Reduce medical errors with strategic hospital design

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As the health of people, animals, and the environment is inextricably connected in many facets, this also rings true in the hospital setting. On the final day of the 2023 American Veterinary Medical Association (AVMA) Convention, Lucas Pantaleon,DVM, MS, DACVIM, MBA, founder of DVM One Health in Versailles, Kentucky; and Heather E. Lewis, AIA, NCARB, AAA, principal at Animal Arts Design Studios in Boulder, Colorado, shared how a strategic hospital design promotes a healthy environment for clients, patients, and staff alike while helping to provide the highest-quality care.¹

Pantaleon compared a veterinary hospital to a complex system. “When we put each of these [design] elements as part of system, sometimes they don’t work very well, or the system is prone to errors, he said.” One of the ways he suggests making these complex systems easier to navigate is through a collaboration between architects and veterinary professionals for multifarious viewpoints of how they can make the most safe, efficient hospital setting.

Additionally, veterinary hospitals “are in an environment where there are risks and we need to mitigate those risks and reduce medical errors,” Pantaleon said. This can be achieved through designing a hospital that is decluttered, has good air quality, and good lighting.

Declutter

“A perfect medical space is a clean and decluttered medical space,” said Lewis. “And it's absolutely possible. It is absolutely inspiring. And working in a space that is clean and well-kept can help you do better work every day and help you feel more positive or productive to have a clean space.” Tips for promoting a clean clinic include working hard not to accumulate clutter, having a bulk storage area, hanging items from the ceiling, providing useful cabinet storage, and blocking the area above cabinets.

Lewis also suggested developing a “same-handed design,” which is a key concept used in human medicine that means having uniform rooms with the same tools located in the same places. For example, each drawer in exam rooms has the same items, so they can be easily located by staff. “Everything is the same, the cabinet is the same. That room could be a pentagon, triangle, indoor outdoor, I don’t care, but your workspace is the same in every room. And that's how we reduce errors by saving time, allowing you to focus on the patient,” she shared with attendees.

Good indoor air quality

Pantaleon noted the recent pandemic underscored the importance of air quality. It not only promotes well-being but also can boost staff productivity. Good air quality can be accomplished through natural ventilation. “We know that opening the windows is a good thing,” said Pantaleon. It can also be done through mechanical ventilation and filtration and paired with emerging technologies such as UV light for an added layer of protection.

Additional methods to improve air quality include isolating potentially contagious patients, direct exhausting your isolation room, boosting ventilation rates in wards, ensuring positive pressure in surgery rooms, and negatively pressurizing in wards, according to Lewis.

Good lighting

Lighting also plays a critical role in providing excellent care. Poor lighting can affect staff as they work long hours in the clinic and also have a toll on pets who are in a stressful situation as they visit the hospital. Lewis used an example of including dimmable lights so when a patient first enters the exam room, the lights can be off for a more comfortable environment, then gradually adjusted. She also suggested using curtains to divide patients and help them feel safe, saying, “My question is, why don't we use [curtains]? These are used in human medicine all the time.”

Reference

Pantaleon LG, Lewis HE. Hospital design, patient outcomes, and client experience. Presented at: AVMA Convention; Denver, Colorado. July 18, 2023.