SlideShare uma empresa Scribd logo
1 de 61
Baixar para ler offline
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Mais conteúdo relacionado

Destaque (17)

Mapa conceptual martin a
Mapa conceptual martin aMapa conceptual martin a
Mapa conceptual martin a
 
E risk ict_audit
E risk ict_auditE risk ict_audit
E risk ict_audit
 
Arrapaketan
ArrapaketanArrapaketan
Arrapaketan
 
India N.A.D. Genesis
India N.A.D. GenesisIndia N.A.D. Genesis
India N.A.D. Genesis
 
Using my momot in i momot game series
Using my momot in i momot game seriesUsing my momot in i momot game series
Using my momot in i momot game series
 
Resultados de Admisión Nuevo Ingreso Feb 2013
Resultados de Admisión Nuevo Ingreso Feb 2013Resultados de Admisión Nuevo Ingreso Feb 2013
Resultados de Admisión Nuevo Ingreso Feb 2013
 
Totales dia 21
Totales dia 21Totales dia 21
Totales dia 21
 
Inspeccion tecnica
Inspeccion tecnicaInspeccion tecnica
Inspeccion tecnica
 
Garciaines ciutatimaginaria
Garciaines ciutatimaginariaGarciaines ciutatimaginaria
Garciaines ciutatimaginaria
 
Plan de acción enero del 2013
Plan de acción enero del 2013Plan de acción enero del 2013
Plan de acción enero del 2013
 
Assetjament escolar.Activitat de Reforç ESO. Llengua Catalana. INS La Serreta
Assetjament escolar.Activitat de Reforç ESO. Llengua Catalana. INS La SerretaAssetjament escolar.Activitat de Reforç ESO. Llengua Catalana. INS La Serreta
Assetjament escolar.Activitat de Reforç ESO. Llengua Catalana. INS La Serreta
 
крокодил оригами-Coffeedelia
крокодил оригами-Coffeedeliaкрокодил оригами-Coffeedelia
крокодил оригами-Coffeedelia
 
Fin biblioteca
Fin bibliotecaFin biblioteca
Fin biblioteca
 
INTERNATIONAL INDEXED REFEREED RESEARCH PAPER
INTERNATIONAL INDEXED REFEREED RESEARCH PAPERINTERNATIONAL INDEXED REFEREED RESEARCH PAPER
INTERNATIONAL INDEXED REFEREED RESEARCH PAPER
 
