EDRA_2015_Being the change

BEING THE CHANGE

HKS

Bringing Research to Practice

TEAM

• Upali Nanda, PhD

• Heath May, AIA

• Tom Harvey, FAIA

• Chris Mundell, AOA

• What’s changing in practice- Research!

• Resistance to change

• Being the change:

– A model of using a project as a lab for research

Why Research is “In”

Changing Market Culture

• Focus on “Value” not Cost

• Increase in Accountability

• “Educated” consumer

• Data-driven culture

• Increased computational ability

• “Green” conscience

3 Initiatives

#1: TECHNOLOGY

LINE

#2: SUSTAINABILITY

DesignGreen

DesignGreen

• Compared and ranked

various renewable power

systems based on costs

and energy produced.

• Analyzed actual roof

space for solar power

system based on

clearance, shading

and existing support

structure.

DesignGreen

#3: HUMAN & ORGANIZATIONAL BEHAVIOR

CADRE

HEALTHCARE RESEARCH

STAYING INFORMED

5 point agenda for Healthcare Research

Improve Patient & Family ExperienceReduce stress, pain perception, anxietyImprove comfort, satisfaction, sense of control, wayfinding, family presence

Improve Safety / Mitigate RiskReduce risk of infections, falls, injury and errors

Improve patient monitoring; improving environmental health

Increase Staff Effectiveness & SafetyReduce staff fatigue, injury, errorsImprove efficiency, communication, collaboration and satisfaction

Improve performance and patient interaction

Lower Life Cycle CostsOperational flexibility; Balancing one-time capital cost with life-time operational cost, accounting for improved outcomes and return on investment

Improve Organizational OutcomesHCAHPS; LOS (Length of Stay); LWBS (Leave without being seen rate); Return Rate; Referrals; Turnovers

HEALTHCARE RESEARCH

STAYING INFORMED

Evidenced Based Design Case Study: Emory Neuro ICU Design

Research Team: HKS and Georgia Tech

Objective:

Design for Patient/Family focused Care

Location:

Emory University Hospital

Procedure:

Industry survey and benchmarking of award-winning Neuro ICU designs.

Design Charrettes with user groups.

Key findings:

Private family zone inside patient room increased family satisfaction

Dissemination:

Wall Street Journal Article

Objective: To assess the performance of membrane ceiling technology in controlling air particulate dispersion in exam rooms.

Location: Washington Hospital Center Mock-up

Published: Journal of Healthcare Engineering

Method: Computational Fluid Dynamic (CFD) Modeling

Key outcome: A membrane diffuser directed

airflow ventilation provides a less

turbulent airflow pattern and less mixing of

the air between the patient and others in

the room.

Membrane Ceilings in ED Exam Rooms

Research Team: CCRD; Fluid Dynamics Solutions Inc. PI: D. Pati; Mik Pietrzak

HEALTHCARE RESEARCH

STAYING INFORMED

Evidenced Based Design Case Study: View and Acute Stress

Objective:

Ascertain impact of view duration and content on acute stress and alertness of nurses

Location:

Children’s Healthcare of Atlanta

Procedure:

Measured acute stress, chronic stress and alertness before and after shift

Key findings:

Nature view reduces staff stress

Nature viewReduced Staff

Stress

Reduced Staff Turnover?

Improved Patient

Interaction

Improved Patient

Satisfaction

More referrals, More

reimbursement, More $$$

Convergence

LINE

CADREGREEN

CADRE

Overall Goal: Individual, Organizational and Environmental Wellbeing

MATERIALS

& SYSTEMS

LINE

DESIGN GREEN

TECHNOLOGYHUMAN

BEHAVIOR

LINE

DESIGN GREEN

CADRE

HUMAN BEHAVIOR TECHNOLOGY MATERIALS & SYSTEMS

Overall Goal: Individual; Organizational and Environmental Wellbeing

Resistance Factors

Billability

Time

ProcessCulture

Tools

Resistance

• Billability

• Time

• Process

• Culture

• Tools

• Billability

Sharing Liability

A Project is a Lab

preomedica

Reported Data Observed Data Spatial Data

16 Interviews

(6 RN; 3 PCS; 3 Leadership;

2 NA; 1 UC; 1 care navigator)

17 hours of RN Shadowing

(day + night)

Travel distance from point

to point using parametric

modeling tools

Surveys (31 responses) Behavior Maps (6) + Sound

Readings (10)

Sight Lines

FIELD RESEARCH + SIMULATION

Human Behavior

Existing Use of Environment

Energy Performance

Environmental Affordance

ProMedica New Patient Tower 37May 13, 2014

RESEARCH FINDINGS: 7TH FLOOR MED-SURG

17 6 3 2Hours of Minute to Minute Shadow Data

RN Interviews Patient Care Supervisor Interview

3LeadershipInterview

1Care NavigatorInterview

131Survey Responses

10Sound readings; Behavior Maps

NursingAssistantsInterview

Unit ClerkInterview

DETAILED PARAMETRIC

ANALYSIS

ProMedica New Patient Tower 38May 13, 2014

Need Parametric Modeling Visuals

ProMedica New Patient Tower 39May 13, 2014

ProMedica New Patient Tower 40May 13, 2014

ProMedica New Patient Tower 41May 13, 2014

Integrating Research into Practice: One Project at a Time

To conclude-let’s begin

preomedica

• Skills cannot be restricted to a few

• “research” with a big “R” must be in

collaboration with academia

• research in design practice must be

integrated throughout the process- not as

an “add-on”

• Please add thoughts here