Re-designing rooms and re-engineering care to reduce infections

There's an article in the Wall Street Journal on the hospital room of the future. It notes elements of architectural and product design that can reduce the transmission of infection. Take a look at the graphic above. You'll note, for example, that on entering the patient room the sink lights up in red to remind healthcare workers to wash their hands. There are a number of other examples of using design to reduce infection in the graphic. One not specifically designed for infection prevention that may still be useful in preventing infection is the large video monitor on the footwall of the room. Let's say I'm a consultant and I have influenza. I could still interact with the patient without being physically present, not feel guilty about staying home, and not risk transmitting influenza to the patient. Obviously I could not perform all the elements of a physical exam, but not all follow-up visits require an exam, though I have heard rumors that some doctors perform perfunctory exams for billing purposes only. Moreover, does every consultant and medical student need to exam the patient every day? Think of how many contaminated stethoscopes and dirty white coats are touching patients every day with the majority of those interactions adding no value to the care of the patient. Perhaps one physician could examine the patient and the rest skype in.

I've been thinking lately that we really need to carefully exam all the things we do in hospitals and then engineer out the opportunities for transmission of infection. I was reminded of this by a paper in Transactions on Healthcare Systems Engineering, which examines something as simple as how ICU nurses cover patients for each other while on breaks. This paper points out that by providing a structured coverage arrangement the number of unique persons interacting with any given patient are significantly reduced, which potentially reduces transmission of infection. I bet there are many such  examples where re-engineering patient care could reduce the potential for infection transmission.

Graphic:  Wall Street Journal