How has the Perth Children’s Hospital work environment impacted on patient, family and nurse experience?

None listed

The new Perth Children’s Hospital (PCH) is designed to maximise patient and family centred care and improve workflow. The intention is to improve direct patient care, placing children and their families at the centre of care by focusing on systems that will enhance nurse workflow and allow nurses to spend more time at the bedside. Key workflow changes include the physical layout – a larger footprint and single rooms, improved facilities for parents, automatic medication dispensing and hands free communication technology. It is anticipated that the layout, technology and communication platforms will contribute to improved workflow and increase nurse time in direct patient care. Nurse time spent with patients is associated with patient and family satisfaction, less error, improved outcomes for patients, and with nurse satisfaction. It is anticipated the inclusion of new technologies will facilitate workflow and nurse time at the bedside. The single-patient room model also has many reported benefits such as improved privacy and infection control practices. However, nurses have voiced concern about the impact of single rooms on communication, patient safety, and nurse ability to access help. Anecdotally, local consumers have also voiced their concern related to patient and family isolation and decreased nurse accessibility. There has been limited research evidence of the impact that hospital moves have on workflow and communication. This study will measure nurse workflow, patient, family and nurse experience, and patient outcomes before and after the move to PCH. This will provide a comprehensive evaluation of the impact of the new hospital environment for patients, families and nurses. The three stage mixed methods design includes three time periods of data collection with an interrupted times series analysis as well as a before and after comparison. For the interrupted time series there are two sources of data collection; 1) the experiences of 15 children, 15 families and 15 nurses per week for 10 weeks will be captured using surveys at PMH, 3 months after and 12 months after the move to PCH, 2) routinely collected monthly hospital patient outcome data for 12 months at PMH before the move to PCH and 12 months post move. For the before and after comparison, two sources of data will collected at PMH and 12 months after the move to PCH. These data are; 1) time and motion observation of nurse workflow for a total of 60 hours for 15 nurses working in 3 inpatient areas, and 2) the Practice Environment Scale Nurse Workforce Index survey to be completed by all nurses (n=800) at PMH and 12 months after the move to PCH. In addition 3-4 nurse focus groups will be held at 3 and 12 months after the move to PCH to understand nurses’ experience of the PCH work environment and identify areas and opportunities for workflow improvement.