A person centred approach to facility design

When designing a care environment, people – residents, patients and caregivers – should be at the centre of the entire process in order to achieve an efficient environment that stands the test of time.   

Residents

With the resident in mind
Getting residents out of bed regularly and helping them to sit, stand, or walk around, has been proven to have significant physical and psychological benefits.Getting out of bed stimulates a resident's cognitive function as well as vital bodily functions such as the heart, lungs, bladder, bowel, bone and muscular structure, and blood circulation. Mobility has been shown to reduce the risk of a number of medical complications, such as pressure injuries, depression, infection, eating problems, and a rapid decline in muscle strength and skeletal structure.2

Daily hygiene routines provide a very important opportunity to mobilise the resident. Residents usually prefer to go to the toilet to empty bladder and bowel, even if they are incontinent, as well as being able to experience a proper shower or bath. By using all possible opportunities to provide stimulation and activity, we can help residents be more active and alert, and help to facilitate the many positive effects of maintaining mobility.

With the caregiver in mind
Having sufficient space and the right equipment to support resident mobility can yield more active and alert residents. A more active resident requires less assistance, which can lead to reduced risk of strain and related injuries. This improves the caregiver’s well-being, allowing them to provide better quality care. Another implication is the improvement of staff retention, fewer sick days, and higher overall job satisfaction, which in turn leads to a reduction in costs for the care facility.

As demand for quality healthcare continues to grow, so will the demands placed upon caregivers. Attracting and motivating caregivers should be a priority, and a well-designed work environment can be a significant factor.

It is important for the caregiver to be able to perform tasks as efficiently as possible while minimising the risk of injury. While the care situation may vary, each lift, transfer and forward bending activity poses some risk of physical overload, and a badly planned work environment only compounds this problem.

sara flex load

Designing and planning to minimising the load
The risk of injury increases when there is insufficient space to allow the use of proper equipment and techniques. Two primary hazards have been identified in ergonomic studies: dynamic overload and static overload. Minimising dynamic and static overload is key to reducing physical strain and the risk of injury for caregivers.

Dynamic load is the load placed on the caregiver's body related to movements such as pushing, pulling, lifting etc. Static loads are those experienced by the caregivers due to postural strain, for example by having to bend over a patient to assist with feeding, or to wash them in bed.

Minimising static overload is achieved by ensuring the caregiver is able to work in an optimal working posture, and spends as little time as possible in a forward bending position. This is done by providing height adjustable equipment, for example, beds, bath tubs and shower chairs.3,4

Dynamic overload is minimised by lifting and transferring patients with the help of the right equipment, such as patient lifters, instead of performing these tasks manually.5,6,7

Architects_Twogirls

How to approach planning and designing healthcare facilities
Arjo has worked closely with care facilities to gain valuable insight into their care routines and challenges, as well as the factors that need to be considered in the first stages of planning and designing a care environment. By considering the needs of the resident, the caregiver, and the operational requirements of their equipment, we have developed a number of visual tools and examples to help make the most of every square metre.

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References
1. Gucer et al 2013
2. Stuempfle and Dury, 2007
3. ISO Standard 11226, 2000
4. Freitag, 2007
5. CEN/ISO TR 12296
6. Nelson et al, 2009
7. Waters, 2007