Toward a Model of Safety and Care for Trauma Room Design

"Toward a Model of Safety and Care for Trauma Room Design" is a $2.47 m grant project awarded by the Agency for Healthcare Research and Quality (AHRQ). It is a cross-disciplinary collaboration between Kent State University’s Healthcare Design, Nursing, and Computer Science programs and Cleveland Clinic Akron General. The project aims to help save patients’ lives by improving the design of Level I trauma rooms. Dynamics among people, technology, organization, tasks, and the physical environment of a trauma room will be studied. The project is a five-phase cycle (problem analysis, design, development, implementation, and evaluation). Goals of the project include developing design strategies to integrate technology and maximize future adaptability, testing proposed design strategies for a trauma room, and developing an evidence-based model for designing trauma rooms that support efficient patient care while maintaining a safe environment. The developed design guide model is expected to contribute to patient safety in trauma rooms by serving as a primary source to direct the design of the next generation of trauma rooms.

Disseminations

Bayramzadeh, S., & Aghaei, P. (2021). Technology integration in complex healthcare environments: A systematic literature review. Applied Ergonomics. DOI: https://doi.org/10.1016/j.apergo.2020.103351

To support safety and efficient care, effective integration of technology into the time-pressured, high-risk healthcare environments is critical. This systematic literature review aimed to highlight the impact of technology on the physical environment as well as the facilitators for and barriers to technology integration into complex healthcare settings, including operating rooms and trauma rooms. PsycINFO, Web of Science, and PubMed databases were utilized, along with a hand search. PRISMA and MMAT guidelines were used for reporting and quality appraisal. Out of 1,001 articles, 20 were eligible. Identified categories included hybrid and integrated environments, technological ambiance, and information technologies. Technology integration has implications for direct patient care, efficiency, throughput, patient safety, teamwork, communication, and the perception of care. The facilitators for and barriers to technology integration included layout design, equipment positioning, and decluttering. The physical environment can improve the impact of technology on factors such as patient safety and efficiency.

Bayramzadeh, S., Ahmadpour, S., & Aghaei, P. (2021). The relationship between sensory stimuli and the physical environment in complex healthcare settings: A systematic literature review. Intensive and Critical Care Nursing, 103111.

Objectives: This systematic review presented the current status of literature on the outcomes resulted from sensory stimuli in critical care environments as well as the environmental interventions that can improve or impede the impact of such sensory stimuli. Methods: Articles found through a systematic search of PsycINFO, Web of Science, and PubMed databases, in combination with a hand search, were reviewed for eligibility by two independent coders. Reporting and quality appraisals were based on PRISMA and MMAT guidelines. Results: Out of 1118 articles found, and only 30 were eligible. Final articles were comprised of issues related to noise, lighting, and temperature. Identified sensory stimuli resulted in psychological and physiological outcomes among both patients and staff. Examples include impacts on stress, delirium, sleep disturbances, poor performance and communication. The environmental factors that influence sensory stimuli included layout, room size, artificial lighting, presence of windows and acoustical interventions. Conclusion: Literature on the impact of sensory stimuli on staff is scarce compared to patients. Studies on environmental interventions are inadequate and lack structure. The physical environment can impact the patient and staff outcome resulting from noise, lighting, and temperature. When applied strategically, sensory stimuli can result in positive outcomes among patients and staff.

Bayramzadeh, S., Anthony, M. K., Sterling, M., & O’Donnell, K. (2021). The Role of the Physical Environment in Shaping Interruptions and Disruptions in Complex Health Care Settings: A Scoping Review. American Journal of Medical Quality.

Interruptions and disruptions in complex healthcare environments, such as trauma rooms, can lead to compromised workflow and safety issues due to the physical environment’s characteristics. This scoping review investigated the impact of the physical environment on interruptions and disruptions and the associated outcomes in complex environments, as they relate to the components of the Systems Engineering Initiative for Patient Safety. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to conduct the scoping review. CINAHL, Web of Science, and PubMed databases were searched. After removing duplicates and eligibility screening, quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). Of 1,158 articles found, 20 were selected. Poor layout configurations, tripping hazards, and technology integration were common examples. More research must be conducted to unveil the impact of the physical environment on interruptions and disruptions.

8th Annual Neuroscience Symposium at Kent State University: A Celebration of Brain Health Research, October 8-9, 2020

SURE (Summer Undergraduate Research Experience) 3-minute presentation, October 2020

2021 MNRS Annual Research Virtual Conference, March 24-27, 2021

Kent State University Undergraduate Research Symposium, April 19-23, 2021

Environmental Design Research Association (EDRA) 52, May 19-23, 2021

European Healthcare Design Conference, June 15, 2021

Timeline

September 2019 - September 2023

Sponsor

Agency for Healthcare Research Quality

TEAM

  • Sara Bayramzadeh, Ph.D., M.Arch.

    Sara Bayramzadeh, Ph.D., M.Arch.

    Coordinator and Elliot Professor, Healthcare Design Program | Principal Investigator
    Dr. Bayramzadeh is recognized for her research on operating room design and is interested in how effective environmental design can enhance healthcare outcomes, such as patient and staff safety and satisfaction. She is also interested in the innovation that emerges from interdisciplinary research collaborations.

  • Douglas L. Delahanty, Ph.D.

    Douglas L. Delahanty, Ph.D.

    Interim Vice President, Research and Sponsored Programs | Professor, Department of Psychological Sciences
    Dr. Delahanty is an expert in the area of early biopsychological predictors of PTSD, and he has extensive experience assessing traumatic experiences, posttraumatic stress disorder, and comorbid disorders in children and adults recruited within hours following traumatic injury at adult and child hospitals.

