Design that Reduces Adverse, Preventable Events & Promotes Safety

Posted by on Apr 14, 2017 in Uncategorized

The World Health Organization (WHO) states that “No adverse event should ever occur anywhere in the world if the knowledge exists to prevent it from happening.” (World Health Organization Collaborating Centre for Patient Safety Solutions, 2010)

Adverse Events that Occur in Patient Rooms

There are many adverse events that can occur in a patient’s room. Today, we are going to discuss two of the preventable ones: Healthcare-Associated Infections (HAI) and falls.

Healthcare-Associated Infections (HAI)

In the United States, about 1 in 25 U.S. hospital patients has at least one reported HAI according to the Centers for Disease Control and Prevention. In 2011, 75,000 hospital patients with HAIs died during their hospitalizations.

In addition to the human toll, HAIs also impact healthcare dollars. Research finds that the overall annual direct medical cost of HAIs to US hospitals range from $28.4 to $33.8 billion dollars.


Falls are another area of concern, both in terms of keeping patients and staff safe and costs down. When a patient falls, on average, they stay 12 days longer and incur charges thousands of dollars higher than non-fallers.

When staff members attempt to lift patients, they too may become injured, which has all sorts of implications. The staff member may need to take time off for a work-related injury. Trust is broken between patient and caregiver. Mentally, it can cause despair, anxiety, embarrassment and guilt for both parties.

Adverse events like HAIs and falls are preventable with design improvements. Evidence that demonstrates it is mounting. Design can promote safety by eliminating these preventable events.

Sacramento VA Medical Center Achieves the Best Possible Outcome

The growing desire to improve patient and staff safety led the Sacramento VA Medical Center to implement a 4th floor renovation heavily based on the research findings known as Evidence Based Design or EBD. EBD is the process of basing design decisions on credible research to achieve the best possible outcome.

The VA project team called upon an expert design team that is well versed in EBD.  Hilliard Architects Inc. and Wikoff Design Studio, together with the VA project team, built a patient room model that proves that design can promote safety and eliminate adverse events such as HAIs and falls.

Focus on Safety

The patent room model that was built by Hilliard and Wikoff has several notable design enhancements. Today, we will focus on the elements that prevent HAIs and falls.

Design Elements that Prevent HAIs

Hilliard Architects and Wikoff Design Studio presented the VA project team with a modified patient room that would reduce the risk for infection. Three main strategies were used – private patient rooms with nearby nurses’ stations, large handwashing stations and design materials that have better indoor air quality, maintenance, and infection control properties.

Private patient rooms and decentralized nurses’ stations help control the spread of infection. The private rooms help isolate contagious disease while the decentralized nurses stations help contain contagious disease and keep it to one spot.

Handwashing is said to be the single most important method to prevent hospital infections. The design team installed a large handwashing sink that is optimally placed as close to the entrance of the room as possible and is large enough to prevent splashing. The sink is equipped with a hands-free control, soap dispenser and paper tower holder.

The materials chosen by the design team are water and fluid resistant and easy to clean. The finishes and fixtures are durable and can be wiped easily.

Design Elements that Prevent Falls

To help prevent slip and fall accidents, the design team created each room with straight lines and clear paths to the bathroom. Each bed has an adjacent handrail that leads all the way to the toilet. The bed and toilet are as close to each other as possible and in a straight line along the wall.

To prevent staff and patient related falls, the design team installed a patient lift system that works on a ceiling track. The track configuration is ideal as it mobilizes the patient and assists them from the bed into the bathroom.

Knowledge Means Prevention

While you can’t defend against everything, you can defend against what you know. What is known, is that many patient and care provider injuries are preventable. The more prepared, the better the outcome.



  1. Hilliard Architects
  2. Wikoff Design Studio
  3. An Introduction to Evidence-based Design: Exploring Healthcare and Design. Concord, CA: Center for Health Design, 2015. Print.
  4. Centers for Disease Control and Prevention