized patients frequently experience poor and disrupted sleep. This is especially true for patients admitted to the ICU. There are many factors negatively impacting on ICU patients' ability to sleep. Some relate to their illness or pre-existing sleep problems; others relate to patient care activities. While the ICU bedspace may facilitate 24h care, there is growing awareness of the detrimental impact the bedspace environment (especially suboptimal lighting and excessive sound/noise) has on sleep quality, and important questions raised regarding how this may impact on recovery and health outcomes. Multiple guidelines and recommendations exist to guide ICU bedspace design. However, questions have been raised whether contemporary ICUs are evidence-based, and whether the available evidence is effectively translated into the built ICU. <b>Methods:</b> A comprehensive literature review was conducted, exploring the evidence supporting current ICU bedspace design and the impact of ICU design and environmental factors on patient sleep. <b>Results and conclusion:</b> This review summarizes the impact of the ICU bedspace environment on patient outcomes and describes features of the ICU bedspace design that may not adhere to best evidence and contribute to poor sleep. Suggestions on how ICU bedspaces can be improved to optimize sleep are provided.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"19375867251317239"},"PeriodicalIF":1.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keeping Healthcare Workers Safe During a Pandemic: Evaluating Doffing Area Design for Safer Removal of Personal Protective Equipment.","authors":"Zorana Matić, Yeinn Oh, Amanda Grindle, Jennifer R DuBose, Lisa Lim","doi":"10.1177/19375867241311273","DOIUrl":"https://doi.org/10.1177/19375867241311273","url":null,"abstract":"<p><strong>Objective: </strong>This study proposes a user-centered methodology to quantify the design affordances of doffing spaces, focusing on the safety and efficiency of healthcare workers (HCWs).</p><p><strong>Background: </strong>Doffing personal protective equipment (PPE) poses a significant challenge for healthcare workers (HCWs) due to the high risk of self-contamination. The physical design of the doffing area plays an important role in ensuring safety during this process. However, there currently are no established spatial metrics for assessing the design of doffing spaces.</p><p><strong>Methods: </strong>Four doffing areas in two Biocontainment Units (BCUs) were evaluated using Functional Scenario (FS) analysis method. FSs, representing the spatial needs of key users (HCW and Trained Observer-TO) were developed based on observations, literature, and discussions with staff. For each FS, we defined quantifiable metrics for visualizing the user's needs and evaluating doffing area design performance.</p><p><strong>Results: </strong>We defined 11 FSs (seven for HCWs and four for TOs) and 19 associated spatial metrics. FSs for the HCW focused on the prevention of self- and cross-contamination, as well as facilitating visibility, efficiency, and situational and process awareness. The FSs for the TO center on preventing self-contamination, promoting visibility and process awareness, and safe waste management.</p><p><strong>Conclusions: </strong>The FS approach allowed for the quantification of doffing area affordances and evaluation of how they impact HCW performance, emphasizing design aspects that enhance safety and efficiency. The presented metrics and study findings are expected to inform the future design of spaces where doffing occurs and provide new guidance for improved doffing safety.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"19375867241311273"},"PeriodicalIF":1.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salutogenic Architecture, Non-Therapeutic Environments and the Health of the Elderly: A Systematic Review.","authors":"Zohre Rakhshani, Mehdi Khakzand","doi":"10.1177/19375867251313980","DOIUrl":"https://doi.org/10.1177/19375867251313980","url":null,"abstract":"<p><p><b>Background:</b> Despite a lot of studies that have been conducted on the effects of the built environment on the health of the elderly and environmental salutogenic factors, a limited number of studies have investigated the architectural physical factors clearly. <b>Purpose and Aim:</b> This paper investigated the architectural elements in the non-therapeutic built environment that can achieve salutogenic goals for the elderly. It also aimed to provide an answer to the question of how architectural design might be used to physically bring salutogenic theory to life. <b>Method:</b> In this review study, data were collected systematically using the PRISMA checklist. The three lists of keywords used for the initial search were \"built environment\" or \"architecture,\" \"elderly,\" and \"health,\" and were supplemented with synonyms for a second search in