DESIGN AND PLANNING GUIDE - CADdetails · to promote the ability to implement process improvements that support the clinician’s ability to administer care. ... , facilities can

Evolution™ Equipment Management Rail System

D E S I G N

A N D

P L A N N I N G

G U I D E

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EVOLUTION EQUIPMENT MANAGEMENT RAIL SYSTEM .......................................................................... 2 Planning and Design Tools .......................................................................................................................................2 Paladin Website ...................................................................................................................................................2 CADdetails.com ....................................................................................................................................................2TRENDS AND CHALLENGES ........................................................................................................................................3 Adaptability .............................................................................................................................................................3 Flexibility ..................................................................................................................................................................3 HCAHPS Scores ........................................................................................................................................................4 Lean,SixSigma,ContinuousImprovement&Kaizen ...........................................................................................4 Safety and Ergonomics ............................................................................................................................................4 Infection Control ......................................................................................................................................................5 Aesthetics ................................................................................................................................................................5 Sustainable Cost Reductions ...................................................................................................................................6 LifecycleCosts–ReturnonInvestment(ROI) ......................................................................................................6 PurchasingDeliversRealSavings .........................................................................................................................7CLINICAL ENVIRONMENTS .........................................................................................................................................8 Intensive Care Units - ICU ........................................................................................................................................8 Rail Placement .....................................................................................................................................................8 GasServices .........................................................................................................................................................9 Electrical/DataServices .......................................................................................................................................9 ClinicalWorkflow .................................................................................................................................................9 Med-Surg .................................................................................................................................................................10 HeadwallDesignusingEvolutionEquipmentRail ................................................................................................12 FootwallDesignusingEvolutionEquipmentRail .................................................................................................14 Emergency Departments .........................................................................................................................................15 PrivateRoomDesign ............................................................................................................................................15 EDExamHeadwall ...............................................................................................................................................16 EmergencyDepartmentBays ...............................................................................................................................18 Infection Control ......................................................................................................................................................19 EquipmentManagementStrategy .......................................................................................................................20 Ambulatory/SurgicalCare ....................................................................................................................................20 Physician’s Offices/Clinics........................................................................................................................................21ADDENDUM .................................................................................................................................................................22 Lifecycle Costs and ROI: A tale of two hospitals. ....................................................................................................22

TABLEOFCONTENTS

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The Evolution Medical Equipment Management Rail Systemempowersyourdesigntodeliverenhancedclinicaloutcomes;superiorworkflowscalability,safetyandergonomics,allwhilehelpingyourfacilityminimizecostsanddriveROI.

Thesystemiscomposedofrail,plates,adapters,anwdaccessoriestohelpyoucreatealinearandscalablecomponent-basedsolutionthatishighlyorganized,clinicallyefficient,verticallymanaged,andeasytomove,change,andadapttoexistingandfutureneeds.

Planning and Design ToolsPaladinHealthcare™hascreatedanentiresuiteofplanninganddesigntoolstohelphealthcareenterprisesandarchitectscreatesaferandmoreefficientpatientenvironments.YoucanaccesstheentirePaladinproductline,whichfeaturesCADdetailsandspecificationsinmultipleformatsincludingRevit,atthePaladinwebsiteorattheCADdetails.comwebsite.

Paladin Websitehttp://www.paladinhc.com/

CADdetails.comhttp://www.caddetails.com,simplykeywordsearchPaladinorusethedirectlinkbelow.http://www.caddetails.com/Main/Company/ViewCompanyContent?companyID=5085

EVOLUTIONEQUIPMENT MANAGEMENTRAILSYSTEM

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AdaptabilityHospitalsareplanningfacilitiesandpatientroomstobemoreadaptabletoanincreasingpercentageofhigheracuitypatientpopulationsasmoderatelyacuteconditionswillbeincreasinglytreatedatinpatientfacilities.Patientsinacutecarespaceswillbeincreasinglyunstableandrequireahigherpercentageofintensivecare.Asaresult,architectsandplannersneedtodesignpatientroomsthatcanmoreeasilyadaptor“flex”toaccommodatechangewithoutmajorservicedisruptionandcapitalinvestment.Theseadaptableroomsaredesignedtohandlehigheracuitypatientsandadditionaldevicesthatrequiremorecapacityforservices,connectivityandequipmentmanagement.

TheEvolutionEquipmentManagementRailSystempermitshospitalstoquicklyscalepatientroomstomeetshiftsintheircensusbyprovidingaflexibleworkflowinfrastructurefromwhichclinicaltools,devices,services,everythingnecessarytoprovidesuperiorcarecanbeaccessed.AddingandrelocatingaccessoriestoEvolutiontakesonlyafewmoments,youcanscaleupamed-surgroomorunitinminutesnotdays.

