BACKGROUND: When older persons with dementia are admitted to hospital, they often feel disoriented and confused and their cognitive impairment may worsen, purely due to the sudden change in their environment. As such hospital design is recognised as an important aspect in the care and well-being of older persons with dementia. As the number of persons with dementia is increasing, the experience of admission to a hospital with, for example, single rooms is more relevant than ever.
OBJECTIVE: This scoping review aimed to identify, explore and conceptually map the literature reporting on what older people with dementia and their families experienced during admission to a hospital with single room accommodation. We followed the Joanna Briggs Institute recommendations for undertaking a scoping review. In addition, we used the Preferred Reporting Items for Systematic reviews (PRISMA-ScR) Checklist, which assisted the development and reporting of this scoping review.
RESULTS: We included 10 sources within a time frame of 23 years (1998-2021). The sources originate from Europe, Australia and Canada. We identified three conceptual maps: Safety and security, Privacy and dignity and Sensorial stimulation. Our review demonstrates that the themes of the three conceptual maps are experienced as mutually interdependent for the older persons with dementia and their families.
CONCLUSIONS: We conclude that it is not merely the single room design that determines what the older persons with dementia and their families experience as important; the exposure to sensorial stimulation and the presence of well-trained staff taking a dignified patient-centred approach are also crucial for their experience of high-quality nursing care.

Recently hospital managers and designers become more interested in \'patient centered design\' (PCD) through the integration of patients\' perceptions and expectations of the hospitals\' physical environment. This increased interest in PCD indicates the improved understanding of the impacts of hospital\'s physical environment on all users including patients, families and hospital staff. Literature shows that incorporating users\' perceptions of the physical environment during the design process is very important to produce PCD. The current study is aimed at assessing the impacts of four demographic factors namely: age, sex, education level and area of residence on users\' perceptions of hospitals\' physical environment. Five principal design factors were identified: views, safety &comfort, facilities &way finding, architectural & hygiene and sensory. For the questionnaire survey, the statistical analysis has been conducted with IBM SPSS Statistics version 27.0. Demographic data was analyzed descriptively by computing frequencies and percentages. Then the descriptive statistics for the items i.e. frequencies, percentages, means and standard deviations (SD) were computed. Non-parametric tests were applied to assess variances in constructed principal dimensions concerning users\' demographic factors. The users of two hospitals: Nekemte specialized hospital & Paulos comprehensive hospital participated in the survey. A total of 480 respondents were participated in ranking the importance of 21 questionnaire items on 5-point Likert scale. The result reveals that education level has a significance role (p-value = 00.001,00.002,0.032) for the difference between perceptions of three out of five summated design factors namely; views, facilities & way finding and architectural& hygiene respectively. Similarly, residence area has significantly contributed for the difference in users\' perceptions (P-value = 00.001, 00.001, 0.025) on three summated design factors; views, safety &comfort and architectural & hygiene respectively. Based on the analysis, the study suggests that identifying perceptions of all users is very important to help designers to design PCD based on empirical evidence.

BACKGROUND: The 7th National Audit Project of the Royal College of Anaesthetists (NAP7) recommended that an emergency call system be immediately accessible in all anaesthesia locations. It is essential that all theatre team members can rapidly call for help to reduce the risk of patient harm. However, the ability of staff to activate this system in a timely manner can be affected by cluttered or unfamiliar environments and cognitive overload. One proposed strategy to enable rapid identification and activation of emergency call systems is to install a red vertical painted stripe on the wall from the ceiling to the activation button. We investigated the effect of introducing this vertical red line on activation times in operating theatres in the UK and Australia.
METHODS: Operating theatre team members, including anaesthetists, surgeons, anaesthetic nurses, surgical and theatre nurses, operating theatre practitioners, and technicians, were approached without prior warning and asked to simulate activation of an emergency call. Vertical red lines were installed, and data collection repeated in the same operating theatres 4-12 months later.
RESULTS: After installation of vertical red lines, the proportion of activations taking >10 s decreased from 31.9% (30/94) to 13.6% (17/125, P=0.001), and >20 s decreased from 19.1% (18/94) to 4.8% (6/125, P<0.001). The longest duration pre-installation was 120 s, and post-installation 35 s.
CONCLUSIONS: This simple, safe, and inexpensive design intervention should be considered as a design standard in all operating theatres to minimise delays in calling for help.

