title: Estimating design impact on waste reduction: examining decentralized nursing.
abstract: The objective of this study was to understand the impact that decentralization of nursing support spaces may have on the total distances nurses walk and hence the magnitude of time that can be diverted to productive use. Reducing nurse walking has attracted attention from multiple perspectives-human factor, system performance, lean process, care quality, and safety. A simulation-based experimental study was designed that incorporated task frequency data from a nationwide sample of 700 RNs. The simulation runs were conducted on a 30-bed medical-surgical unit, over 12-hour day shifts, in which physical locations of 8 nursing support spaces were systematically manipulated. Findings suggest that total walking time can be reduced by as much as 67.9%, depending on the level of decentralization. Care quality and efficiency issues can be significantly addressed through appropriate levels of decentralization.
authors.affiliation: College of Human Sciences, Department of Design, Texas Tech University, Box 41220, 1301 Akron Ave, Lubbock, TX 79409, USA. d.pati@ttu.edu
authors.forename: Debajyoti
authors.initials: D
authors.lastname: Pati
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Harvey
authors.forename: Terry
authors.initials: T
authors.lastname: Thurston
mesh_terms: D003198:Computer Simulation; D017598:Efficiency, Organizational; D006801:Humans; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D013996:Time and Motion Studies; D016138:Walking