Date of Award

5-2010

Document Type

Thesis

Degree Name

Master of Architecture (MArch)

Legacy Department

Architecture

Advisor

Allison, David

Committee Member

Battisto , Dina

Committee Member

Verderber , Stephen

Committee Member

Craig , Janet

Committee Member

Garrett , Sandra

Abstract

Is there a place for the semi-private patient room in contemporary American hospitals? This thesis purposes that the semi-private room remains a viable option for some patient populations and care scenarios and merits reconsideration and redesign. This inquiry is among few in the literature devoted to advancing semi-private patient room design and application within contemporary healthcare. The semi-private room may yet offer increased opportunities to address pressing issues of increasing healthcare costs, improving operational efficiencies, and reducing environmental footprint while simultaneously attempting to address both longstanding and recent industry concerns with traditional semi-private patient rooms. Further, it will serve as an opportunity to better understand the benefits and limitations for both the private and semi-private patient room models as there remains limited empirical evidence in support of all private rooms in all circumstances.
This study aims to uncover the possible advantages and disadvantages of the semi-private patient room in relation to the private model in order to inform and establish criteria for
evaluating and executing applicable and successful semi-private patient room design. Private patient rooms prevail as the preferred model of care in new hospital construction in the United States today. The 2006 AIA Guidelines for the Design and Construction of Health Care Facilities mandates the construction of all private rooms 'unless the functional program demonstrates the necessity of a two-bed arrangement' (Burnette, 2006). As a result, the semi-private patient room has become nearly obsolete, neglecting its potential benefits on the basis of limited empirical evidence in support of the private patient room. This re-evaluation of the semi-private patient room seeks to assess its remaining relevance in certain acute care patient populations today, such as pediatrics, oncology, or whole organ transplant patients.
An extensive literature review was conducted in the beginning of this process to verify the assertions and assumptions made at the outset of this thesis and to ground the study in research and empirical evidence. In order to establish a framework of comparison, several case studies of recently constructed healthcare facilities that utilized the semi-private patient room model were identified. The selected facilities, located in London, United Kingdom, Deventer and Groningen in The Netherlands, were visited in the summer of 2009 and a thoughtful analysis of each was conducted during and upon returning from this tour. An assumption that not all patient populations would be appropriate for sharing a patient room led an investigation to identify which patient care scenarios might benefit from a semi-private room model. Patient populations were evaluated based upon characteristics, such as acuity, diagnosis and average length of stay. Several scenarios were recognized and deemed most qualified as being appropriate conditions for sharing a patient room, such as pediatric patients, rehabilitation patients and transplant patients. To guide the redesign of the semi-private patient room a set of design guidelines intended to address the particular needs of staff, families and patients sharing a room were identified and modeled after the pattern structure used in Christopher Alexander's A Pattern Language.
The final product of this study is a re-conceptualized and redesigned semi-private patient room that encompasses the attributes that make the private patient room a viable model for care, while providing for a more cost and operationally efficient room model with a smaller environmental footprint. To ground this study in an existing care context, the Medical University of South Carolina (MUSC) was selected as the site and operational context for the redesigned semi-private patient room. MUSC is the only hospital in South Carolina that services whole organ and bone marrow transplant patients, therefore the renal transplant inpatient unit was chosen as an appropriate patient care scenario for the redesigned room. The intention of the redesigned room is that it would satisfy, to the fullest extent possible, the design guidelines originally established to inform an improved, more patient-centered and operationally supportive shared patient room model for the contemporary American healthscape.

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