8 Trends in Emergency Department Design

Many hospitals are expanding and renovating their emergency departments to accommodate increased patient volume, update old facilities and facilitate a smooth patient flow. Christine Gamlen, RN, MSN, CNO of health IT vendor Vocera, shares eight trends in ED design.

Christine Gamlen shares eight trends in ED design.1. Projecting 10 years out. The pace of new technology and medical innovation is causing many hospitals to plan their ED to meet the needs of patients, families and healthcare providers at least a decade in the future. "You have to stretch to envision what may be possible," Ms. Gamlen says.

2. Patient, family and frontline staff involvement. Many hospitals are seeking input from patients, their families and front-line staff on the design of the new ED. By taking a more patient-centered approach to design and engaging front-line staff, hospitals can design an ED that is more efficient for employees and more pleasing for patients.

3. Private rooms. Another trend in the ED, as well as in hospitals generally, is a move toward private patient rooms. Private rooms are designed to provide greater privacy for patients, improve the patient experience and help prevent the spread of infections.

One challenge with this design is communication with other providers. When patients shared rooms, providers could easily speak with other providers in the room. In private rooms, EDs will need to invest in a communication strategy that enables direct contact with the intended recipient. "The ability to go directly to the person and have that communication is critical," Ms. Gamlen says.

4. Flexible rooms. In addition to including more private rooms, EDs are also moving toward a model with rooms that can accommodate the needs of many different patients. In the past, ED rooms tended to have specific functions and were designed for specific patient populations, such as children or trauma patients. Now, many EDs are designing rooms that can manage children, adults, trauma patients and patients with less urgent conditions.

This flexibility eliminates the need for ED staff to constantly move patients to different rooms as new patients arrive.

5. Geriatrics. While EDs are designing individual rooms to be more flexible, EDs are also designating different areas of the ED for populations with different needs. For example, as baby boomers age, the number of older adults visiting the ED has increased. Many patients older than 65 are sensitive to light and sound. Some EDs are creating a space that is quieter with less harsh light to better care for geriatric patients, according to Ms. Gamlen.

6. Waiting areas. An emerging trend in ED design is creating areas where non-emergent patients who have been treated but not discharged can wait. For example, patients frequently need to wait for medication or test results. To free up beds for patients with more serious conditions, these patients can wait in a separate area.

Similarly, some EDs are creating open lounges where patients with non-urgent needs can sit under the supervision of a nurse. "Not all patients need a bed, so that's going to help move patients through the ED," Ms. Gamlen says.

7. Fast track.
Many EDs are creating fast track areas to treat patients with minor conditions. To optimize ED capacity, ED leaders can make the fast track area flexible so it can be used as an ED room at peak times, when more patients need beds, according to Ms. Gamlen.

In addition, some EDs are staffing the fast track area with advanced practice nurses who follow standardized protocols for low acuity conditions. Ms. Gamlen provides an example of a protocol for an ear ache: The nurse would start by asking questions about pain, loss of hearing and history of ear problems and would then take vital signs. After evaluating findings and other symptoms, the nurse would determine a plan for intervention based on the protocol. If the patient has a fever greater than 101 degrees and inflammation on an ear exam, the nurse can start certain antibiotics for a specified period of time.

Nurse practitioners can typically manage at least 90 percent of fast track patients, which enables ED physicians to spend more time with patients with emergencies, according to Ms. Gamlen. "Taking advantage of the care team and maximizing their skills is another way hospitals become more cost-effective and efficient," she says.

8. Freestanding EDs.
Freestanding EDs are becoming increasingly popular, in part due to a desire to treat patients closer to home, according to Ms. Gamlen.

More Articles on Emergency Departments:

Stratify and Manage Your Emergency Patient Populations: The Importance of Streamlined Follow-up Communication
ED "Super-Utilizers" Are Center of Nationwide Initiative

Baptist Health System Opens New 'Emergency Hospital'

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