Health Care Facility Design Safety Risk Assessment Toolkit

Patient and staff safety in a hospital or other health care facility can be protected by a properly designed built environment. Assessing safety risks and incorporating preventive measures into the design of health care facilities can minimize such safety problems as health care-associated infections, patient falls, medication errors, and security risks. Unfortunately, design-related vulnerabilities that adversely impact patient safety are sometimes inadvertently built into the physical environment during the planning, design, and construction of health care facilities. These problems are difficult and expensive to address once a facility has been built and occupied.

To support health care facility design that protects patient and staff safety, AHRQ funded the development of a Safety Risk Assessment Toolkit for facility designers. The goal of the toolkit, developed by the Center for Health Design, is to assist in the design of a built environment that supports workflow, procedures, and capability while ensuring the safety of patients and staff.

The toolkit:

• Targets six areas of safety—infections, falls, medication errors, security, injuries of behavioral health, and patient handling—as required by guidelines of the Facility Guidelines Institute.
• Addresses  more than 200 potential environmental considerations for the built design.
• Functions as a quality check tool that allows teams to take into account level of priority and risk as well as budget constraints about what is feasible.

The toolkit uses an evidence-based approach to identify solutions, proactive process that can mitigate risk, and a discussion prompt for a multidisciplinary team. The  discussion prompt enables a team of architects and designers, frontline staff, clinicians, pharmacists, risk managers, facility managers, security staff, and others, depending on the scope of the project, to discuss ways to mitigate safety problems in the built design or renovation of a health care facility.

For example, a team could use the toolkit to examine staff workflow, patient treatment protocols, and room locations to decide where to place isolation and medication preparation rooms, where to place sinks, how to ensure separation of clean and soiled materials to reduce infection risk, how to address noise and light problems that may distract from correct medication administration, and where to locate slings and supplies for mobile lifts to ensure safe patient handling.

Different solutions are based on the particular facility and model of care. For example, a renovation of a neuro-oncology unit that requires single rooms due to reduced patient immunity instead of semi-private rooms would differ from design of a medical/surgical unit.

Select to access the toolkit.