FlexibilityPatientcareandoutcomesareincreasinglysupportedbytechnologyatthebedsidesuchaslifesupportdevices,treatmentmodalities,monitoringsystems,PPE/hygieneequipmentandinformationmanagement.Ashospitalacuityincreases,additionaltechnologyisintroducedintothepatientroomandthebedsidethatpresentnewchallengestohavesufficientoutlets,spaceandconnectivity.Patientroominfrastructuremustbedesignedtoaccommodatetechnologyasdiverseasportableclinicaldevicestobuilt-inpatientliftsandhandlingequipment.

TheEvolutionEquipmentManagementRailSystemletshospitalsquicklyandefficientlyaddnewtechnologyandreorganizesupplementarycaretoolswithinthepatientenvironmentinamannerthatfacilitateschangestotheirworkflow.

TRENDS AND CHALLENGES

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HCAHPS Scores HospitalsandhealthsystemsconstantlystrivetoimprovepatientscoresasmeasuredthroughtheHospitalConsumerAssessmentofHealthcareProvidersandSystems(HCAHPS)survey,theresultsofwhicharetiedtoCMSreimbursementsusingthehospitalvalue-basedpaymentmodel.

TheHCAHPSsurveyfocuseslargelyonthepatient’sexperienceofcare,whichstronglyreinforcestheneedfordesigntopromotetheabilitytoimplementprocessimprovementsthatsupporttheclinician’sabilitytoadministercare.Agrowingbodyofresearchindicatesthatthepatient’sperceptionofcleanlinessisimprovedbytheeliminationofclutter.CluttercanleadtolowerHCAHPSscores.Cluttercandiminishworkflowandstaffresponsiveness.

EvolutionMedicalEquipmentManagementRailSystemletsyoudesign,sustainandmaintainorderinthepatientenvironment.Creatingaclean,clutter-freespaceforpatients,cliniciansandfamilyprovidesasenseofwell-beingandpromotescaregiverefficiency.AllofthiscanhelpyourclientandtheirfacilitiesonthejourneytolowerHCAHPSscores.

Lean, Six Sigma, Continuous Improvement & KaizenInordertokeeppacewithevolvingpatientneeds,healthcaredesignwillbecontinuouslyevaluatedtoensurethatcriticalmetricsarenotonlybeingmet,butalsobeingimproved.Instillingworkflowflexibilitythroughoutthedesignofhealthcarespacesenablefacilitiestoquicklyandeasilyreconfiguretheirworkflow,improvetheirmetricsandmaximizetheirinvestmentin“leanprocesses.”

EvolutionMedicalEquipmentManagementRailSystemsupportsafacility’sneedtoengagecontinuousimprovementandrealizecostsavingandefficiencyresultsquicklyandefficiently.It’sadynamicrailsystemthathelpsparlevelcriticalinventory,empowersworkflowandpermits“realtime”adjustmentinprocessesyieldingimmediateROIfortheentireteamandthepatientstheyserve.

Safety and ErgonomicsTheU.S.continuestoexperienceashortageofRegisteredNurses(RNs)thatisexpectedtointensifyasBabyBoomersageandtheneedforhealthcaregrows.Today’snurses’averageageis50.Weneedmorenursesandweneedtodesignspacesthatminimizebending,reaching,stretchingandlifting:allkeycontributorstostaffinjury.

WiththeEvolutionEquipmentManagementRailSystem,facilitiescanavoidthepitfallsofpoorergonomicdesign.Evolutiongivestheentireteam(clinicians,architects,medicalplanners)theabilitytodesignsafeandeffectivecarespaces,minimizingthethreatofinjurytoallwhoengagethepatientenvironment.

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Infection ControlHospital-acquiredinfections(HAI)andothereasilytransmittablediseasesareaseriousconcerninmostfacilitiestodayastheyhaveadirectimpactonhospitalreimbursementrates.

Implementingsomeofthelatestbestpracticesinyourphysicalenvironmentcanhelptominimizetheirimpact—andhelpyougetthebestoutcomesfromyourefforts.Theequipmentmanagementstrategythatthedesignteamandhospitalcreatescanhaveaprofoundimpactoninfectioncontrol.Itisimportanttoacknowledgethatthisisaprocess.Architectsandhospitalsdesignandimplementstandard(directional)workflowthroughouttheirfacility,workflowthatwillalmostcertainlychangewiththeintroductionofnewtechnologies,newprocesses,andnewacuities;itisimportantthattheinfrastructurenotonlyaccommodateterminalcleaning,butalsothechangethatissuretocomewithclinicalprogress.

TheEvolutionEquipmentManagementRailSystemletshospitalstakehand-washingstations/handsanitizersandplacethemanywhere.Facilitiescanimplementtoday’sbestpracticesandleveragestandarddirectionalflow,toprovideeasyaccesstothesinkandhandwashingprotocols.Evolution’shighlycleanableinfrastructureisquicklyandeasilyadaptedtonewworkflowandtrueterminalcleaningiscreated.Insteadofcleaningarounddevices,bioengineeringisabletoremoveandcleanthedevices,therail,andthewalltohelpdeliveraclean,healthyenvironment.

