Related Experiment Video
Updated: Nov 19, 2025
06:48
Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
9.8K
Lessons Learned From Decentralization of an Elective Surgery Medical-Surgical Unit.
Laurie Waggener1, Debajyoti Pati2, Apoorva P Rane2
1EYP Architecture & Engineering, Houston, TX, USA.
HERD
|February 2, 2021
Summary
Moving to a decentralized unit improved healthcare staff perception of the work environment and reduced patient falls. However, some areas like walking distance and collaboration need further attention.
Area of Science:
- Healthcare Design
- Nursing Unit Configuration
- Patient Safety
Background:
- Previous research on decentralization yields inconsistent findings.
- The impact of unit configuration on the physical work environment and patient falls requires further investigation.
Purpose of the Study:
- To evaluate changes in healthcare practitioners' perception of their physical work environment.
- To assess patient fall trends after transitioning from centralized to decentralized unit configurations.
Main Methods:
- A pretest-posttest study design was employed on a medical-surgical unit.
- Healthcare staff perceptions were assessed via surveys and interviews before and after the configuration change.
- Patient fall data were analyzed over a 3-year period using statistical models.
Main Results:
- Favorable changes were noted in perceived supportiveness of design, equipment location, peer support, process flow, and overall satisfaction.
- A significant reduction in patient falls was observed post-decentralization.
- Challenges identified include increased walking distances, decreased multidisciplinary collaboration, and issues with alarm audibility and PPE location.
Conclusions:
- Successful unit redesign requires a holistic approach integrating operations, processes, policies, culture, and physical design.
- Decentralized models can positively impact staff perception and patient safety, but require careful planning to mitigate potential drawbacks.
