Laboratory testing has grown from a manual, “hands-on” process providing a simple test menu — with staff organized by testing methodology or discipline in multiple small rooms — to an automated, multidisciplinary, high-volume instrument-centric clinical enterprise. A visit to a hospital laboratory today reveals a varying array and number of instruments, often operating with little human intervention. While test volume and staffing were once used to determine the amount of space in a laboratory, today, the instruments and degree of automation dictate the test volume capacity. The number of staff required to support the instrumentation is then determined.
How To Articles
Learn how to determine facility capacity, estimate bed need, plan specialized facilities, and much more.
Consolidating Healthcare Facilities Requires a Unique Facility Planning Process
Hospital mergers and acquisitions continue to increase at a rapid rate with precedent-setting deals occurring in 2018. Given that this a primary business strategy for a majority of healthcare organizations, this trend is expected to continue into 2019 and beyond. One of the many challenges that newly merged healthcare systems face is eliminating redundant services and surplus capacity. Realigning services and reallocating resources among multiple campuses requires a unique strategic, operations improvement, and facility planning process. The planning team needs to understand the market and patient population, look at alternate ways of allocating resources, and evaluate the impact on operational costs, before recommending investments in bricks and mortar. This article looks at opportunities for improving efficiency and eliminating surplus capacity, separating major issues from less important issues, and other key considerations.
Changes to the 2018 FGI Guidelines Impacting Space Planning
The FGI Guidelines were updated in 2022. You can see what’s new in the SpaceMed Guide (fourth edition) on the SpaceMed website.
The Facility Guidelines Institute (FGI) is a nonprofit organization that works to develop guidelines for designing and building hospitals and other healthcare facilities in the U.S. Through a consensus process that includes public input the FGI Guidelines documents are updated every four years. The SpaceMed Guide complements the FGI Guidelines by helping healthcare architects, planners, and providers to develop the functional program, required prior to application of the FGI Guidelines, and the room-by-room space requirements necessary to begin the design process. Although the 2018 FGI Guidelines documents provide indispensable guidance for the designer on risk assessment, infection prevention, architectural detail, surface, and built-in furnishing requirements, this article identifies changes that specifically impact space planning — including the types, numbers, and minimum sizes of spaces.
How Sacramento’s Busiest ED Doubled Capacity Without Expansion
The emergency department (ED) at the Kaiser Permanente South Sacramento Medical Center, one of California’s busiest EDs, has cut patient turnaround times by hours and to far below the national average, through operations improvement, according to Healthcare Informatics. This Level II trauma center saw its workload almost double from 2008 to over 120,000 annual patient visits by 2015. The existing ED space was constrained with only 49 ED bays of which three are dedicated for trauma and four are dedicated to psychiatry. This calculates to 2,500 annual patients per ED bay compared to a recommended 1,500 to 1,800 for a well performing ED. The increasing patient volume and space constraints resulted in long ED wait times with patients waiting five to six hours to see a doctor and every night there were 30 to 40 patients in the waiting room.
After an intensive operations improvement effort using “lean” production principles, South Sacramento Medical Center’s average wait time in the ED was reduced to 19 minutes, less than half the national average of 58 minutes. The average length of stay (LOS) in the ED was reduced to 43 minutes for low-acuity patients compared to a national average of 118 minutes. The LOS for discharged patients was decreased from 4.5 hours to about 2 hours and the LOS for admitted patients dropped from 8 to 6 hours. According to Karen Murrell, M.D., the chair of emergency medicine at Kaiser Permanente Northern California, “Decreasing the length of stay creates capacity, so if we have a patient in a bed for two hours rather than four hours, we can see twice as many patients.”
Source: “How Eliminating Waste and Opening Data Helped Kaiser South Sacramento Create a “No Wait” ER” by Heather Landi, October 23, 2015 [Retrieved online at www.healthcare-informatics.com]
This article is an update of a previous post.
Key Ways Hospital Design May Affect C-Section Rates
According to a new report published by Ariadne Labs and MASS Design Group, the physical design of a hospital’s birthing unit may affect its Cesarean section rate. Based on previous research, the team knew C-section rates can vary from 7 percent to 70 percent simply depending on the facility. As many as half of these C-sections are unnecessary and add surgical complications and increase costs. To begin to determine how much the physical layout of a hospital may impact C-section rates, the team chose 12 diverse childbirth locations — three birth centers and nine hospitals. They conducted site visits and phone interviews to develop facility profiles and compare the childbirth locations as quantitatively as possible.
Sixteen Features of the Safe Hospital Room
AARP, the nation’s largest organization for people age fifty and older, has illustrated an inpatient hospital room focused on patient safety, identifying 16 features used by innovative hospitals around the country.