AestheticsInadditiontostrivingtoachievethehigheststandardsofclinicalcare,hospitalsseektocreatewarmerandmorewelcomingenvironmentsforpatientsandfamilies.Implementingevidencedesignprinciplessuchasnaturalmaterials,accesstodaylightandminimizingsoundhelpcreateacomfortable,healingexperienceforpatients.Blendingfunctionalneedswithdesignfeaturestodeliveroptimaloutcomesand asatisfyingpatientexperiencecansecurecustomerandcommunityloyalty.

TheEvolutionEquipmentManagementRailSystemiseasilyintegratedintothefacility’shospitalitydesigngoals.Evolution™isaseamless,extrudedaluminumprofilewithaclearanodizedfinishfeaturinganintegratedgrooveallowingyoutoincorporateaseamlessstripofdecorativelaminateinlaytocoordinatewithyourdesign.Whenaredesignbecomesnecessary,simplyreplacethelaminatestriptomatchthenewaesthetics.Additionally,therailcanbepowdercoatedtomatchanyfixtureorfinishintheroom’senvironment.Anti-microbialfinishes(inselectcolors)areavailableaswell.

TheEvolutionEquipmentManagementRailSystemcancontributetotheaestheticoftheroom.Selecttheproperlaminate/finishanditcanvanishintothewalltowhichitisattached.Selectadifferentcombinationoflaminate/finishanditcan“pop”intotheroomcreatingafocalpointfordesign.

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Sustainable Cost ReductionsLifecycle Costs – Return on Investment (ROI)Forhospitalsandhealthsystemstoachievethekindofdeep,sustainablecostreductionsrequiredforsuccessintoday’shealthcaremarket,theymustcollectandminedatatoalterclinicianbehavior,leveragedesignandapplyprocessrigortoreducevariationsincareandestablishasenioradministrationthatleadsbyexample,relentlesslyseekingefficiencywhilemakingpatientcentricdecisions.

TheEvolutionEquipmentManagementRailSystemhelpssenioradministrationontheirquesttoachievethesegoals.Evolutionhelpssupportsmart,effectiveclinicalbehavior.Evolutionempowersdesignandprocessrigortobringbestpracticestoallareasofthehealthcareenvironment.Andthedataiscompellingandclear.EvolutionEquipmentManagementRailSystemhelpshospitalsandhealthcareproviderslowertheircostsandachieveROI.

Example: A Tale of Two Hospitals with 250 bedsFacilitiesareconstantlymakingchangestobemoreefficient,moreeffective,improvepatientsatisfactions,reduceHAI’sandcutcosts.Aprimeexampleofhowfacilitiescontinuouslyaddresstheircoststructureisthroughsupplychainmanagement.Thefollowingisasimple,all-too-familiarexampleofhowtheEvolutionEquipmentManagementRailSystemhelpshealthcareprovidersachievedeep,sustainablecostreductionsandit’sbuiltaroundasimple“costreduction”initiativeata250bedhospital.

Total Cost of Occupancy/Installation

Thistaleinvolvestwohospitals.HospitalAandHospitalB.Bothhospitalsarededicatedtorelentlesslyreducingcostsandarereviewingtheprojectedprojectcosts.Afterscrutinizingthenumbers,theadministrationofHospitalAdecidestominimizeTotalCostofOccupancyandattachclinicaltools(asmallsamplelistedabove)inthe“traditionalwall-mounted”method.HospitalB,however,optstoinstallrailsontothewallsinordertoprovideflexibility,scalability,clean-abilityandworkflow.ThenumberscertainlyappeartosupportthefinanceteamofHospitalA. Theywereabletosaveover$40,000!

Clinicalcarespacesarenotcreatedtolastaday,aweek,orsimplyayear.Newhospitals,renovationsorupgradestoexistingspaces…allarebuiltwitha30-50yearfunctionallifeinmind.Thestorycontinues.

Traditional Wall-Mounted

Installation

HandSoap $ 20

PaperTowelDispenser $ 40

FoamDispenser $ 30

Labor(90minutes@$30/hr) $ 45

InstalledDeviceCosts $ 135

CostsxNumberofRooms(250) $ 33,750

Hospital A

Rail-Mounted

Installation

HandSoap $ 20


FoamDispenser $ 30

3' Rail System $ 206




Hospital B

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Purchasing Delivers Real SavingsBothfacilities,HospitalAandHospitalB,belongtoapurchasinggroupwhojustrenegotiatedacontractwiththeirFoamDispensersupplier.Notonlydoesthenewfoammoreeffectivelyprotectpatientsandclinicians,butalsoitcostsless(boththedispenserandthefoam!)Thesavingsarerollinginandthehospitalislessthanayearold.


