Extracorporeal membrane oxygenation (ECMO) is a procedure that uses a machine to take over the work of the lungs and sometimes the heart. Extracorporeal means that the blood circulates outside of the body with the help of a machine. Membrane oxygenation, referred to as the “artificial lungs,” is a special part of the machine that puts oxygen into the blood and takes out carbon dioxide just like the lungs do normally. Although similar to a heart-lung machine that is used during open-heart surgery, ECMO therapy is intended for patients whose heart and lungs cannot normally function on their own. ECMO is used to provide intensive care for babies, children and adults. The two most common modes of ECMO are veno-venous (VV) where access is via a vein for patients who have suffered loss of the lungs exclusively and veno-arterial (VA) with dual access by a vein and the carotid artery for patients with both lung and heart impairment.
Common Clinical Support Spaces
Whether a patient care area is used for patient exams and treatments, diagnostics, medical or surgical procedures, or for inpatient recuperation, associated space is needed to store and stage medical supplies, medications, nourishment, and equipment used in the department or nursing unit. These spaces are often referred to as “clinical support space” and are usually standardized throughout a healthcare facility. The generic rooms or areas listed in this article can be used for most patient care areas. The minimum sizes can generally support a wide range of exam/treatment rooms, procedure rooms, and inpatient beds. A further increase in workload or beds can usually be met with the addition of a second supply cart, bin, cabinet, etc. For very large departments or nursing units, an additional set of these spaces may be provided to reduce staff walking distances.
Ten Key Questions When Planning the Clinical Laboratory
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.
Rethinking Customer Access Services
In the traditional healthcare facility, multiple departments and staff were involved in patient reception, admitting and registration, scheduling, cashiering, insurance verification, and billing, resulting in fragmented customer service and complicated wayfinding. Although many of these departments are located on the first floor of the facility — along with various patient and visitor amenities — only a few staff in each department needed face-to-face interaction with visitors, patients, and their families. The question is: How can a healthcare organization better utilize both its staff and space to potentially enhance operational efficiency and improve customer service?
Case Study: Planning a New Outpatient Clinic
University Hospital (UH) planned to replace three outpatient clinics, currently in different locations, in a new freestanding building. Although the number of annual visits (30,000) was not expected to grow significantly, there was considerable debate among the physician leadership regarding the planning of the new facility. Some wished to maintain the status quo regarding their current productivity and wanted to simply replace the three separate clinics in new construction. Others wanted to consolidate the clinics into a single, efficient ambulatory care space ― recognizing that reducing their staff and facility costs would make them more profitable while potentially improving customer service with more streamlined and better coordinated processes. The physician leadership agreed to evaluate the impact on overall space need (and resulting construction cost) of planning a lean facility versus a more generous facility.
Estimating Capacity and Space for Cardiovascular Services
Cardiovascular procedures include routine noninvasive diagnostic tests as well as more complicated cardiovascular diagnostic and therapeutic interventions. Noninvasive tests typically include electrocardiography (ECG), cardiac stress tests, Holter monitoring, tilt table testing, echocardiography, transesophageal echo (TEE), vascular studies, and nuclear cardiography. Interventional cardiovascular procedures involve longer procedure times and recovery periods and include cardiac catheterization, therapeutic cardiovascular procedures, and electrophysiology.