Dps
DpsDps
Dps
 
We are sisters
We are sistersWe are sisters
We are sisters
 
Land use by Jens
Land use by JensLand use by Jens
Land use by Jens
 

Healthcare Presentation V2 6 November

Notas do Editor

  1. One of the things that we are trying to change is our behaviors as it relates to how will build out our interior environments in Healthcare applications. The amount of change that occurs with in hospitals is constant: most hospitals have a permanent construction trailer on site to be able to handle the reality of their environments not being able to keep up with the need for flexibility. This is the same message that we have been delivering since 2004 – there is a better way to build out our interiors – one that gets away from fixed in place construction. With a modular solution we can reduce our initial construction waste, but more importantly be able to respond to the need for flexibility not only today, but in the future. Additional Information: Supportive design is being recognized as an integral part of the healthcare experience. Empathy is an essential part of Healthcare design because good designers put themselves in the mind of whoever is going to experience the product or service they are designing. Empathetic people recognize the importance of context. Empathy is also reshaping medicine more directly. There is a dramatic shift for the medical professional from detached concern to empathy. Empathy supplements objective knowledge and the use of technology and other tools for making accurate diagnoses. This is giving way to a new generation of healthcare professionals – people who can combine rule based detachment with emotion-based empathy into a whole new medicine.
  2. Three key “clients” – Patients, Medical Staff, Technical Group – Rather than having 3 different solutions to meet very different needs for each group – one solution that is flexible to respond to the various requirements. Key Concerns in a Healthcare Environment: Patient Safety and Recovery Reducing Medical Errors Improved Air Quality Reducing Facility Acquired Infections Reducing Patient Falls Reducing other medical misadventures First group is the patients: Without patients we would not need healthcare facilities: Patients are looking for: Getting in and out of the hospital as quickly as possible Environments that promote healing – getting away from the traditional clinical look we have seen in the past Privacy – shift from semi private to private rooms Comfort – not only for themselves but also for their families Medical Staff is looking for: An environment that is not going to get in their way of doing their tasks – on average a nurse will walk 5-7 miles per shift and spend 80% of their time “fetching” – they want more efficiencies in the space Environment that responds to creating a better workplace – safer environment, less chance of injury, facilitates ease of care with their patients Hospital Executives are looking for an environment that promotes attraction and retention of talent Hospitals are also businesses – what is separating themselves from their competition. Technical Group is looking for: An environment that can adapt to whatever existing and future technologies need to be introduced. No one can predict what the technology is going to look like two years from now…10 years from now. An environment that allows for change…easily. Today and in the future
  3. Innovation in Medical Equipment – New Medical Equipment, using new technologies, that promotes healing but must be hooked up, stored, and maintained. The unknown space and connectivity demands of future new equipment makes a flexible facility essential. The need for such flexibility will lead to what author Michael Bobrow calls “Universal Rooms”. A great example is digital X-rays. 4 years ago everyone was specifying light boxes…today it’s monitors to read the digital X-rays.
  4. Giving control back to the patient. As soon as you enter a medical facility the individual looses control – you become a chart, someone wheels you places to avoid patient falls, you are told when and what to eat, privacy is challenged – the design of the space can impact the human factors. Improving the design of medical settings helps patients get better faster. What if we can give more control back to the patient in the Healthcare environment? Additional Information Patients in better-designed wards needed less pain medicine than those in less inviting wards, and were discharged on average nearly two days early. Many Hospitals are now redesigning their facilities to include greater amounts of natural light, waiting rooms that provide both privacy & comfort, and an array of design features such as meditative gardens and labyrinths that physicians now realize can speed the healing process. Viewing nature may decrease pain by eliciting positive emotions, reducing stress, and distracting patients from focusing on their pain. (Malenbaum et al., 2008; Ulrich et al., 2006; Ulrich, 2008) Medical Staff … the use of acuity-adaptable rooms can substantially reduce possible sources of medical error (such as transfers, delays, communication discontinuities among staff, loss of information and changes in computers or systems.
  5. Infection Prevention is paramount in a Healthcare facility. What if we can use materials that are easier to sanitize? What if we can actually get into the cavity of the wall to insure mold is not growing? What if we can get everything up off the floor and have it easily support from a horizontal detail on the wall – including wardrobes, patient bedside tables and even IV stands? When doing renovations, what if we can avoid drywall dust, having to seal off a ward under construction, and having to seal off base building mechanical? What if we can change the behaviors and do clean construction instead? Additional Information In 2002 alone, hospital-acquired infections in U.S. Hospitals Numbered approximately 1.7 million, and the number of associated deaths reached 98,987 (Klevens et al., 2007a). This means that approximately 1 of every 22 hospitalized patients acquired an infection. According to the CDC (2000), the cost of treating hospital-acquired infections is estimated to be $5 billion per year. (Weinstein, 1998) A telephone survey of a national sample of U.S. households found that 93% of respondents indicated that if information on hospital infection rates were published, it would influence their selection of hospitals (McGuckin, waterman, & Shubin, 2006) Sources and Environmental routes of Airborne Infections … pathogens can enter building from outside air through dust that harbors pathogens such as aspergillus, streptococci, or staphylococci (Beggs, 2003)