Replacement Costs New Foam Dispenser

NEWFoamDispenser $ 15

Labor(5hours@$20/hr) $ 100

Materials(Paper/Paste/Paint) $ 10

LostRevenue($70/hr) $ 350

CostsperRoom(Bed) $ 475

Costs x Number of Rooms (250) $ 118,750

Hospital A

Rail-Mounted




Materials $ N/A

LostRevenue($70/hr) $ N/A


Costs x Number of Rooms (250) $ 5,000

Hospital B

Bothhospitalsimmediatelyengageinimplementingthenewsavings.Dispensercostsalonerepresenta50%savings.HospitalAsendsmaintenanceuptoprytheold,wasteful,lesseffectivefoam-ladendispenseroffthewallandinstallthenewfoampartner’ssolution.It’sgoingtotakeaboutfivehours.Theyneedtopullthedispenseroffthewall,fixthewall,paintthewallandreattachthedispenser.Obviouslytheroomswillhavetobetakenoutofcommission(sothere’slostrevenue)whiletheworkisbeingdone.(There’squiteabitoflogisticalworkhereaswell.Lotsofplanninginvolvinganentirematrixofcareproviders,schedulers,administrativeassets.)

HospitalBsendsmaintenanceuptoremovetheoldfoamdispenserandattachthenewonetotherailsystem.It’sdonequickly,cleanly,effectivelyandwithoutanydisruptiontoclinicalprocesses.

Hospital A spent $118,750 dollars to secure their savings. Hospital B spent just $5,000.

First Year Lifecycle Savings


Lifecycle Costs First Year

TotalCostsofOccupancy $ 33,750

CostofFirstChange $ 118,750

Costs $ 152,500

Hospital A Hospital B

Rail-Mounted


TotalCostsofOccupancy $ 76,500

CostofFirstChange $ 5,000

Costs $ 81,500

Whatwentwrong?Bothhospitalswerededicatedtocontrollingcostsandcreatingpatient-centrichealthcareasapriority.HowisitthatHospitalAspentover$150,000dollarswhereasHospitalBspentonly$81,500dollarstoachievethesame(!)cost-savingsgoals?

TheteamatHospitalBfromplanninganddesignthroughtheadministrationunderstoodtheTrendsandChallengesfacingtheirfacilityandoptedtobuildaninfrastructuretolastthelifeoftheirhospital.Withakeeneyeonworkflow,scalability,adaptability,infectioncontrol,safetyandergonomicsandevenaesthetics,theyrelentlesslypursuesustainablecostreduction,clinicalefficiencyandpatientsatisfaction.SeetheAddendumonpage22toseeallofthetablesconsolidatedintoasinglesheet.

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CLINICALENVIRONMENTS

Intensive Care Units - ICUICU’shaveconcentratedspecialequipmentrequirementsandhighlytrainedpersonnelforthecareofseriouslyillpatientsrequiringimmediateandcontinuousattention(intensivecare,sometimescalledcriticalcare).Equipmentneedsoftenvaryfrompatient-to-patient.Workflow,scalabilityandtheabilitytocreateandmaintainacleanenvironmentareofparamountimportance.

Cliniciansinthisspacearealwayshighlyengagedandtheadministrationofcarecanrequirequickthinking,easyaccesstotoolsanddevicesandcanbephysicallydemandingaswell.

Rail Placement

Inordertominimizebending,stretchingandreaching(activitieswhichcancauseinjurytoclinicians,patientsandattendees)railsshouldbeplacedinthe“ergonomicstrikezone”between24”offthefloorand70”inchesoffthefloor.Herewe’veplaceahorizontalrailat31.5”,oneat45.5”andathirdrailat70”.

Limittheareaabove72”tovisualdisplays,whichareeasilymountedtotherailsystem.Avoiddevicesorstoragebelow28”astheseitemscancausetriphazardsandcanbedifficulttoclean.

RunningtheEvolutionEquipmentManagementRailSystemacrossthebreadthoftheclinicalzoneprovidesenhancedhorizontalandverticalinfrastructurefortheadditionalclinicaltoolsrequiredintoday’sICU.

O V O A NC A O V V

PATIENTMONITOR

CHARTINGMONITOR

KEYBOARD

120”

451/2” 54” 70

”

311/2”

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Gas Services

Configuringin-wallservicesshouldbebasedontheloadingofspecifiedservicesandmedicaldevicestobemountedinordertofacilitatepatientcare.Devicessuchasflowmeters,regulators,handsanitizers,etc.comeinavarietyofsizesthatifnotproperlyspacedcanrestricttheuseofoutlets.

Therecommendedminimumspacebetweengasservicesshouldbe4.5”center-to-center.Railsshouldbeplaced6”-18”belowgasoutletsinordertoprovideadequateclearanceforattacheddevicesthatmyhavesuspendedcanisters.

