Why is patient visibility important? Patient visibility is a top factor affecting patient safety. This was the key finding of a 2008 study conducted by a group of researchers from Harvard Business School and Stanford University Center for Health Policy. Using a nationally representative sample of 20 hospitals across the United States, the study focused on identifying operational and physical design factors affecting patient safety. Facility (or physical design) and equipment related issues shared the top spot among the factors. Difficulty of observing patients resulting from poor layout was a recurring factor among physical design issues.

The fundamental challenge in optimizing patient visibility is that patient visibility is a complex construct. Outcomes of two studies conducted by the HKS Research Group suggest that patient visibility is not merely a visual phenomenon. In a multi-site study conducted in 2006 to understand and identify physical design decisions impacting operational flexibility, study data demonstrated that patient visibility has an additional dimension of consequence that of auditory connection with the patient room. A third dimension emerged from a recent study conducted at a major tertiary care center, where it was found that in-board rooms (with completely obstructed sightline from the corridor) were perceived to have better patient visibility as compared to outboard rooms (with full and easy visibility of the patient from the corridor). A closer analysis showed that the mean distance between the in-board room locations and the documenting/support spaces was half of the distance between the outboard rooms and documenting/support spaces. This suggests that physical proximity, where caregivers can document, mentor and socialize in locations proximal to assigned patients, is a significant third dimension of the construct visibility, and may in fact be more important than sightline obstructions from the corridor.

What does this mean for bed unit design? The presentation will introduce the three research studies mentioned above, in order to articulate the three dimensions of visibility, hitherto perceived as a simple construct. Attributes of unit design/configurations that adversely impact visibility will be presented, based on HKS study findings. Study data that shows limitations and constraints pertaining to technology solutions in this new 3-dimensional framework of patient visibility will be articulated. Operational challenges and psychological factors in optimizing visibility will be explored. Audience will be encouraged to propose potential solutions to optimizing patient observation, and hence safety, during the Q&A session.