four databases: Scopus, Science Direct, Web of Science, and PubMed, in the period from 2000 to 2024. By applying inclusion and exclusion criteria, 26 articles were selected for review and data extraction. The data were then qualitatively analyzed, and two reviewers independently verified the analysis. <b>Conclusions:</b> This study found that architectural elements can be salutogenic by supporting the comprehensibility, manageability, and meaningfulness. Porches, Stoop, above-grade entrances, and balconies are key elements in the home that support the sense of coherence. In assisted living facilities, walls were recognized as the only physical factor supporting the sense of coherence due to the creation of a personal, distinct, meaningful, comprehensible, and manageable space.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"19375867251313980"},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Attributes of Wayfinding in Care Facilities by Individuals With Mild Cognitive Impairment (MCI).","authors":"Hessam Ghamari, Nasrin Golshany","doi":"10.1177/19375867251313987","DOIUrl":"https://doi.org/10.1177/19375867251313987","url":null,"abstract":"<p><p>Navigating unfamiliar environments poses significant challenges, especially for individuals with cognitive impairments. These individuals often struggle with maintaining orientation, recalling routines, and traveling through new environments due to their limited cognitive capacity. The current state of research on visual environmental attributes of wayfinding reveals a gap, particularly regarding individuals with mild cognitive impairment (MCI), compared to healthy older adults. Few studies have objectively identified the visual cues and environmental factors that influence wayfinding in those with cognitive impairments. This study addresses this research gap by objectively identifying the visual environmental attributes influencing wayfinding among MCI subjects in a memory care facility compared to healthy older adults. Using eye-tracking technology, we investigated which visual environmental attributes attract eye fixation during wayfinding in care facilities. Forty-eight subjects, categorized into MCI and non-MCI groups, navigated through unfamiliar indoor environments while their eye movements were tracked. The results, in agreement with previous research, showed that MCI group exhibit significant reduced success rates and longer navigation times compared to non-MCI group. Findings of the eye-fixation rank-order analysis showed that MCI subjects prioritized directional signs and architectural features, while non-MCI subjects focused on identifying signs and informative elements. These findings emphasize the importance of tailored design practices for care facilities, highlighting specific visual cues crucial for guiding navigation in individuals with MCI. The study provides insight to guide architects and healthcare professionals in creating inclusive environments that support independence and well-being for older adults with cognitive impairments, advocating for interventions to enhance wayfinding in care facilities.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"19375867251313987"},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping Review: Association of Inpatient Hospital Design Features With Patients' Clinical Outcomes.","authors":"Esther Jiin Oh, Alice J Liu, LaTeesa James, David Varon, Mitchell Mead, Andrew M Ibrahim","doi":"10.1177/19375867241302799","DOIUrl":"10.1177/19375867241302799","url":null,"abstract":"<p><p><b>Objective:</b> To identify associations between inpatient hospital design features and empirical patient clinical outcomes as well as changes over time. <b>Background:</b> A growing body of literature has emerged evaluating the association of hospital design features with measurable clinical outcomes during inpatient hospital admissions. However, there has been limited effort to evaluate the scope and quality of studies examining individual, inpatient hospital design features on empirical patient clinical outcomes. <b>Methods:</b> Primary research articles published in English between 1980 and 2021 evaluating inpatient clinical outcomes were included. Key terms for hospital designs and clinical outcomes were used. Ovid Medline, Embase, CINAHL, Web of Science, Scopus, Cochrane Library, Elsevier Embase, and Google Scholar were searched on May 28, 2021. Data were independently extracted by two authors, with arbitration from the third author. <b>Results:</b> Forty-six research articles were included for analysis. Predominantly studied inpatient hospital design features included: single versus multibedded rooms/wards, windows, furnishings, installed lighting, ward size and spatial arrangement, noise level, air ventilation, and patient visibility. Although nearly half (43%) of the articles lack appropriate methods to account for residual confounding, a trend of improvement in the use of appropriate methods was identified with 68% of studies in the last decade having appropriate methods. Studies demonstrating positive associations were more likely to be cited than those with negative associations (average citation per article, 508 vs. 27). <b>Conclusion:</b> Our study demonstrates the use of empirical patient clinical outcomes as a feasible approach to evaluate hospital design features, and identified an incremental improvement in the methods being applied.