Electrical/Data Services

Minimumspacingbetweenelectricaldevicesis1.812”minimumanditisrecommendedthatcarebetakentoplaceelectric/databetween3”-6”belowtherailandnotdirectlyunderagasservice,inordertofacilitateclinicalaccess.

Clinical Workflow

Placechartingmonitorsandkeyboardsontherailonthesideclosesttotheroom’sentry.Thispermitsthecliniciantoquicklyaccessandassessthepatientandconductnecessarycareprotocolsandcharting.

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Med-SurgAmedical-surgical(Med-Surg)unitistaskedwiththecareofadultpatientsinabroadrangeofsettings.Patient’sneedsaretypicallynotasurgentasinanEDorasacuitydrivenasanICU,however,theneedtosupportclinicalworkflowandscalabilityhasneverbeengreater.

Let’sexaminetheuseoftheEvolutionEquipmentManagementRailSysteminthedesignofaMed-Surgorstepdownroom.

Med-Surg rooms, indeed many ICU rooms, are typically comprised of five clinical design opportunities:

1. Theheadwall,wheremedgases,electrical,dataandaccessoriesareconfiguredtosupportpatientcare, provideergonomics,powerworkflow,andenablescalability.(PR.2|Left).

2. Thefootwallspace,wherecliniciansengagehandwashing,PPEandotherclinicaldevices(PR.3).Oftentimes, cabinetryandotheritemsdesignedtofacilitatestorageareincludedhereaswell.

3. TheEntrywall(PR.2|Right)wherewecanstationstoragecontainersforclinicaltools,glovesormounthand sanitizerforeaseofuseuponentryorexit.

4. The“FamilySpace.”Thisiswherethedesigneraccommodatesloved-oneparticipationwiththeuseof healthcarefurnituresuchasrecliners,sidetables,sofas(includingpulloutsofastoenablelovedonestostay thenight).

5. TheBathroom.Med-SurgandStepDownpatientsareoftenwellenough,evenrequired,togetoutofbedand managementbathroomfunctionsontheirown(orwithamodicumofassistance).Facilitatingsafetraverseof thisareaisachiefconcernforclinicians,architectsanddesignersastheydesignpatientrooms.

PR.2LEFT

PR.3

PR.2RIGHT

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Right at home in the Emergency Department, the Evolution Equipment Management Rail System supports workflow and cleanability as no other system can. New tools, storage options and treatment modalities can be quickly configured so the room is ready in minutes and not days.

The Evolution Equipment Management Rail System at work in a Med-Surg environment. Evolution easily integrates with all commercial or custom wall panel systems to bring order, scalability and extendability to the patient environment.

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Headwall Design using Evolution Equipment RailRail Placement

Inordertominimizebending,stretchingandreaching(activitieswhichcancauseinjurytoclinicians,patientsandattendees)railsshouldbeplacedinthe“ergonomicstrikezone”between18”offthefloorand70”inchesoffthefloor.Herewe’veplacedahorizontalrailat43”,oneat56”,oneat69”,andoneat26”.

Therailat43”helpssecureaworkingsurface,integratesbedbumpers(byPaladinorothers)forwallprotectionandservestomountanynumberofclinicaltoolseasilywithinreachofcaregivers.

Therailat56”isusedtosecurethepatientmonitor,easilywithinreachofclinicians.Therailat69”facilitatesstorage,baskets,clinicaltoolsandadditionalspacefortracksandthemonitorsorelectronicdevicesrequiredtoprovidedataintheclinicalenvironment.Lastly,arailplacedat26”offthefloorhelpssecurevacuumcanistersoutofthewayofmedgas,nursecallanddataattachments(nottomentionthebed)butwellwithinthereachoftheclinician.Loweringthevacuumcanisteralsoremovesitfromthepatient’sfieldofvision,protectingthepatientexperience.AnintegratedGCXchannelforCPU,monitorsand/orkeyboard(hereleveragingtherailsplacedat43”and69”providessuperioraccesstothepatientwhilekeepingthefloorclearoftriphazardsandcleaningliabilities.

Limittheareaabove72”tovisualdisplays,whichareeasilymountedtotherailsystem.Avoiddevicesorstoragebelow28”astheseitemscancausetriphazardsandcanbedifficulttoclean.

LEFT HEAD WALL

120”26”

69”

56”

43”

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Gas Services

Configuringin-wallservicesshouldbebasedontheloadingofspecifiedservicesandmedicaldevicestobemountedinordertofacilitatepatientcare.Devicessuchasflowmeters,regulators,handsanitizers,etc.comeinavarietyofsizesthatifnotproperlyspacedcanrestricttheuseofoutlets.

Therecommendedminimumspacebetweengasservicesshouldbe4.5”center-to-center.Railsshouldnormallybeplaced6”-8”belowgasoutletsinordertoprovideadequateclearanceforattacheddevicesthatmyhavesuspendedcanisters.