New ways of providing acute care outside of traditional hospital building complexes, such as virtual care or hospital in the home, are becoming more common. Despite this, many hospitals are still conceived as \"bricks and mortar\" centralised constructions, and few health service infrastructure organisations meet intensively with consumers or clinicians prior to conceptualising hospital design. Our study sought to understand the needs and expectation of community members and healthcare providers, and co-design innovative models of acute care to inform development of a new metropolitan hospital in Australia. Our study used a three-step approach, consisting of academic and grey literature reviews; a demographic analysis of the hospital catchment population; and a series of 20 workshops and 6 supplementary interviews with community members and local healthcare providers. We found that care should be tailored to the healthcare needs and expectations of each consumer, with consumers cared for in the community where possible and safe. We propose an innovative model of care for hospitals of the future, consisting of fully integrated acute care underpinned by appropriate digital architecture to deliver care that is community focussed. It is vital that new hospitals build in sufficient adaptability to leverage future innovation and meet the needs of growing and changing communities.

UNASSIGNED: The purpose of this scoping review is to map the knowledge about the multisensory birthing room regarding the birth experience and birth outcomes.
UNASSIGNED: The concept of multisensory birthing rooms is relatively novel, making it relevant to explore its impact.
UNASSIGNED: Five databases were searched. The search was limited to articles in English, Danish, Norwegian, and Swedish. There were no time limitations. Fourteen relevant articles were identified providing knowledge about multisensory birthing rooms.
UNASSIGNED: Eight articles focused on birth experience, six articles focused on birth outcome, and one on the organization of the maternity care. Seven of the studies identified that sensory birthing rooms have a positive impact on the birth experience and one qualitative study could not demonstrate a better overall birth experience. Five articles described an improvement for selected birth outcomes. On the other hand, a randomized controlled trial study could not demonstrate an effect on either the use of oxytocin or birth outcomes such as pain and cesarean section. The definition and description of the concept weaken the existing studies scientifically.
UNASSIGNED: This scoping review revealed that multisensory birthing rooms have many definitions and variations in the content of the sensory exposure; therefore, it is difficult to standardize and evaluate the effect of its use. There is limited knowledge concerning the multisensory birthing room and its impact on the birth experience and the birth outcome. Multisensory birthing rooms may have a positive impact on the birth experience. Whereas there are conflicting results regarding birth outcomes.

Empathic care benefits patients and practitioners, and empathy training for practitioners can enhance empathy. However, practitioners do not operate in a vacuum. For empathy to thrive, healthcare consultations must be situated in a nurturing milieu, guided by empathic, compassionate leaders. Empathy will be suppressed, or even reversed if practitioners are burned out and working in an unpleasant, under-resourced environment with increasingly poorly served and dissatisfied patients. Efforts to enhance empathy must therefore go beyond training practitioners to address system-level factors that foster empathy. These include patient education, cultivating empathic leadership, customer service training for reception staff, valuing cleaning and all ancillary staff, creating healing spaces, and using appropriate, efficiency saving technology to reduce the administrative burden on healthcare practitioners. We divide these elements into environmental factors, organisational factors, job factors, and individual characteristics.

UNASSIGNED: It is proposed that patients in single-occupancy patient rooms (SPRs) carry a risk of less surveillance by nursing and medical staff and that resuscitation teams need longer to arrive in case of in-hospital cardiac arrest (IHCA). Higher incidences of IHCA and worse outcomes after cardiopulmonary resuscitation (CPR) may be the result.
UNASSIGNED: Our study examines whether there is a difference in incidence and outcomes of IHCA before and after the transition from a hospital with multibedded rooms to solely SPRs.
UNASSIGNED: In this prospective observational study in a Dutch university hospital, as a part of the Resuscitation Outcomes in the Netherlands study, we reviewed all cases of IHCA on general adult wards in a period of 16.5 months before to 16.5 months after the transition to SPRs.
UNASSIGNED: During the study period, 102 CPR attempts were performed: 51 in the former hospital and 51 in the new hospital. Median time between last-seen-well and start basic life support did not differ significantly, nor did median time to arrival of the CPR team. Survival rates to hospital discharge were 30.0% versus 29.4% of resuscitated patients (p = 1.00), with comparable neurological outcomes: 86.7% of discharged patients in the new hospital had Cerebral Performance Category 1 (good cerebral performance) versus 46.7% in the former hospital (p = .067). When corrected for telemetry monitoring, these differences were still nonsignificant.
UNASSIGNED: The transition to a 100% SPR hospital had no negative impact on incidence, survival rates, and neurological outcomes of IHCAs on general adult wards.

