Roger S. Ulrich, PhD, 3137 TAMU, Texas A&M University, College Station, TX 77843-3137 (
HERD. 2007 Fall;1(1):31-43. doi: 10.1177/193758670700100113.
Literature on healthcare architecture and evidence-based design has rarely considered explicitly that patient outcomes may be worsened by intra-hospital transport (IHT), which is defined as transport of patients within the hospital. The article focuses on the effects of IHTs on patient complications and outcomes, and the implications of such impacts for designing safer, better hospitals. A review of 22 scientific studies indicates that IHTs are subject to a wide range of complications, many of which occur frequently and have distinctly detrimental effects on patient stability and outcomes. The research suggests that higher patient acuity and longer transport durations are associated with more frequent and serious IHT-related complications and outcome effects. It appears no rigorous research has compared different hospital designs and layouts with respect to having possibly differential effects on transport-related complications and worsened outcomes. Nonetheless, certain design implications can be extracted from the existing research literature, including the importance of minimizing transport delays due to restricted space and congestion, and creating layouts that shorten IHT times for high-acuity patients. Limited evidence raises the possibility that elevator-dependent vertical building layouts may increase susceptibility to transport delays that worsen complications. The strong evidence indicating that IHTs trigger complications and worsen outcomes suggests a powerful justification for adopting acuity-adaptable rooms and care models that substantially reduce transports. A program of studies is outlined to address gaps in knowledge.Key WordsPatient transports, transports within hospitals, patient safety, evidence-based design, hospital design, healthcare architecture, intra-hospital transport complications, acuity-adaptable care, elevators, outcomes.
关于医疗保健建筑和循证设计的文献很少明确考虑到患者的预后可能因院内转运（IHT）而恶化，IHT 是指在医院内转运患者。本文主要关注 IHT 对患者并发症和预后的影响，以及这些影响对设计更安全、更好的医院的意义。对 22 项科学研究的回顾表明，IHT 会引发一系列并发症，其中许多并发症经常发生，对患者的稳定和预后有明显的不利影响。研究表明，患者病情严重度和转运时间延长与更频繁和更严重的 IHT 相关并发症和预后影响有关。似乎没有严格的研究比较过不同的医院设计和布局，因为它们可能会对与转运相关的并发症和预后恶化产生不同的影响。尽管如此，从现有研究文献中可以提取出一些设计意义，包括减少因空间限制和拥堵导致的转运延迟的重要性，以及创建缩短高病情严重度患者 IHT 时间的布局。有限的证据表明，依赖电梯的垂直建筑布局可能会增加因转运延迟而恶化并发症的易感性。强有力的证据表明 IHT 会引发并发症并恶化预后，这有力地证明了采用适应病情严重度的病房和护理模式来大大减少转运的合理性。本文概述了一项研究计划，以解决知识空白。
患者转运，医院内转运，患者安全，循证设计，医院设计，医疗保健建筑，院内转运并发症，适应病情严重度的护理，电梯，预后。
