Recent attention in healthcare has focused on the architectural design of new construction or remodeled healthcare facilities. This attention includes technology and its effect on occupational safety. Federal initiatives, such as the To Err is Human work, are aimed at addressing the problems of safety, which include SPHM. To address SPHM in a meaningful way, fundamental changes in healthcare processes, culture, and the physical environment must be aligned. This alignment should be planned so that healthcare workers, and the resources that support healthcare workers, are set up to promote safety of both the healthcare worker and the healthcare recipient. Facility design of the hospital, with its technology, has not historically considered impact on the quality of care and safety of healthcare recipient or worker. This provides a unique opportunity to use current and emerging evidence to change the physical environment in a way that improves outcomes.

Consider Banner Health, a healthcare system that has developed “Safe Patient Handling Design and Construction” standards. The principles of ergonomic
design and integration of SPHM technology are clearly defined within the Banner Health standards. These standards have become a reference point, within Banner Health, during consideration of all new construction projects and remodels. The standardization includes statements such as the following: 50% of all medical-surgical inpatient rooms will have a ceiling lift installed with a designated weight capacity. Each project may have specific considerations for the team to address, but the general expectations for safety, risk avoidance, and standardization are clear and easy for the project managers to interpret. The goal of this approach is to design in such a way as to optimize safety and human performance.

Ergonomic design principles, such as the Banner Health Safe Patient Handling Design and Construction standards, can be used as a systematized and proactive process to prevent or reduce occupationally related illnesses, fatalities, and exposures by including prevention considerations in all designs that affect both the healthcare worker and recipient in the occupational setting. Experts such as cognitive psychologists and others recognize that the physical environment has a significant impact on safety and human performance. Understanding the interrelationships between healthcare workers, the tools they use, and the environment in which they work is critical to safety. This includes the design of facilities, process flow, technology selection and implementation, ongoing education and training, accountability, and accessibility issues. Experts explain that organizational/system factors that can potentially create the conditions conducive for errors are called latent conditions. The design of a patient care room that allows flexibility and can be adapted to meet changing acuity and the care needs of the healthcare recipient has been found in some institutions to lead to fewer errors by controlling for latent conditions. To that end, researchers are investigating variable-acuity rooms. For example, researchers suggest that two different levels of acute care (intensive care and step-down care) could effectively be merged into a single patient care room by making the room acuity adaptable to accommodate the changing needs of patients. The benefits of the variable-acuity rooms/units are numerous, but speci fic to SPHM are that fewer handoffs and transfers are necessary, and there are quantifiable increases in available time for direct care without additional cost.

Safety design principles, which address safety among healthcare recipients and healthcare workers, include the following:

These widely recognized principles are the foundation of a safe environment, as they encourage designs that support the anticipation, identification, and prevention of adverse events. These considerations become essential in today’s economic climate. For instance, the burden of occupational injury, illness, and death is still significant. In the United States, 3.8 million individuals experience work-related injuries. The annual direct and indirect costs have been estimated to range from $128 billion to $155 billion. Moreover, the social consequences of occupational morbidity and mortality affect families, communities, and personal mental health. Consider the nameless nurse, who graduated with a BSN on her 21st birthday. Like 50% of nursing students, she sustained a shoulder injury in her last year of nursing school. The neck, shoulder, and arm pain was so great that she was started on muscle relaxants, physical therapy, and painkillers shortly after graduating. By the time she turned 35 years of age, she had enrolled in the state of California’s drug diversion program for impaired nurses.