Designing the Built Environment for A Culture and System of Patient Safety – A Conceptual, New Design Process

Abstract

There is growing recognition that the risks and hazards of injury and harm associated with health care are a result of problems with the design of systems of care rather than of poor performance by individual providers. Furthermore, substantial evidence suggests that the design of hospital physical environments contributes to medical errors, increased rates of infection and injuries from falls, and to slow patient recovery and high nurse turnover. Growing research points to the need to change facility development and design methodologies used in the past to incorporate patient safety into the design. The design professions have been slow to comprehend the gravity and character of the problem. Designers appear to be taking “solution based” approaches rather than using intensive, focused research to develop environments that support caregiving processes. Key causes for these deficits relate to the way designers are trained, the way design knowledge is shared and propagated, and the history of architectural theory. In design, the notion persists that the same processes and tools used in the past will somehow result in the safe environments required for the present and future. The authors compare changes in medical education and architectural design training that illustrate the different approaches. Attention to systems thinking, evidence-based care, and the identification of a different design process that can be used to create health care facilities are needed.

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