Electrical/Data Services

Minimumspacingbetweenelectricaldevicesis1.812”minimumanditisrecommendedthatcarebetakentoplaceelectric/databetween3”-6”belowtherailandnotdirectlyunderagasservice,inordertofacilitateclinicalaccess.

Clinical Workflow

Placechartingmonitorsandkeyboardsontherailonthesideclosesttotheroom’sentry.Thispermitsthecliniciantoquicklyaccessandassessthepatientandconductnecessarycareprotocolsandcharting.

Aesthetics

TheEvolutionEquipmentManagementRailSystemiseasilyintegratedintothefacility’shospitalitydesigngoals.Evolutionisaseamless,extrudedaluminumprofilewithaclearanodizedfinishfeaturingandintegratedgrooveallowingyoutoincorporateaseamlessstripofdecorativeinlay.Additionally,therailcanbepowdercoatedtomatchanyfixtureorfinishintheroom’senvironment.Anti-microbialfinishes (inselectcolors)areavailableaswell.

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Footwall Design using the Evolution Equipment Management Rail SystemRail Placement

Mountingtherailsat52”,spanningtheclinicalworksurfaceandsink,providesahorizontal,mountable,movableandre-mountablesolutiontopowerclinicalworkflownowandinthefuture.Placementofasoapdispenser,handsanitizer,andglovesnearthesinkmakespromotinghandwashingsimpleandsustainable.Thefacilityisfreefromthemomentofcommissiontochangesuppliersanddevices,andtomove/relocatecriticalhandwashingassetswithoutthetime,troubleandexpenseof“pealing,paperingandpainting”surfaces.(SeethesectiononReturnOnInvestment,page7.)

Cabinetry Design

Justasintheheadwalldesign,railsareasuperiormethodfromplacingtoolsandequipmentwithintheclinician’sreach.Placingclinicalequipmentinsideofcabinetsisanoption,butonetobeconsideredcarefullyandwithgreatcareasitcreatesworkflowchallengesforcliniciansintermsofaccessandavailabilitytotheequipmenttheyneedtoprovidecare.

Whenincorporatingcabinets,suspendtheminamannertofacilitatecleaningbypermittingclearaccesstothefloorandbasemolding.Additionally,suspendingcabinetscanhelpprotectthemfromdamagefromcarts,COWs(computersonwheels)andothermobileclinicaldevices.

Entry Wall DesignJustinsidethedoor,hangarailat~66”,spanningthespaceoftheadjacentbathroom.Thisisaconvenientspacetoplacebasketsasreceptaclesforfrequentlyusedclinicalequipmentorpatienteducationperiodicals.

72”

52”

48”

66”

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Emergency DepartmentsTheeraoflong,fear-inducingwaitsinaged,impersonalemergencyroomsisdrawingtoaclose.TheAffordableCareAct,competitionamongsthealthcareproviders,andthedemandsofanincreasinglyengagedpatientpopulation,allhavecontributedtohospitalsystemsreformulatingtheiremergencydepartmentsintomorewelcoming,moreefficientenvironments.

TheED,historicallyagatewaytoadmissions,continuestobeafocalpointforhealthcaresystemsastheyseektoservetheircommunities,strengthentheirrelationshipsandsharpentheirfacilities.ThedemandforEDservicesintheUScontinuestogrow.

Private Room DesignTheEvolutionEquipmentManagementRailSystemisuniquelycapableofhelpinghospitaladministrators,architectsandcliniciansdeliverontheirgoalsofpromptandefficientcare.Let’sreviewsomeoftheplanninganddesignconsiderationsforPrivateRoomDesign.InthistypicaldesignwehavetheEDexamheadwallthatwillfeaturetheclinicalworkzonesnecessarytotriageortreatapatient.Therearesidewallsandafootwall,eachpresentingthedesignerwiththeopportunitytosupportclinicalworkflow,facilitatehandwashingandengagethepatientandfamily.

IN-WALLMEDGASOUTLETSED.1A

ED.1C

ED.1D

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ED Exam HeadwallRail Placement

Arailplacedat33”permitstheintegrationofwallprotection(bedbumpersorbedlocator)whileprovidinghorizontalanchoringofbasketsinwhichyoucanstorerapidlyaccessibleclinicaltools,hooksfortheambubagsandotherrespiratoryequipmenttoooftenhungfromthemedgasoutletsthemselves(whichrisksdamagetothedeviceandinfection),vacuumbottleslidestoquicklyattach,detach,cleanandquicklymaketheroomavailableforthenextpatient.

Arailplacedat48”providesflexibleandscalablesupportofgas,dataandelectricalservices.Basketsanda4-Binsupplyholdermaketools,cordmanagementtouncluttertheworkflow,equipmentandPPEnecessarytogivepromptattentiontopatientsquicklyandreadilyavailableatalltimes.