  6. Impact of the interior space on the effectiveness of patient healing. The environment plays a huge role in the successful treatment of a patient. Every decision that we make on the interiors ultimately impact the patient and those who work in the environment. Contemporary design of interior spaces in hospitals is based on making the inpatient hospital a friendlier, more responsive place. The change in the look of hospitals over the past 10 years reflects the recognition that hospitals must be sensitive to patients’ needs, for comfort, control and other psychological requisites. Also must be designed to increase its comfort, appearance for not only patients, but also family, visitors, physicians, nurses and all hospital staff members. The built environment also impacts the speed of recovery for patients. A study of matched patients recovering from abdominal surgery found that those assigned to rooms with a bedside view of nature (trees_) had better postoperative recovery than matched patients assigned to identical rooms with windows overlooking the wall of a brick building. Patients with the nature view suffered substantially less pain, as indicated by their need for far few doses of strong pain medication than their counterparts with the wall view. …shorter post-surgery stays, better emotional well –being, fewer minor complications such as nausea and headache. Patients assigned a picture of a spatially open, well-lighted view of trees and water needed few doses of strong pain drugs than patients exposed to abstract images or a control condition of no picture (Ulrich et al., 1993) Effects of Daylight Exposure on Pain Patients in the bright rooms were exposed to 46% greater sunlight intensity than those assigned to more shaded rooms. Finding indicated that patients in rooms with more sunlight reported less pain and stress, and took 22% less analgesic medications, resulting in a 21% reduction in medication costs. … patient rooms should be carefully oriented and designed to receive natural daylight and maintain the normal light-dark cycle of 24-hour periods to help patients retain normal circadian rhythms and improve sleep. 80% of patients who reported poor sleep regarded environmental factors as the cause (Kuivalainen at al., 1998) But every decision that we make on the internal environment ultimately impacts…..
  7. Every decision that we make on the internal environment impacts our external environment. Some facts: For every square foot of new construction we create 3.89 lbs of material waste (that is a commercial number, you can double it for Healthcare construction). For every square foot of drywall we introduce into an environment, we create 1 lb of material waste from cutoffs from doors, windows, etc. When we renovate a unit in a hospital, the EPA shows that we create 155 lbs of material waste per square foot. Instead of worrying about diverting waste…what if we don’t create it in the first place? That’s what a modular solution brings to a healthcare facility. Being able to reduce the waste, and being able to reuse our interiors. There is a movement for sustainable spaces. Construction behaviors in healthcare care environments need to change – focus on reduce and reuse. This is true sustainability. Additional information: Trends show that we are not only building new hospitals, but also reusing and retrofitting existing healthcare facilities. With the rapid changes in healthcare delivery, the impact on inpatient care is significant and constantly evolving. With traditional fixed in place construction, the only way to facilitate that change is by demolishing the built environment, throwing out the construction waste, and starting to build from scratch with drywall.
  8. As it relates to healthcare, DIRTT has not created a new “healthcare” wall. This is the same solution that we have been delivering for the past 5 years in a multitude of different markets.
  9. DIRTT has not changed our product to respond to a patient care environment…it is the very nature of the DIRTT walls in that they are completely parametric in design and can respond to a multitude of demands of the built environment. The walls really don’t care what type of environment they are in. We have only added options as it relates to finishes that better suit a healthcare environment.
  10. DIRTT represents true flexibility by being able to quickly reinterpret a space without any major disruptions. The whole notion of Universal rooms is gaining a foot hold in the design of healthcare environments
  11. DIRTT represents true flexibility by being able to quickly reinterpret a space without any major disruptions. The whole notion of Universal rooms is gaining a foot hold in the design of healthcare environments
  12. The patient room may start as a Critical Care Unit. Perhaps demographics change over time and the acuity levels need to change…what was a Critical Care Unit today,
  13. Can become Labor and Delivery unit. The flexibility of the tiles means that without having to take down structure, we can simply gain access to either add or take away technology in the wall, easily handling different levels of acuity. Being able to integrate things such as an Amico Art wall to make the med-gases discreet in the space…
  14. Showing the art wall in an open position, med gases easily accessible.
  15. Four years from now…the room may need to be a Med/Surg suite, again the walls can handle the need for flexibility over time. * The DIRTT walls essential have 4 distinct layers: The first layer is the structure that sits in behind (antler is showing through as part of the structure) The second layer is what sits out front… the tiles. The third layer is the technology that is supported in the wall – med gases, electrical, data, LED screen, flat screen monitors…and the 4 th layer is where the wall actually sits in the environment. All four layers can change independently of one another, without disturbing the other layers.
