The Relationship between Nursing Unit Design, Communication and Teamwork among Care Providers, and Quality of Care
When the 300 million dollar expansion and renovation of Meridian Health’s Jersey Shore University Medical Center was designed more than five years ago, the architects, administrators, physicians and staff envisioned a project that would dramatically change the delivery of health care to the community that the hospital has served for more than 100 years. A central feature of the project was the new inpatient area of the Northwest Pavilion, featuring three 36-bed units containing all private rooms, with an additional 36-bed shell for future expansion.
To better understand the effect of such a “neighborhood” design on staff communication patterns and their resultant patient outcomes, a research team led by Profs. Ying Hua and Franklin Becker from the Department of Design & Environmental Analysis, College of Human Ecology, Cornell University, and Dr. Teri Wurmser, the Director of the Meridian Health (MH) Ann May Center used a “before and after” study design that captured data on the current nursing units, which basically have a centralized design, prior to moving into the new facilities; and then again after the move into the new decentralized units. This allowed comparison of both process and outcome data between the two environments to determine the impact of the new environment.
Data collection included the use of the Clinical Work Measurement Tool, adapted from research led by Prof. Johanna Westbrook at the University of Sydney’s Health Informatics Evaluation Unit, that records actual communication patterns; a survey of teamwork, job stress, and informal learning; pedometers to measure actual distance nurses walk; interviews; and institutional data on medical outcomes from the hospital’s quality improvement dashboard. Pre-move data was collected June-August 2009, and post-move data was collected in the first quarter of 2010, allowing staff time to adapt to their new work environment.
Wurmser, T. and Becker, F. (2009) Transforming Care: The Jersey Shore Hospital.