title: Effects of acuity-adaptable rooms on flow of patients and delivery of care.
abstract: BACKGROUND
  Delayed transfers of patients between nursing units and lack of available beds are significant problems that increase costs and decrease quality of care and satisfaction among patients and staff.
  
  
  OBJECTIVE
  To test whether use of acuity-adaptable rooms helps solve problems with transfers of patients, satisfaction levels, and medical errors.
  
  
  METHODS
  A pre-post method was used to compare the effects of environmental design on various clinical and financial measures. Twelve outcome-based questions were formulated as the basis for inquiry. Two years of baseline data were collected before the unit moved and were compared with 3 years of data collected after the move.
  
  
  RESULTS
  Significant improvements in quality and operational cost occurred after the move, including a large reduction in clinician handoffs and transfers; reductions in medication error and patient fall indexes; improvements in predictive indicators of patients' satisfaction; decrease in budgeted nursing hours per patient day and increased available nursing time for direct care without added cost; increase in patient days per bed, with a smaller bed base (number of beds per patient days). Some staff turnover occurred during the first year; turnover stabilized thereafter.
  
  
  CONCLUSIONS
  Data in 5 key areas (flow of patients and hospital capacity, patients' dissatisfaction, sentinel events, mean length of stay, and allocation of nursing productivity) appear to be sufficient to test the business case for future investment in partial or complete replication of this model with appropriate populations of patients.
authors.affiliation: Methodist Hospital, Clarian Health Partners, Inc, Indianapolis, Ind., USA.
authors.forename: Ann L
authors.initials: AL
authors.lastname: Hendrich
authors.forename: Joy
authors.initials: J
authors.lastname: Fay
authors.forename: Amy K
authors.initials: AK
authors.lastname: Sorrells
mesh_terms: D003325:Coronary Care Units / Q000458:organization & administration*; D006749:Hospital Design and Construction / Q000379:methods*; D006801:Humans; D009732:Nursing Care; D017060:Patient Satisfaction; D010360:Patient Transfer