One of the ways that hospitals strive to provide patient-centered care is by altering the physical facility to incorporate larger visitor and family space within patient rooms. It is believed that this space increases comfort and allows family members to spend more time with and better support their loved one in the hospital, impacting patient care. As few rigorous empirical studies have been conducted to measure the impact of this design feature on family members’ behavior as well as their degree of presence in the room, the authors sought to study this in more depth.
The objective of this study was to determine whether family members in a patient- and family-centered ICU spend more time in the patient room with their loved ones than in more traditionally designed units, and whether family members in the patient- and family-centered spaces interact more with their loved ones and with caregivers than family members do in more traditional units.
Presence of family members, as well as family-patient and family-caregiver interactions, was studied in two intensive care units at Tampa General Hospital. The two units were very similar in terms of patient characteristics and operation, but one unit was designed to be more patient-centered with a family area, while the other unit was older and had a more traditional layout in the patient room. Patient rooms within the patient-centered unit have more comfortable and accommodating furniture, a privacy curtain, a larger area dedicated to visitors, and are 40% larger than those in the other ICU. Through a behavior-mapping method, the team directly observed family presence and interaction in the rooms and recorded peoples’ specific locations, as well as their physical and verbal interactions, on floor plans. The observer walked the unit and recorded activities and locations every 15 minutes for 12-hour periods on 10 weekdays over the course of five weeks. Additionally, informal interviews with nurses allowed the researchers to collect data on patients and ensure that there were no confounding variables or issues that might impact family presence and interaction on the two units. 81 patients and their families were included in the analysis. Patient characteristics were evaluated, and then a two-step process involving a Pearson correlation analysis and an independent samples t-test was conducted to identify statistically significant associations and find differences between the two different unit designs.
Presence of family members, as well as family-patient and family-caregiver interactions, was studied in two intensive care units at Tampa General Hospital. The two units were very similar in terms of patient characteristics and operation, but one unit was designed to be more patient-centered with a family area, while the other unit was older and had a more traditional layout in the patient room. Patient rooms within the patient-centered unit have more comfortable and accommodating furniture, a privacy curtain, a larger area dedicated to visitors, and are 40% larger than those in the other ICU. Through a behavior-mapping method, the team directly observed family presence and interaction in the rooms and recorded peoples’ specific locations, as well as their physical and verbal interactions, on floor plans. The observer walked the unit and recorded activities and locations every 15 minutes for 12-hour periods on 10 weekdays over the course of five weeks. Additionally, informal interviews with nurses allowed the researchers to collect data on patients and ensure that there were no confounding variables or issues that might impact family presence and interaction on the two units. 81 patients and their families were included in the analysis. Patient characteristics were evaluated, and then a two-step process involving a Pearson correlation analysis and an independent samples t-test was conducted to identify statistically significant associations and find differences between the two different unit designs.
One limitation mentioned by the authors was the fact that information was not gathered from family members to learn their perspectives about the design of the unit they experienced. This may have allowed for a better understanding of the impact. Another limitation was the manner of obtaining patient data; informal interviews were conducted with nurses, rather than a formal review of patient medical records. This was believed to add a degree of subjectivity that should be avoided in future studies on the topic.