Visibility-based layout of a hospital unit - An optimization approach.

Area of Science:

• Healthcare Facility Design
• Human Factors Engineering
• Operations Research

Background:

• Patient falls are a significant adverse event in hospitals, leading to potential disability or death.
• Existing research highlights the importance of nurse visibility for patient monitoring but lacks data on optimal unit layouts.
• There's a need to understand how physical space design impacts provider-to-patient visibility and patient safety.

Purpose of the Study:

• To develop an optimization model for hospital unit layouts that maximizes patient visibility and minimizes visibility inequity.
• To evaluate the impact of different inpatient unit layouts (L-shaped, I-shaped, Radial) on nurse-patient visibility.
• To determine the optimal placement of nurses and patient beds within these layouts to enhance patient monitoring.

Main Methods:

• An interdisciplinary approach combining human field of view principles with facility layout design.
• Development of a bi-objective optimization model to determine nurse location and patient bed orientation.
• Utilizing the ray casting algorithm to quantify visibility, considering nurses' visual field and depth perception.
• Employing Multi-Objective Particle Swarm Optimization (MOPSO) heuristic to solve the complex bi-objective model.

Main Results:

• The Radial layout demonstrated superior performance in maximizing patient visibility and minimizing visibility inequity compared to L-shaped and I-shaped layouts.
• A Radial layout can offer up to a 50% improvement in the equity measure over an I-shaped layout.
• The orientation and placement of patient beds significantly influence the overall visibility of patients within their rooms.

Conclusions:

• Inpatient unit layout is a critical factor in achieving optimal provider-to-patient visibility.
• Radial layouts offer a promising design strategy for enhancing patient monitoring and potentially reducing adverse events like falls.
• Quantifying the relationship between physical layout and visibility provides actionable insights for designing safer healthcare environments.