Observation Units

Their Impact on Patient Outcomes

According to Bill Sheely, NCARB, AIA, ACHA/Partner, Observation Units have become an essential component of the contemporary hospital. Patient volumes, revised admissions and reimbursement policies, as well as extended recovery times for some imaging and diagnostic procedures have made the Observation Unit critical to managing patient diagnoses, improving emergency department throughput, and freeing up in-patient beds.

Experience and Understanding
Hospitals and healthcare organizations are being compelled in unprecedented ways to improve their quality of care and find ways to reduce costs. The design solutions that will improve quality and reduce costs will be based in fundamentals of innovation: observing, understanding, incorporating recent EBD research and creating alternatives that are more responsive to patient, physician and staff needs. Integrating technology and systems, maximizing space/units and offering ease of access will be essential.

HonorHealth John C. Lincoln Medical Center Observation Unit is a small project with a big impact that provides a connection to nature and a quality healing environment within the core of a hospital.

Improving Productivity
An Observation Unit requires an efficient layout that enhances patient, staff and material flow. Careful attention to eliminate “cross-over” traffic between the patients flow, clean and souled materials flow and staff circulation will need to be designed to minimize conflicts.

To help evolve operational strategy to address both patient and staff engagement in this unique environment, our team of A/E designers focus on three strategies:

Mitigate “Limbo” within the Patient Environment
FGI provides guidelines for temperature, lighting, acoustics, and hygiene, however, the patient experience in the typical Observation Unit remains that of waiting—a kind of limbo until something happens: a confirmation of diagnosis, the availability of a patient room, or even simply signing off on discharge orders.

Leverage Operational Efficiencies
The benefit of design for an Observation Unit is not only to fulfill its functional and strategic missions: providing the most economical patient space until the patient’s disposition is resolved, but to create an environment and experience that can help to relieve the anxiety of waiting and the frustration of boredom.

Maximize Patient Outcomes
According to Brian Ledesma, Co-Studio Leader at Orcutt | Winslow, an Observation Unit will, most likely, not be able to provide views to the exterior, or daylight into all the rooms. How can the Observation Unit compensate for these critical features for improved patient outcomes? Providing biophilic design elements with a few upgraded finishes can enhance the experience for the patient, family members and even staff on the Unit. Positive distractions and appealing to pleasing emotions and perhaps even memories, can help reduce a patient’s anxiety level in such an environment. Giving the control back to the patient by allowing them to have choice and control regarding different lighting levels/elements and entertainment such as television. Generally, people like things that they can have control over, especially if they are put in an environment where they are restricted to for an insurmountable amount of time. While meeting the functional and strategic operational goals of the hospital, the health and well-being of the patient can be supported through the selection of circadian rhythm lighting, appropriate acoustic and noise control, and an aesthetically comfortable interior environment.

Bill Sheely, NCARB, AIA, ACHA/Partner is a Managing Partner and Healthcare Studio Leader for Orcutt | Winslow, a Phoenix-based architectural, interior design and planning firm of 100+, bringing more than 30 years of architectural expertise in healthcare design, especially related to healing environments and Evidence Based Design.

Brian Ledesma, Co-Studio Leader is experienced in a myriad of design industry types including Healthcare, Higher Education, Science and Technology, and Senior Living facilities with over 18 years of experience. He leads conversation and strategy in thought leadership topics of Healthcare Architecture and Technology and Project Management.

Jennifer Wilcynski, IIDA, NCIDQ, LEED-AP, EDAC is a NCIDQ and EDAC certified Interior Designer and Associate at Orcutt | Winslow with over 18 years in the profession who creates exceptional experiences for patients, families and staff in healthcare spaces.