Smith Thomas J, Schoenbeck Kathleen, Clayton Sandra
School of Kine-siology, University of Minnesota, Minneapolis, MN 55455, USA.
Work. 2009;33(2):211-27. doi: 10.3233/WOR-2009-0868.
This study collected staff responses to an occupancy quality survey before, and 6 and 22 months after, St. Paul Children's Hospitals and Clinics (CHC) replaced an open bay (OB) with a private room (PR) neonatal intensive care unit (NICU) design. Staff interview responses and task activity observations also were collected. The goal was to assess how this change would influence staff perceptions and performance. As a result of the transition from the OB to the PR environment: (1) rankings of overall physical environment, patient care, job, technology, and off-the-job quality significantly improved; but (2) rankings of patient care team interaction quality significantly declined. Results for the 22-month PR survey indicate essentially no meaningful changes in rankings of occupancy quality from the 6-month survey, suggesting no consolidation of quality gains in the intervening 16-month period. Written comments pertaining to private room NICU design issues by survey respondents, targeting problems with unit operations, may explain this finding. Collectively, the findings suggest that NICU operational management was not effectively modified to deal with the new design, and that an OB to PR NICU transition requires a systems approach to macroergonomic challenges imposed by the new design.
本研究收集了圣保罗儿童医院及诊所（CHC）将开放式病房（OB）新生儿重症监护病房（NICU）设计替换为单人病房（PR）设计之前、之后6个月和22个月时工作人员对入住质量调查的回复。还收集了工作人员访谈回复和任务活动观察结果。目的是评估这一变化将如何影响工作人员的认知和表现。从开放式病房环境向单人病房环境转变的结果如下：（1）整体物理环境、患者护理、工作、技术和非工作质量的排名显著提高；但（2）患者护理团队互动质量的排名显著下降。22个月单人病房调查的结果表明，与6个月调查相比，入住质量排名基本没有有意义的变化，这表明在中间的16个月期间质量提升没有得到巩固。调查受访者针对病房运营问题就单人病房NICU设计问题给出的书面评论可能解释了这一发现。总体而言，研究结果表明，NICU运营管理没有得到有效调整以应对新设计，从开放式病房到单人病房的NICU转变需要一种系统方法来应对新设计带来的宏观工效学挑战。
