Steelcase Health has released a new insights report which highlights the importance of family involvement in patient care to support positive health outcomes and showcase how current patient room settings do not meet the needs of families.
"The benefits of family involvement in care are well-documented in clinical literature," commented Michelle Ossmann, MSN, PhD, Director of Healthcare Environments at Steelcase Health. "Family and friends who are present at the bedside can reduce patient stress, enhance trust, contribute to safety by helping the staff know the patient, and, ultimately, support positive health outcomes. Well-designed healthcare environments can be a powerful tool in supporting a family's ability to meaningfully engage in their loved one's care, but many hospitals have yet to fully harness their spaces to maximize this engagement."
Steelcase Health sought to better understand how families are involved in the healthcare experience, uncover the contribution of environmental influences on family involvement in patient care, and examine how family members adapt to living in a patient room. Its researchers observed clinicians, patients, and family members in maternity and pediatric settings, and interviewed healthcare executives, nursing and facilities staff responsible for inpatient adult care across several service lines, including intensive care. Additionally, the team explored peer-reviewed research and industry trend data, and examined case studies about family involvement in patient care.
Researchers identified five key issues that can affect family wellbeing and engagement in a patient room:
Family members can be unintentionally blocked from critical communications
Family members often want to be active participants with clinicians and the patient, but the layout of most healthcare environments does not promote communication. Arranged to avoid interference with patient care, families may be seated in a corner or on the other side of the room, or furniture may inhibit the view of critical information -- away from where medical information is delivered to the patient. If able to participate, family members can share medical and dietary information, take notes and review test results, among other things. Effective communication can help family members make a patient's transition from hospital to home easier, and help the patient follow discharge plans, which can prevent emergency room visits and hospital readmission.
Difficult Sleeping Conditions
Many healthcare environments cannot comfortably accommodate family members who stay with their loved ones overnight. In many instances, the furniture in a patient room, such as chairs, temporary cots and in-room sleepers, are uncomfortable, which compromises family member sleep. Steelcase Health researchers found family members improvising their own "beds" using chairs, duffel bags and pillows. In addition to wearing on the family member, concerns about their loved one's sleeping situation caused stress on hospitalized patients.
No place to share a meal
Despite having a cafeteria in the building or dining spaces across the hall, families will often choose to have meals and snacks together in the same room, but existing inpatient environments lack support for meal sharing. Researchers observed families improvising with whatever furniture they could find in the patient room. This was inconvenient and frequently displaced items needed by the patient and clinicians.
Uncomfortable hospitality environment
Visitors aren't easily accommodated in current healthcare environments. In many hospital settings, there is limited furniture so visitors can crowd a room. Limited storage for guests' bags, coats, computers, and bedding adds to crowding that is awkward and frustrating for guests, patients and hospital staff. This crowding also can block access to medical equipment and impede clinical staff's ability to perform their duties.
Nowhere to plug in
Often family members try to maintain some of their daily routines, including working from the hospital room, while supporting their loved one. In most cases, this requires the use of computers, tablets and smartphones. Researchers saw family members struggle to create ad hoc workspaces while their loved ones slept. Their efforts were often complicated by a lack of access to light, power sources, and surfaces to hold paperwork.
"Family members are eager to be involved in their loved ones' care, but our research shows that healthcare environments often don't invite their participation," said Patricia Wang, researcher, WorkSpace Futures, Steelcase Health. "Uncomfortable or temporary furniture, the persistent need to find space for personal items and daily activities, concerns about receiving incomplete information, and stress about getting in the way of clinicians can leave family members feeling more like an audience than an active, valued partner in care. This can impact patient, family member and clinician experiences."
Steelcase Health findings show that family members need intuitive, welcoming and hosted environments that both support fundamental needs, such as sleeping, sharing meals and working, and assists them in productively partnering with clinicians to meet their loved one's healthcare needs.
"Creating spaces that encourage family involvement is a critical challenge that those who design healthcare environments can work to address," added Wang. "Space constraints, layout, storage concerns, and access to light and power are all important considerations, along with dynamics such as how simple it is to effectively clean a room or piece of furniture. And, of course, flexibility and adaptability are paramount because there is no one-size-fits-all approach that will meet the needs of every healthcare setting."