  16. LED Screen imbedded in a modular wall behind back painted glass LED screen’s are 1” thick, and use 40% less energy Some benefits in imbeding the technology behind a glass tile: Mounting Technology behind glass reduces the amount of horizontal surfaces that need to be cleaned Glass is very easy to clean The technology has been protected from the patients Tile is easily removable with a special tool to allow easy access to either repair or switch out to newer technology over time.
  17. The horizontal detail can support things like monitor arms without the need for additional blocking in the wall. The technology can also sit anywhere along that horizontal – it is not dedicated to one spot. USB ports can be incorporated into the wall as well. Address this in slide 22.
  18. DIRTT walls can support medical gas outlets, medical gas pipelines, zone valves, gas control panels, alarm systems, electrical and data. Because of the horizontal antler, we do not need blocking in the wall; this means we never have to worry about interference with these critical elements in the cavity of the wall.
  19. The design process in healthcare environments is often overwhelmed by the functional needs of medical science, and too often the psychological needs of the patient and the family are overlooked while the body is treated. Patient experience – USB port to bring their own drive with family photo’s that can be displayed on a screen, or their own music. Integrating patient entertainment such as iPod docking stations, DVD, and other systems right into the wall
  20. Instead of having the TV bolted to the ceiling, we can support it from the horizontal antler detail for better viewing for the patient
  21. New “Write Away” Film - This amazing factory applied film is specified for painted or veneered tiles turning them into elegant marker boards. It is available in dozens of standard colors and is also available in custom colors and custom veneer applications. You can also specify custom graphics like you see above. Things such as hospital signage can also be incorporated right into the wall. One project we are working on is a pediatric playroom where they are specifying cartoon characters on the write away surface…the kids can come in a color in the characters right on the wall. Dry-erase markers wipe off without ghosting the Write Away. Even unintended use of non-erasable markers can be removed with appropriate cleaning products.
  22. Sit Stand Application – Being able to respond to ergonomics in areas such as nurses’ stations – flexible environment. This is a perfect solution. Fun Fact – Hospitals lose a substantial percentage or RN’s every year due to worker comp claims and long term disability
  23. Sit Stand Application – Being able to respond to ergonomics in areas such as nurses’ stations – flexible environment
  24. Sit Stand Application – Being able to respond to ergonomics in areas such as nurses’ stations – flexible environment
  25. Sit Stand Application – Being able to respond to ergonomics in areas such as nurses’ stations – flexible environment
  26. Sit Stand Application – Being able to respond to ergonomics in areas such as nurses’ stations – flexible environment
  27. Any of a hospitals standards can be incorporated from the horizontal antler. The walls are completely product neutral. For example, patient lighting being supported from the antler extrusion.
  28. Again the walls are completely product neutral. Hand rail supported directly from the antler extrusion. Handrail locks into place. No drilling into or damaging the tiles on the modular wall. The biggest thing is we do not need additional blocking in the wall to support hand rail details. Over time this handrail can be removed, and no repair is ever needed on the wall.
  29. Ability to support other products such as bed locators, plug and play electrical & data, and medical architectural products such as flat walls and equipment rails. The antler is where you can put the DIRTT walls to work, but there are going to be certain areas where you do not want the horizontal and vertical reveals…the DIRTT solution is to butt joint the tiles vertically, or once you have everything hanging of the wall as needed, (next slide)
  30. DIRTT has a gasket detail that can seal up either the vertical or horizontal seams once the wall is up.
  31. DIRTT has a gasket detail that can seal up either the vertical or horizontal seams once the wall is up.
  32. Acoustics is critical in healthcare environments. Today, the traditional method of dealing with acoustics is building slab to slab to construction. Great solution, but it does not respond to the reality of change in healthcare environments: For example, new data being run means that a data contractor is up in the plenum putting a hole into the slab construction to run new cabling. This means that we have now degraded the acoustical solution with a penetration. The better solution is sound masking: Sound masking is no longer white noise, it is now pink spectrum noise (40 different sound waves audible to the human ear that are scrambled constantly. This means that you can never audible focus in on a base sound – much more discreet) It’s a solution for 100% of the environment, not just where there are walls. It is also tunable to different levels of traffic. For example, you can tune it up over a nurses station. For a MOB (Medical Office Building) you can tune it up in the exam room as well as outside in the corridor. If the traffic level changes over time…it can be tuned down. About $ 1.25 a square foot as opposed to the cost of slab to slab construction Different systems can be run through the soundmasking speaker: paging systems, life safety systems Sound masking can add a factor of +10 to the environment (i.e. DIRTT solid walls have a 44 STC rating…add sound masking and the environment now reads at 54 STC rating. Call your local sound making solution provider Additional Information: 80% of patients who reported poor sleep regarded environmental factors as the cause (Kuivalainen at al., 1998) Single bed rooms can reduce noise disturbance from roommates, visitors, and healthcare staff (Southwell & Wistow, 1995; Yinnon, Ilan, Tadjor, Altarescu, & Hershko, 1992), and thereby improve patient sleep (garbor et al., 2003). Second, experimental studies support the installation of high-performance sound absorbing materials to reduce reverberation time, sound propagation, and noise intensity levels, as well as to improve sleep.