Arailplacedat71”maintainstheBPCuffandmanometer,thermometer,ophthalmoscope,gloveboxesandpatientmonitorwellwithinreach,whilegivingcliniciansunencumberedaccesstothepatient’shead.AnintegratedGCXchannelforCPU,monitorsand/orkeyboardprovidessuperioraccesstothepatientwhilekeepingthefloorclearoftriphazardsandcleaningliabilities.

Alloftheinherentbenefitsofscalability,flexibility,andworkflowareondisplayintheever-evolvingEmergencyDepartment.

Clinical Workflow

Placechartingmonitorsandkeyboardsontherailonthesideclosesttotheroom’sentry.Thispermitsthecliniciantoquicklyaccessandassessthepatientandconductnecessarycareprotocolsandcharting.Supplymanagementtoolssuchasbaskets,clips,hooks,andtilt-outbinsprovideimmediatevisualidentificationandeasyaccesstotheparlevelinventoryofsupplieswithouttediouslydiggingfortheminasupplycart.

10’6”

EQ. EQ.

114”6” 6”

33”

48”

71”

V O A VNC

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Adjacent Walls – Sidewall and Footwall

Aclinician’sworkinandEDcanbefast-pacedanddynamicasinthecaseoftrauma.OthertimespatientspresentattheEDandtherecanbeagreatmanytests,diagnosticsandlabstorun.Thegreatdiversityofcaremakessidewallsandfootwallsofcriticalimportance.Designthat“locksdowntheplacement”ofclinicaltools,accessories,evenpatiententertainment/educationtoolssimplycannotprovidethehospitalwiththeworkflowadaptabilitynecessarytodeliveritsbestpatientcare.Designthatdoesnotaddresscleanability,order(ortheperceptionofcleanability),workflowandsafety…whilegivingthefacilitytheabilitytoimproveuponitsprocessisantiquatedandnotinthebestinterestofthepatientsweserve.

TV

72”

30”

22”

34”

50”

CUBICLEC

URTAIN

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Emergency Department BaysTheEvolutionEquipmentManagementRailSystemhelpsyoucreateEDBaysthatwork.Thewallbecomesyourtemplate.Partneringwiththecliniciansyouserve,youcannowdemonstrateyourproblemsolvingabilities.Yourdesignbecomesintegraltoenhancingtheoutcomesofyourclientandthecliniciansarefreetochangetheplacementoftheircriticaltoolsonanas-neededbasisthroughoutthefacilitylifecycle.

120”

132” 132” 132”

70”

48”

32”

PATIENTMONITOR

CUBICLEC

URTAIN

CUBICLEC

URTAIN

CUBICLEC

URTAIN

CUBICLEC

URTAIN

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Infection ControlStudieshaveshownthatthebacteriathatcausehospital-acquiredinfections(HAI)aremostfrequentlyspreadfromonepatienttoanotheronthehandsofhealthcareworkers.

Creatingastandarddirectionflowwitheasyaccesstosinkandhandwashingaccessoriesattheroom’spointofentryhasbecomeadesignstandard.Placingthehandwashingaccessoriesonanequipmentrailallowsforadjustmentinthesystemwithoutcreatingwalldamagethatcreatesapotentialhomefordeadlyornefariouspathogens.

Equipment Management StrategyEvolutionEquipmentManagementRailSystemhelpsfacilitiescreatestandardprocessestofacilitatethepracticeofhandwashingbefore,afterandduringpatientinteraction.A3”-0”lengthofrailplacedat4’-2”abovethefloorlineprovidesampleclearanceforclinicianstoengagethesink,toolsandprocessbehindastandardhandwashingprocess.Handsanitizer,soapandtowelsareplacedintheorderofapplicationtofacilitatealinearprogressionofhandwashing.Asecondrail,placed5’-4”offthefloorcontainsglovesandadjustablesanitizingwipesdispenser.

TominimizetheriskofHAI’s,thisspacemustbehighlycleanable.Attachingthesetoolsdirectlytothewallcreatesanopportunityforpathogensto“hide.”Itmaysoundtrite,butitistrue:“Ifyoucan’tpaintit,youcan’tcleanit.”TheabilitytoterminallycleanahandwashingstationisparamounttoaneffectiveHAImitigationstrategy.

3’-0”

1’-2”

4’-2”

20

Ambulatory/Surgical CareAmbulatorycare,oroutpatientcare,ismedicalcareprovidedonanoutpatientbasis.Itrunsthegamutofservicesthatwereoncestrictlyinthedomainoftheacutecareenvironment.Theseservicesinclude:diagnosis,observation,consultation,treatment,intervention,surgicalproceduresandrehabilitationservices.