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"157-175"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Study on the Chinese Environmental Audit Tool (C-EAT) for Long-Term Care Facilities.","authors":"Fei Lian, Yanan Huang, Richard Fleming","doi":"10.1177/19375867241276211","DOIUrl":"10.1177/19375867241276211","url":null,"abstract":"<p><p><b>Objective:</b> The aim of this study was to translate the Australian Environmental Assessment Tool (EAT) into Chinese and identify culturally specific characteristics in the Chinese context for adaptation. <b>Background:</b> In the context of dementia-specific care, the design of the environment is considered an influential factor in supporting and maintaining skills. However, despite the increasing number of individuals with dementia in China, there is currently no valid instrument available to systematically assess the quality of the physical environment in long-term care facilities (LTCFs). <b>Methods:</b> This study utilized a mixed-method procedure consisting of seven steps, including translation and adaptation. The study involved focus groups comprising an expert panel (<i>n</i> = 17) and potential users (<i>n</i> = 64) of the newly developed tool. Cross-cultural adaptation was performed through Chinese literature review and literature quality appraisal, field study, and expert committee review. <b>Results:</b> The final version of the China Environmental Assessment Tool (C-EAT) consisted of 10 key design principles and 64 items. The C-EAT was tested in four LTCFs in China and underwent two rounds of review by an expert panel. <b>Conclusions:</b> The C-EAT was deemed a suitable tool for assessing the environment and enhancing the living environments for individuals with dementia in LTCFs in China. In future research, field tests will be conducted to validate the C-EAT scale and modify the EAT-HC to enhance its applicability in China.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"21-40"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating Patient and Family Perspectives into ICU Environmental Design: A Systematic Review and Narrative Synthesis of Existing Literature.","authors":"Yvonne Patricia Fahy, Oystein Tronstad, Jana Waldmann, John F Fraser","doi":"10.1177/19375867241302414","DOIUrl":"10.1177/19375867241302414","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to assess the incorporation of patient and family input into intensive care unit (ICU) design processes. It aims to highlight the importance of prioritising patient and family perspectives in ICU design to improve patient experiences and clinical outcomes.</p><p><strong>Background: </strong>Traditionally, ICU design has focused on clinical efficiency at the expense of patient-centered needs, leading to heavily sedated patients and neglected holistic care delivery. While architects historically dominated design decisions, there's no recognition of the necessity to integrate patient and family perspectives. However, such efforts remain rare despite professional guidelines advocating for multi-professional team involvement.</p><p><strong>Methods: </strong>This review summarises the published literature on built ICUs that have incorporated patient and family input into the design process. It evaluates methodologies used and measures patient-centric outcomes to identify successful examples and areas for improvement in future initiatives.</p><p><strong>Results: </strong>The limited published literature identifies only three projects successfully integrating patient and family input into ICU design. Additionally, one project was identified in a search of the gray literature. However, these projects often lack rigorous evaluation of patient-centric outcomes, with initiatives involving patients and families remaining uncommon. The review underscores the need for more comprehensive evaluation and greater emphasis on patient and family involvement in ICU design.</p><p><strong>Conclusion: </strong>This review emphasizes the significance of integrating patient perspectives into ICU design to enhance outcomes and improve experiences. While progress has been made in recognizing their importance, more efforts are needed to prioritize patient and family involvement for creating conducive environments for healing and recovery.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"194-204"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}