  • Mary K. Anthony, Ph.D., RN

    Mary K. Anthony, Ph.D., RN

    Professor and Associate Dean for Research, College of Nursing
    Dr. Anthony has made significant contributions to nursing and health systems research focusing on building the science exploring the relationship between care delivery systems and patient, nurse and organizational outcomes, primarily in acute care settings. Her work has been funded by NINR, AHRQ and other prestigious professional organizations and has been used in shaping national nursing position statements.

  • Terri Stefanko

    Terri Stefanko

    Project Coordinator
    Terri assists with the research project in different capacities, including coordination among the three institutions involved in the research. She holds a Master’s degree in Art Therapy from Florida State University. She also has a Bachelor’s degree in Psychology with an Art minor from Bowling Green State University. When not at work, she enjoys painting, traveling, reading, yoga, and spending time outside.

  • Kayla O'Donnell

    Kayla O'Donnell

    Nursing Honors Student
    Kayla is an undergraduate Honors nursing student at Kent State University. She is an active member in Kent State’s Student Nurses Association and volunteers through the American Red Cross Club. She enjoys hanging out with friends and family, watching movies, and exercising when she’s not studying.

  • Madeline Sterling

    Madeline Sterling

    Nursing Honors Student
    Madeline is a nursing student at Kent State University. After graduating, she hopes to work on a labor and delivery floor and then earn her Master’s degree in Midwifery or Women’s Health. When she’s not studying, she enjoys spending time with her family and pets, crafting, or going on a run in the national parks.

  • Sahar Ahmadpour

    Sahar Ahmadpour

    Graduate Research Assistant, Healthcare Design Program
    Sahar holds a bachelor’s and a master’s degree in Architecture. She has held positions as a faculty member and an architectural designer. Sahar’s research focuses on safety in trauma rooms and investigating how to enhance efficiency in healthcare environments, especially in emergency departments using Lean methodology. Her research interests also include the impact of the physical environment on social relationships with a focus on the elderly. 

  • Parsa Aghaei

    Parsa Aghaei

    Graduate Research Assistant, Healthcare Design Program
    Parsa is conducting research on designing trauma rooms based on a systems engineering model. He started his career as a multi-disciplinary designer at an early age. Having worked for major hospital contractors in Iran as a designer, he is now pursuing his graduate studies in Healthcare Design to make his mark in human-focused architecture and design. His other research interests include the effects of technology on healthcare architecture and improved experiences through the use of AR/MR.

  • Leong Yin Tanya Chiu

    Leong Yin Tanya Chiu

    Graduate Research Assistant, Healthcare Design Program
    Tanya is a graduate student in the Master of Healthcare Design Program. She earned a bachelor’s degree in interior design from the University of Florida in May 2020. During her senior year, she worked as a research assistant for research “Design for Mindfulness” supported by the ASID Foundation Research Grants Program 2019. In addition, she worked as a summer interior design intern at Hong Kong Gensler in 2018 & 2019. 

  • Md Mazharul Islam

    Md Mazharul Islam

    Graduate Research Assistant, Healthcare Design Program
    Md Mazharul Islam (Maz) completed his Master of Architecture from Miami University, Ohio. He did his summer internship in PENH Studio, LLC in Houston, Texas where he worked on schematic design, design development, construction drawings, AHJ submittals, and visualization of retail projects. Before pursuing his master’s degree in the US, he worked for more than two years in Bangladesh as an Assistant Architect. He completed his Bachelor of Architecture from Bangladesh University of Engineering and Technology. 

  • Zhengyong Ren

    Zhengyong Ren

    Graduate Research Assistant, Computer Science Program
    Zhengyong is a doctoral student in Computer Science at Kent State University. His research focuses on Visualization and Deep Learning. Zhengyong has his Master’s degree in Computer Science from Kent State University as well. Before he came to the United States in 2016, Zhengyong taught in Zhengjiang Province in mainland China as a high school physics and computer science teacher for five years. 

  • Kambiz Ghazinour Naini, Ph.D.

    Kambiz Ghazinour Naini, Ph.D.

    Associate Professor, Center for Criminal Justice, Intelligence and CyberSecurity at SUNY in Canton | Director of the Advanced Information Security and Privacy Lab
    Dr. Ghazinour has been actively involved in the areas of security, privacy, and data analysis since 2008. He has also conducted many privacy-related research projects investigating data mining and machine learning and privacy-aware models.

  • Hossein Mirzajani Shahrestani

    Hossein Mirzajani Shahrestani

    Graduate Research Assistant, Healthcare Design Program

    Hossein holds a master's degree in architecture from the College of fine arts at Tehran University. He has established his own Interior Design office since 2017. Hossein is passionate about interaction between the end-user experience and the built environment, especially in healthcare projects. His other fields of interest include computer graphic imagery, and as a CG artist, he has extensive experience in Architectural Visualization and illustration.

  • Hamid Estejab

    Hamid Estejab

    Graduate Research Assistant, Healthcare Design Program

    Hamid got his bachelor’s degree in architecture in 2017 at Shiraz University. After graduation, with the help of his thesis supervisor, he established a lab in the university named "Techlab", focusing on the integration of Architecture, Art, and Technology. He has been working there as a researcher in VR/AR since he came to KSU. Now, he is looking forward to implementing new technologic terms into healthcare design.

CLEVELAND CLINIC AKRON GENERAL

  • Ali F. Mallat, MD, MS, FACS

    Ali F. Mallat, MD, MS, FACS

  • Jessica Krizo, Ph.D.

    Jessica Krizo, Ph.D.

  • Steven Brooks, MD

    Steven Brooks, MD