Healthcare Design - October 2013 - 30

C THE CENTER | 10.13
Ensuring safety by design
Development is under way on a safety risk assessment toolkit meant to
enhance focus on patient and worker safety in the healthcare environment
By Debra Levin
Thanks to a grant from the Agency for Healthcare Research and Quality (AHRQ), The Center
for Health Design (CHD) has embarked on a
three-year quest to make hospitals safer for
patients and staff. As part of this project, CHD
and its partners, the Facilities Guidelines Institute (FGI) and MedStar Institute for Innovation,
invited industry experts from a wide variety of
disciplines to a meeting in Washington, D.C.,
earlier this year.
Such a gathering isn't necessarily new to
our industry, but the spirit and energy at this
meeting was unique in so many ways. The goal
of the event was to come to a consensus on a
variety of approaches that would, in time, find
their way into a safety risk assessment (SRA)
toolkit. As anyone involved in a consensusbuilding exercise knows, they're complicated
and challenging. Add to the mix close to 100
professionals-all experts in their fields-and
a complex set of variables not easily compartmentalized, and you have what could easily
have been a disaster.
But far from that, what actually happened
was a bit magical. Throughout the two days,
people approached me to say that they could
feel a tidal shift at this meeting. There was a
sense of camaraderie and collaboration that
seemed to break through old barriers and help
form new alliances.
The focus and ultimate goal of the project is
to funnel all the energy and expertise from these
industry experts into the creation of the SRA
toolkit to supplement FGI's Guidelines for Design and Construction of Health Care Facilities
and significantly strengthen the focus on patient
and worker safety in healthcare environment
design. The charge during this first year, specifically, has been to develop the structure and
format that the toolkit will take, which included
coming to a consensus on the key hazards
and latent conditions to be considered and the
degree of risk associated with different environmental design features.
Early on in the process, the group cast a
wide net and over the course of the year worked
to narrow down that focus to core areas to be

considered. The in-person meeting allowed the
volunteers to discuss face-to-face the merits
and complexities of each of the final six areas
identified and come to a decision on what
would be included in the complete structure.

In six core areas, the physical
environment can play a role in improving
safety and reducing the potential
for errors.
Those six core areas are: healthcareassociated infections, patient falls and immobility, medication errors, patient handling and
movement, behavior health, and security. In all
of these, the physical environment can play a
supportive role in creating safer environments
and reducing the potential for errors.
Beyond developing the content for the
toolkit, the group was also charged with taking
a strategic look at how it could be successfully
and readily adopted once complete. Breakout
groups looked at how the toolkit might be
used in the healthcare design process, how it
would be adopted, its impact on workflow, and
potential barriers to successful implementation. The hope is that by 2015, the toolkit will
be available and will easily and quickly find its
way into application.
There are still two more years of work ahead
on this project and many pieces yet to be
developed, designed, and made intuitive to
use. The group will continue to meet by phone
over the course of the year and come together
again in person in mid-2014.
If this work interests you and you'd like to
learn more about it or keep abreast of progress, email me your thoughts. I'd love to hear
from you. HCD
Debra Levin, EDAC, is president and CEO of
The Center for Health Design. She can be
reached at dlevin@healthdesign.org.

Debra Levin
30

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