Findings from a research study funded by the AAHF (Academy of Architecture for Health Foundation) grant and Herman Miller will be reported in this presentation. The issue of handedness is currently gathering prominence in healthcare architecture. The concept of same-handed rooms was borrowed from the aerospace industry to reduce errors (and hence improve patient safety). In aerospace, reducing physical environment inconsistencies through standardization of flight deck controls showed that the chances of operating the wrong switch or control during emergency are reduced. Identical argument drives the concept of same-handed rooms, asserting that standardization reduces cognitive demand and help automate several cognitive processes.

However, the concept of same-handed rooms is predicated on the assumption that we have a thorough understanding of the way nurses behave naturally during care delivery, and there exists common patterns of behavior that could be best supported by one physical design configuration. Neither of these assumptions, however, have evidence to support or refute them.

In order to gather preliminary empirical evidence pertaining to handedness of care environment, a simulation study was designed by researchers from HKS Architects and faculty of the UT Arlington School of Nursing. The newly opened Smart Hospital in UT Arlington was used as the setting. Twenty nurses, 10 right handed and 10 left handed, simulated 27 scenarios each, resulting in a total of 540 simulation runs in May 2008. The scenarios involved 3 typical nursing tasks:
1) check vital signs,
2) conduct suction, and
3) help the patient sit and dangle.

The three tasks were repeated in nine physical configurations, that ranged between having no environmental constraints (just the patient bed) to scenarios where direction of approach was manipulated and an IV connected to the patient's hand. A patient actor was used for all simulations. All simulation runs were captured in video. Coding of video segments are currently in progress by nursing and ergonomic experts. Data analysis is expected to provide evidence for the following hitherto unanswered questions:
1. Are natural (basic) nursing behaviors random and unrelated to caregivers' characteristics?; In what manner are right-handed caregivers different from left-handed caregivers?
2. Do physical design elements impose constraints on natural (basic) nursing behavior, for both right-handed and left-handed caregivers?
3. If so, in what types of nursing behavior and what subgroups of caregivers are potentially uncomfortable, stressful and harmful behaviors observed?
4. Do same-handed (more specifically, right-handed) patient rooms promise a more supportive environment to the caregivers? So far as basic nursing activities are concerned, how do they compare with left-handed patient rooms?
5. From a facility design viewpoint, which elements need additional attention to reduce the environment's impact on caregivers and patients (through the caregivers' activities)?