2024-01-18 23:15:00
THURSDAY, Oct. 20, 2022 (HealthDay News) — “Location, location, location” works in real estate, and a new study argues that the location of your hospital room might save your life following surgery.
Patients are more likely to die following surgery if they are placed in certain types of rooms to recover, researchers at the University of Michigan School of Medicine found.
Specifically, the researchers said patients can expect to have a better recovery if they:
Have a room to themselves instead of sharing it with another patient.
They are placed in the room closest to a nursing station on their floor.
They are in a location that offers a clear line of sight from the nursing station
How big was the difference? People who lived in rooms that did not include any of the positive features mentioned above were 50 percent more likely to die than those who lived in rooms that had all of the features, the research team reported.
The study was led by Dr. Andrew Ibrahim, assistant professor of surgery, architecture and urban planning at the University of Michigan.
In the study, Ibrahim and his colleagues reviewed the plans of the University of Michigan University Hospital, and rated each room to reflect design features that might influence patient outcomes.
They then used data from electronic medical records to find out how well surgical patients recovered when assigned to a specific room.
Their analysis included nearly 4,000 patients who underwent one of 13 different types of high-risk surgical procedures, including a kidney transplant or removal of the pancreas or colon.
Researchers were surprised to find that sicker patients already tend to be assigned to rooms with features that appear to promote better recovery, Ibrahim said.
“Clearly, there is some sense that the nursing managers who assign patients know that some rooms are better than others, because the sickest patients got rooms that had more of those features,” Ibrahim said. “Clearly, the sickest patients were being placed in individual rooms, near the nursing station, with better sight lines.
“That was very comforting, because the people who are doing this work on the front lines agree with us that not all rooms are the same,” Ibrahim said.
But the association between survival odds and room location held even following researchers controlled for factors such as age, the surgical procedure involved, and how sick the patient was before the procedure, he said.
“Still, we found that rooms with these features seem to do better,” Ibrahim said.
A double room increased a surgical patient’s risk of death during recovery by 35 percent, the study found, while people placed in rooms farther from a nursing station had up to a 36 percent higher risk of death. .
The researchers also tested whether having a room with a window view might help patients.
Their initial analysis suggested that a window view might improve survival by 20 percent, but that advantage “disappeared” when the researchers controlled for the patient’s age and health, Ibrahim said.
The findings are “very encouraging,” said Dr. Daniel Herron, chief of general surgery at the Icahn School of Medicine at Mount Sinai in New York City.
“While we are all aware of the effect our architectural environment has on our mood and comfort, we generally do not consider that it may have an impact on our surgical outcomes,” Herron said.
However, “to really know if hospital room type has an impact on mortality, a large, prospective, randomized trial would be necessary, which would be a difficult endeavor,” Herron added.
The results suggest that hospitals might better serve patients by evaluating their building design, Ibrahim said.
“In architecture, we have something called post-occupancy assessment,” Ibrahim said. “After a building is built and it is occupied, you need to evaluate how well the building is performing. That is done in less than 5% of hospitals in the United States. I think that, in light of our findings, it suggests that such Maybe we should do this more routinely and systematically.
Hospitals might also formally adopt the kind of patient placement strategies that apparently are already being used informally by nursing managers, Ibrahim added.
“As we better understand which rooms work best with the sickest patients, we can begin to adjust the size of our patient allocation,” Ibrahim said. “In the same way that we have precision medicine for this specific drug or this specific therapy for a certain type of patient, we will probably have some type of precision design where we can assign patients to the optimal room to give them the opportunity to the best recovery.
The researchers presented their findings Sunday at the American College of Surgeons annual meeting in San Diego. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.
More information
Harvard Business Review offers more information on how hospital design can affect patient outcomes.
SOURCES: Andrew Ibrahim, MD, assistant professor, surgery, architecture and urban planning, University of Michigan, Ann Arbor; Dr. Daniel Herron, chief of general surgery at the Icahn School of Medicine at Mount Sinai in New York City; American College of Surgeons, annual meeting, San Diego, October 16, 2022
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