Peter S. Harsh, AIA, CCS Todd A. Gindelberger, AIA Ami M. Bement, Interior Designer E. Lynn App Architects, Inc. Englewood, Ohio Mary M. Gregory, RN, BA, BSN HealthCare Design Consultant, Cincinnati, Ohio Karen S. Herby, RN, MBA, CHE Director, Surgical Services, The Children's Medical Center, Dayton, Ohio

In recent years there has been a dramatic shift in surgery departments from inpatient to outpatient procedures. The Department of Surgical Services at the Children's Medical Center in Dayton, Ohio, has experienced this change with an increased overall volume of 32 percent since the last department renovation in 1989. The existing open-bay preop and postop units were found to be inefficient in terms of space and staffing, and lack of privacy was problematic.

A team of architects, consultants, and hospital staff was formed to investigate the possibilities for improvement, given the limited space available in and around the existing surgery department. It was determined, after a preliminary analysis of the spatial requirements, that a new model of care would be the best solution for the renovated suite. The new model of care would allow nurses and staff, who formerly cared for many patients in open-bay bed configurations, to be assigned to a small group of patients in single rooms. The single room model therefore became the desired spatial model for the renovated suite floor plan.

The benefits of the single room model include:

•	Greater privacy for patients and parents
	Auditory
	Physical and visual
	Olfactory
•	Enhanced confidentiality
•	Improved infection control
•	Better room flexibility
•	Increased customer satisfaction.

The opportunity to test early space planning solutions arose during the design process. A computer simulation program was used to model the traffic flows of patients and staff at different times of the day. In this case the simulation reinforced the space planning theories.

Design issues such as wayfinding, lighting, and color selection were addressed with the patients and parents in mind. A theme of travel was selected early in the project as it appealed to young and old alike. In terms of navigating through the Day Surgery Area, compasses in the flooring and framed maps on the walls act as landmarks. The lighting throughout the corridors and patient rooms is indirect, allowing patients to be transported on gurneys without the glare of fixtures directly above them. The color palette of blues, greens, and beiges is calming and relates to the framed maps on the walls.

The single room model is proving to be successful on many levels at this facility. Patients and parents appreciate the privacy and amenities offered in the individual rooms. The nurses and staff can now focus on a few patients for an entire day, allowing better quality and continuity of care. Finally, from a marketing standpoint, the renovated suite with private rooms provides features that exceed those of other area outpatient surgery centers.

Photos/Plans

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