Dr. Ricciotti is chair and residency program director, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and associate professor of obstetrics, gynecology, and reproductive biology, Harvard Medical School, Boston, Massachusetts. Mr. Armstrong is senior vice president for capital facilities and engineering, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Mr. Yaari is a design architect specializing in science facilities and large-scale academic and health care buildings, Boston, Massachusetts. Ms. Campion is co-chief administrative officer, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Ms. Pollard is co-chief administrative officer, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Dr. Golen is vice chair for quality, safety, and performance improvement, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and assistant professor of obstetrics, gynecology, and reproductive biology, Harvard Medical School, Boston, Massachusetts.
Acad Med. 2014 Sep;89(9):1235-8. doi: 10.1097/ACM.0000000000000364.
An expanding obstetrics-gynecology department at an academic medical center was faced with too little physical space to accommodate its staff, including trainees, attending physicians, researchers, scientists, administrative leadership, nurses, physician assistants, and scheduling/phone staff. Staff also felt that the current use of space was not ideal for collaboration and innovation.
In 2011, the department collected data on space use, using a neutral surveyor and a standardized data collection tool. Using these data, architects and facilities managers met with the department to develop a floor plan proposal for a new use of the space. Site visits, departmental meetings, literature reviews, and space mock-ups complemented the decision process. The final architectural plan was developed using an iterative process that included all disciplines within the department.
The redesigned workspace accommodates more staff in a modernized, open, egalitarian setup. The authors' informal observations suggest that the physical proximity created by the new workspace has facilitated timely and civil cross-discipline communication and improvements in team-oriented behavior, both of which are important contributors to safe patient care.
This innovation is generalizable and may lead other academic departments to make similar changes. In the future, the authors plan to measure the use of the space and to relate that to outcomes, including clinical (coordination of care/patient satisfaction), administrative (absenteeism/attrition), research (grant volume), and efficiency and cost measures.
一家学术医学中心的妇产科部门不断扩张，面临着空间不足的问题，无法容纳其员工，包括培训生、主治医生、研究人员、科学家、行政领导、护士、医师助理和调度/电话工作人员。员工还认为，目前的空间使用方式不利于协作和创新。
2011 年，该部门使用中立的测量员和标准化的数据收集工具收集了空间使用数据。利用这些数据，建筑师和设施经理与该部门会面，为空间的新用途制定了一个平面图提案。现场考察、部门会议、文献回顾和空间模型补充了决策过程。最终的建筑计划是使用迭代过程开发的，其中包括该部门的所有学科。
重新设计的工作空间可容纳更多的员工，采用现代化、开放、平等的布局。作者的非正式观察表明，新工作空间带来的物理接近度促进了及时和文明的跨学科交流，并改善了以团队为导向的行为，这两者都是安全患者护理的重要贡献因素。
这项创新具有普遍性，可能促使其他学术部门做出类似的改变。未来，作者计划衡量空间的使用情况，并将其与包括临床（护理协调/患者满意度）、行政（缺勤/离职）、研究（拨款量）以及效率和成本措施在内的结果联系起来。