TheEvolutionEquipmentManagementRailSystemmakesthedesignandimplementationofascrubsinkalcovesimpleandeffective.Evolutiongivesyoutheabilitytocreatearailinfrastructuretowhichyoucanmountallthenecessarygowningequipment(shoecovers,caps,PPEandgowns)andscrubbingequipment,manageandoptimizetheworkflowatthescrubsink,whileprovidingthesimplescalabilityandprofoundclean-abilitythattraditionalwall-mountingtechniquesdeny.

Duetotheuseofhighlyengineeredwallcladdingmaterialsinthisenvironment,theconceptof“peeling,papering,painting”simplytointroduceanewsupplierorpieceofequipmentisuntenable.Thesurgicalsuitedrivestheambulatoryenvironmentandtakinganoperatingroom(ortwo!)outofcommissionisunthinkable.Equallyunpalatableistheideathatanydesignrenderedinthisworkspaceisnotoptimizedforterminalcleaning.

Inthisexample,24”railsmounted64”ofthefloorabovethescrubsinkprovidessuperiorplacementofthesoapandsterilizationmedia.Ontherightadjacentwall,a36”longrailmounted8”offtheforwardwallat60”heightyieldsabasketforstorage(alcohol,betadine,etc.)atalldispenserandaneyewashstation.Ontheleftadjacentwalltheclinician’sPPEisneatlyorderedinamannerconsistentwiththefacilitationofgowning.

72” 92” 54”

72” 24”

64”

24”36”8”

EYEWASH

MISC.BOTTLESALCOHOLBEDTADINEETC

STERISWALLMOUNTEDSOAPDISPENSERPER SPEDS

SHIELDST

YLE

EARLO

OP

EARLO

OP

EARLO

OP

EARLO

OP

CONE

STYLE

14”

54”

68”

43” 64

”

511/2”

SIDEVIEW

60”

21

Physician’s Offices/ClinicsIntoday’shealthcareenvironment,runningasuccessfulpracticemeanslookingforwaystoimprovepracticeprocesses,eliminatewasteandgivepatientsthebestpossiblecare.Carefulplanningandattentiontodesigncanphysiciansandclinicsachievethesegoalsnowandinthefuture.

Careintheprimarycarephysician’sofficefrequentlycentersontheuppertorsoandheadofthepatient.Configuringtheroomsotheclinicianhasallthetoolsandequipmentnecessarytointeractwiththepatientwiththeleastamountofreaching,bending,orsearchinghelpsfacilitateexpedientcareandpatientrelationshipbuilding.

TheEvolutionEquipmentManagementRailSystemmakesagreatdealofsenseintoday’sbusyprimarycareandclinicenvironment.Newtools,newmethodologies,eventheapplicationofelectronicmedicalrecords(EMR)canbequicklyandefficientlyimplementedwiththescalableworkflowprovidedbyarailsystem.

Onthewallproximaltotheentranceoftheofficetherearetworails4’-0”inlengthoneplaced3’-0”offthefloorandthesecondat4’-4”offthefloor.Theraiwlat3’0”offthefloorprovidesaworksurfaceandsomestorage,perhapsforpatientliterature,gloves,orsyringes/wipes.Thesecondrail(4’-4”)hasasharpscontainer,bloodpressurecuff,thermometer,andbasketaswellasspaceforclinicaltoolstosupportthisphysician’sprocesses.

Thewalldistaltotheofficeentrancefeaturesarail4’-0”long,5’-0offthefloor.Placingtherailheregivesamplespaceforcordmanagementconsiderationsfortheophthalmoscope.Additionally,gloveboxesaresuspendedjusthighenoughtobewithinthecliniciansreach,butperhapsjustoutofreachofayoungpatient.

TheEvolutionEquipmentManagementRailSystemgivesphysicians,designersandclinicianstheabilitytoimplementworkflowthatfacilitatesthehighestqualityofcarewiththemostinteroperabilityforthenewtechnologiescomingtotheprimarycareenvironment.

102”

IE.1

114” IE.2

60”

50”

60”

60”

DEM-110 SM-101 DEM-109

DEM-108DEM-106

22


Installation

HandSoap $ 20


FoamDispenser $ 30






Labor(5hours@$20/hr) $ 100

Materials(Paper/Paste/Paint) $ 10

LostRevenue($70/hr) $ 350




TotalCostofOccupancy $ 33,750

Soap $ 118,750

Soap $ 152,500

Hospital A Hospital B

Rail-Mounted

Installation

HandSoap $ 20


FoamDispenser $ 30

3’RailSystem $ 206







Materials $ N/A

LostRevenue($70/hr) $ N/A




TotalCostofOccupancy $ 76,500

Soap $ 5,000

Soap $ 81,500

AddendumLifecycle Costs and ROI: A tale of two hospitals.

Documents

DESIGN AND PLANNING GUIDE - CADdetails · to promote the ability to implement process improvements that support the clinician’s ability to administer care. ... , facilities can