BACKGROUND: To improve patients\' privacy, comfort and infection control, newly built hospitals increasingly offer 100% single-occupancy patient rooms. Our study examines how nurses perceived the transition from a hospital with multi-bedded patient rooms to one with solely single-occupancy patient rooms designed according to principles of a healing environment.
METHODS: In a single-centre, before-after survey study, nurses completed a questionnaire of 21 items in three domains: perceived patient safety and monitoring, nurses\' working conditions and patient environment. Before-measurements (n = 217) were compared with two after-measurements in the new hospital, respectively after one (n = 483) and two years (n = 191).
RESULTS: Nurses considered the single rooms in the new hospital worse for visibility and monitoring but this had improved somewhat after two years. In either setting, the majority perceived working conditions (walking distances and designated rest area) as unfavourable. The patient environment in the new hospital was generally perceived as much better than in the former hospital.
CONCLUSIONS: The transition to solely single-occupancy patient rooms was largely considered positive by nurses in terms of patient environment. However, monitoring of patients and working conditions remain a concern. When designing new hospitals, attention should be paid to optimal working conditions for nurses. To improve monitoring of patients, we recommend the use of remote-sensoring.

UNASSIGNED: A working group conducted a survey on the use of the principle of buffer space (BS), which in case of emergencies, could benefit healthcare settings. The aim of the preliminary investigation is to define new research lines in hospitals\' functional design.
UNASSIGNED: The global experience of the COVID-19 pandemic highlighted challenges faced by hospitals when responding promptly to emergencies, including spatial reorganization and suspension of ordinary medical activities for ensuring adequate management of the emergency surge of patients.
UNASSIGNED: The group designed questionnaires to be administered to healthcare staff and healthcare designers aimed at understanding varied conceptions and features of BSs. Content across the two surveys overlapped significantly, allowing for direct comparisons of responses, while also including tailored questions in relation to the respective experience and skills of the two groups of respondents.
UNASSIGNED: 102 healthcare professionals and 56 designers took part to the survey. Analysis of the responses permitted for initial recommendations regarding BS typology including (a) proximity to the emergency department (ED), intensive care units (ICUs), and inpatient wards (IWs); (b) location within hospitals but separate from other medical areas; (c) need for independent access; (d) organizational and spatial features similar to ED, ICUs, and IWs; (e) existing as a fully flexible operational space; and (f) BS bed capacity to be approximately 12% of ED beds.
UNASSIGNED: Although the analysis is related to the Italian context, the expansion of this preliminary research to alternate healthcare facilities and geographic areas is necessary for reaching a wide consensus by different professionals on this field. It serves as a starting point for future investigations regarding the implementation of BS in hospital settings.

UNASSIGNED: The COVID-19 pandemic placed healthcare design at the heart of the crisis. Hospitals faced challenges such as rapidly increasing their intensive care unit capacity, enabling physical distancing measures, quickly converting to telehealth and telework practices, and above all, keeping patients and staff safe. Improving flexibility in hospital facility design and adaptability of hospital operations to function in \"crisis mode\" can be seen as ways of future-proofing for pandemics. In a design brief, flexibility is typically mentioned as an important target. Meanwhile, robustness of technical infrastructure is called for, and standardization at unit level with single-occupancy inpatient accommodation may be considered a way to enhance flexibility and adaptability in dealing with a surge in infectious patients.
UNASSIGNED: To future-proof facility design with pandemic preparedness and resilience in mind, this study evaluated what kinds of interventions were taken in Dutch hospital facilities and what perspectives need to be considered when hospitals operate in crisis mode.
UNASSIGNED: We have collected data from facility and estate professionals from 30 Dutch hospitals. Using a practice-based approach, in-depth interviewing helped uncover and compare successful operational strategies and design elements that provided the flexibility needed in the early stages of the recent crisis.
UNASSIGNED: As we looked at existing facilities and alterations made to allow hospitals to operate during the COVID-19 pandemic, we discovered that staff availability and adaptability were deemed crucial.
UNASSIGNED: We add the perspective of staff as an essential factor to be considered when future-proofing hospital facility desigr crisis mode operation.