CHOA SCU/EUHM BCU
Children’s Healthcare of Atlanta (CHOA) Special Care Unit (SCU)/ Emory University Hospital Midtown (EUHM) Mother-Baby Biocontainment Unit (BCU)
Keywords: Implementations, Design Review, Biocontainment Unit (BCU)
Methods: Mock-Up Simulation, Functional Scenario Analysis
The SimTigrate Design Center’s ultimate goal is the implementation of our research findings in real-world scenarios. As part of this effort, we provide our expertise and knowledge of evidence to advise the design of BCUs in local Atlanta building projects, including Children's Healthcare of Atlanta (CHOA) and Emory University Hospital Midtown (EUHM).
For the CHOA Special Care Unit, the SimTigrate team collaborated with CHoA in mock-up simulations to observe and document the space utilization, and conduct Functional Scenario Analysis to provide systematic evaluation and feedback on proposed design options and optimize the final design solution for the SCU.
For the EUHM Mother-Baby BCU, the SimTigrate team collaborated with researchers from Pacific Northwest National Laboratory to evaluate the design for biocontainment use, the unit layout for the simulation and training lab, as well as the overall lighting quality.
The PEACH Project
Prevention Epicenter of Emory and Atlanta Consortium Hospitals
Keywords: Infection Control, Built Environment, PPE Doffing Safety
Methods: Simulations
The study objective is to identify ways that the built environment may support or disrupt safe doffing of personal protective equipment (PPE) in biocontainment units (BCU). We observed interactions between healthcare workers (HCWs) and the built environment during 41 simulated PPE donning and doffing exercises, conducted across the BCUs of four Ebola treatment facilities and one high-fidelity BCU mockup. In total, 64 participants took part in this study, including 41 doffing HCWs and 15 trained observers (TOs).
In each facility, we observed how the physical environment influences risky behaviors by the HCW. The environmental design impeded communication between TOs and HCWs because of limited window size or visual obstructions with louvers, which allowed unobserved errors. The size and configuration of the doffing area impacted HCW adherence to protocol, and the lack of clear demarcation of zones resulted in HCWs inadvertently leaving the doffing area and stepping back into the contaminated areas. Lack of a standard location for items resulted in equipment and supplies frequently shifting positions. Finally, different solutions for maintaining balance while removing shoe covers (ie, chair, hand grips, and step stool) had variable success. We identified the 5 key requirements that doffing areas must achieve to support safe doffing of PPE, and we developed a matrix of proposed design strategies that can be implemented to meet those requirements. In conclusion, simple, low-cost environmental design interventions can provide structure to support and improve HCW safety in BCUs. These interventions should be implemented in both current and future BCUs.
Access full publication:
Design Strategies for Biocontainment Units: Creating Safer Environments
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Serious Communicable Disease Unit (SCDU)
Keywords: Patient Experience, Biocontainment Unit (BCU)
Methods: Interview
The project aims to understand the Ebola patients’ experience living in a BCU and learn how the built environment impacted that experience. Our team had the opportunity to interview all 4 Ebola patients treated at Emory University Hospital in 2014 and 2 of the nurses who cared for them about the care experience. This qualitative study looks at the unique needs of patients with highly infectious diseases treated in BCUs, their experiences while held in isolation, and how those needs change over the course of their stay. This study has given us great insight into the patient’s perspective and how the patient room can be designed to improve their experience while in isolation. Through this project, SimTigrate became the first research lab to interview patients who were treated for Ebola in the United States.