Emergency Department Design Building Blocks Series: The Patient Treatment Room Presented by Huddy HealthCare Solutions – ED Design Specialists
This is a continuing series from Huddy HealthCare Solution’s ED Design Team on various components that may be designed in your new or renovated emergency department project.
THE PATIENT TREATMENT ROOM
Every emergency department design will revolve around the basic building block of the patient care room. My first recommendation is to attempt to design a “universal exam room” that can treat any type of patient. Fight the need to develop special room; for example: suture rooms, orthopedic rooms, ENT rooms, etc. Any time you design a unique room for only one type of use you will immediately develop a queue of patients to access that unique room. Use mobile carts with special supplies that you can pull into each room that can assist you with suturing, orthopedic procedures, etc. The more universal you can make the rooms the more likely you are to have a location suited for the next patient that walks in your door.
Larger than Code Minimum
Most states have codes or design guidelines that allow a private ED exam room to be a minimum of 120 square feet (sf). This generally means that the room will be 10 feet wide by 12 feet deep with the head of the patient (on a stretcher or bed) at the far end of the room opposite the door. It has been my experience through working on more than 300 ED design projects that the 10 x 12 foot room size is too small for today’s emergency department. With all of the equipment, accompanying family members, and the “swarming” method of physicians, nurses and technicians arriving at the same time to encounter the patient, the need for more space in every general exam room is a must. I recommend a 12 foot by 12 foot configuration for your universal exam room. This 144 sf room is larger than code minimum, but delivers the necessary space around the patient to allow you to perform your work.
Since the recommended room size of 144 square feet is in a square 12 foot by 12 foot configuration, this allows you to turn the patient stretcher 90 degrees from the traditional position so that the patient is parallel with the corridor. This concept positions the head of the patient on the left wall as you enter the room allowing everyone that enters the room to access the right side of the patient first. This is also considered a “lean” design because you are only half way into the room and already at the head of the patient. This patient positioning allows you to maintain visibility of the patient from outside the room from the nurse station while the patient (and family) will be focused on the flatscreen TV opposite the patient (and this keeps them from staring out at the nurse station wondering why you’re not in their room!)
This universal room layout delivers three separate zones in the same room. The entry side of the door is considered the staff zone, the stretcher/bed area is the patient zone, and the far wall is considered the family zone. With 144 sf you will still be able to get around to access any side of the patient, have room for equipment, and still not trip over the accompanying family members.
Don’t Mirror Rooms
A mistake that most inexperienced designers make is mirroring the exam rooms so that one room may have a patient’s head to the right and next room will have the patient’s head to the left. This is done to save on plumbing costs because you can back-up the sink in each room to the sink in the other room. This method is called “mirroring” since each room is a mirror image of the adjoining room. However, this saves limited money on plumbing while making every-other-room different. What you need to do is to design every room standardized (i.e. exactly the same!) so that every time you enter a room you have the patient, sink, computer, supplies, etc. in the same exact location. This supports lean processes, reduces potential errors, and eliminates the “hunting and searching” for supplies that would be in different locations in every room.