  33. 8018072 ICEBERG!!!!!
  34. Modular may not be all things for all environments – for example, a modular wall will never be a fire rated wall. There will be some areas, due to code that conventional construction will be the right solution. However, there are many areas in a healthcare facility where modular is a solution.
  35. NeoCon East Patient Room: Horizontal is supporting everything off of the wall Cove base detail Thermofoil finish on the tiles, as well as butt jointed tiles for the verticals Patient Bedside table supported from the antler Med gases supported in the wall iPod docking stating right in the wall Horizontal gasket detail
  36. Horizontal rail detail from Amico – all accessories supported from the horizontal WAHU case goods – all being supported from the horizontal antler. Wardrobes, sink units, etc WAHU has a great drawer detail – completely hands free This area is easy for house keeping to come in and clean as there are no impediments sitting on the floor. Better ability for infection prevention.
  37. Art wall detail from Amico – the ability to hide the med gas outlets, and incorporate that unit right into the wall.
  38. Arcadia Assisted Living Facility – Hawaii Instead of a curtain separating the beds in semi-private rooms, they wanted more privacy between the patient beds. Cornice height moveable wall. Key details: etched glass to bring daylight through to the second patient bed. The wall is being put to work by supporting the television arm. 4” offers much more of a sense of privacy than a typical curtain application.
  39. Providence Hospital – Physio and Rehab Facility – Anchorage, AK This client used a completely modular solution on this large floor plate. Key items: Barn door to get rid of the 9 sq ft of swing space – more efficiency in the patient treatment rooms. True acoustical seal around the barn door for speech privacy Other manufactures product hanging off of the horizontal – the product no longer dictates the modular size of the wall, and it can be supported anywhere there is a horizontal. The esthetic was exactly what the designer wanted
  40. AnMED ER Department
  41. AnMED ER Department
  42. Hermann Eye – Boston, MA DIRTT can also do a vanilla solution (but why would you want to sustain ugly?) Thermofoil wrapped tiles…but they thought about future flexibility in the environment by including a horizontal detail on the demising wall that can support medical cabinetry in the future.
  43. Herman Eye – Boston, MA
  44. New York Infirmary Waiting Room / Crossroads Dental – Vancouver BC Key items for the waiting room: more privacy for those checking in, and we have created a sense of division without taking away important sight lines for the medical staff.
  45. Northwestern Prentice Women’s Hospital – Chicago, IL This is a modular solution: what a beautiful patient intake area. Picture the cost of doing this conventionally, and the amount of trades required. This is stand up construction for the interiors.
  46. Banner Health – Gilbert, AZ Another example of a patient intake area
  47. Seattle Genetics DIRTT is a perfect solution for lab and pharmacy departments. Typical solution would be constructing a drywall pony wall on top of this bench. We can use the DIRTT parametric wall and have the gases, electrical, data done in a manufactured setting. Huge construction schedule saving using a modular solution.
  48. Seattle Genetics Example of gases and electrical coming through the wall. All was a pre-engineered solution, not pulling pipe and wire on site.
  49. St Joseph’s Hospital – Tampa, FL These are the DIRTT walls…just shorter. Perfect solution for a nurses station. Again, electrical run in a manufactured setting and the electrical contractor just need to tie of to the j-box. Sit stand leg should also be used in this solution. Can daisy chain up to 16 legs together from one control
  50. St Joseph’s Hospital – Tampa, FL
  51. Piedmont Spine, Atlanta GA – Waiting Room Stickbuilt faceted wall
  52. Piedmont Spine, Atlanta GA – Waiting Room Stickbuilt faceted wall
  53. DIRTT has also done physician lounges, break out rooms, cafeteria areas in additional to conference rooms
  54. Seattle Children’s Hospital – Seattle, WA
  55. Seattle Children’s Hospital – Seattle, WA
  56. St John’s Healthcare - Springfield
  57. DIRTT is a solution for not only new construction, but really shows it’s powerful benefits in existing hospitals and the need for responding to change. Use the Dialysis / Chemotherapy rooms as an example – challenge that the client was having was that they could not seal off this area properly as per HEPA standards, and they could not cancel appointments. A modular wall solution was the best fit: the walls arrived on site ready for tilt up construction, no drywall dust getting into the air handling systems, no need to cancel appointments – work was done during normal unit hours, and they got the look they were looking for. The patients had rave reviews about the updated environment. Clean construction for the interior. Did not need to divert any waste. DIRTT Modular walls can be created to suit virtually any need. The power of a simple set of components assembled to suit space needs.  
  58. There is a growing body of evidence that well designed supportive health care environments improved outcomes. *Reduced stress/anxiety for Patients *Improved sleep quality *Lower infection occurrence *Improved patient satisfaction* *Benefits for Personnel: Reduced workplace stress; reduced turnover; attract and retain *Cost savings by improving medical outcomes .Some patients moved sooner from intensive or acute care to less costly care