Ask to see: Having a window in a hospital room increases the chance of survival after surgery

San Diego – Modern medical care continues to advance and improve at a rapid pace, and today’s doctors and surgeons have never been more skilled or well-known. However, sometimes it’s the little things that make a major medical difference. University of Michigan researchers report that certain hospital room qualities — such as window views, being in a single room or proximity to a nursing station — can affect outcomes after high-risk operations.

The United States spends about $50 billion a year on the construction of health care facilities. Beyond the obvious need for state-of-the-art facilities, previous research suggests that architecture and interior design can improve patient care and outcomes. An early study published in 1984 found that providing patients with a window view could affect surgery recovery. Other studies have shown that critically ill patients assigned to ICU rooms that are “not well visualized” by medical staff may be more likely to have poor health outcomes.

So, while there was some precedent for the idea that Right hospital room While all may make a difference, few projects have actually investigated how room characteristics such as single versus double occupancy, distance from the nursing station, and a window view may affect clinical outcomes. The team at the University of Michigan set out to better understand whether different hospital room characteristics can really affect mortality and length of stay. Results after surgery.

“We were impressed from a previous study that mortality was different in rooms within sight of the nurse’s station. Nurses can assess the patient’s condition more easily and intervene more quickly in critical cases. We wanted to see how this finding would apply at our institution, particularly in the surgical population,” study co-author Mitchell J. said Mead, a health and design scholar at the University of Michigan. Media release. “One of the next big steps in health care design is to understand these pathways of causality that can lead to different clinical outcomes for patients in hospital rooms with different characteristics.”

A window can reduce the risk of death by 20 percent

This single-site study involved 3,964 patients who underwent 13 high-risk surgeries (including colectomy, pancreatectomy, and kidney transplant) at the University of Michigan Hospital between 2016 and 2019. Patients were admitted to rooms on two floors of the hospital.

These patient rooms were coded based on several characteristics: windows or no windows, single occupancy, double occupancy, distance to the nursing station, and physician line of sight. The study authors linked patient encounters by room number, which helped identify clinical outcomes, including mortality and length of stay, related to room design.

Key findings of the study include:

• Mortality rates in high-risk surgeries vary across room design features and room types.
• Room characteristics that influence clinical outcomes after surgery include distance from a nursing station, single room occupancy, and a direct line of sight through which physicians can see into the room.
• Mortality was 20 percent higher (odds ratio 1.2) if patients were admitted to a windowless room than if they were placed in a windowed room. This was true even after the researchers accounted for patient co-morbidities and complications of the operation.
• Among patients in a room without a window, the 30-day mortality rate was 10 percent higher (odds ratio 1.1).
• Although mortality rates differ across house designs, mortality rates did not When considering length of stay varies by room type. This suggests that length of stay does not account for differences in mortality.

“This investigation provides evidence that room design features have differential outcomes when accounting for clinical risk to patients and warrants further investigation into how Hospital design could affect the outcome,” added Mr Mead.

Who gets the best room in a hospital?

When researchers evaluated different rooms based on optimal design features, it became clear that sicker patients were assigned single rooms, closer to and within direct line of sight of a nursing station, and A window view. According to study co-author Andrew M. Ibrahim, MD, MSc, assistant professor of surgery, architecture and urban planning at the University of Michigan and co-director of the Center for Outcomes and Policy, this study is just one example. The relationship between hospital design and patient care and outcomes has been overlooked. Investing in research on the best design features could potentially help countless patients.

“I think we can get a much better return for what we build and hopefully safe designs, Healthy Hospital,” he said.

Moving forward, the study authors want future projects to analyze results at multiple hospitals. They are already in the process of replicating a similar study across Michigan Medicine and hope to recruit collaborators at other hospital systems. They plan to expand the scope of the study to include other metrics such as pain medication use and patient satisfaction across room types.

“Our general question is, do you want us to rebuild our hospitals? Of course, this is not practical. But we can recognize clear patterns where certain room types have better outcomes after surgery,” concluded Dr. Ibrahim. “We can start prioritizing the sickest patients out there. Just as we’ve developed precision health models to get the right patient care, the right room for the right patient and the way to collectively optimize outcomes can have a consequence.”

The team presented their findings at the American College of Surgeons (ACS) Scientific Forum. Clinical Congress 2022.