When hospitals group patient rooms into small clusters, nurses have more time for their patients. But the design of these "bed clusters" is important.
This finding has emerged from a new report from hospital researchers at SINTEF. The "bed cluster concept" can have different configurations, but it means that patient rooms are grouped into clusters, with work stations for the nursing staff attached to each group. Shorter walking distances make it easier for the nurses to keep an eye on patients, prevent undesirable incidents and give them more time to care for patients.
The researchers have reviewed the literature and conducted interviews with nursing staff and managers at three of the hospitals using the concept. They compared and analysed existing hospitals and planned hospital projects.
Less walking time
Bed clusters are in widespread use in Norway's newer hospitals. St Olavs Hospital, Ringerike Hospital, Stavanger Hospital and the new Ahus have these clusters. Internationally, the trend is also towards clusters and "bed courtyards", and countries like the USA, the UK, Sweden, Denmark and Latvia use them extensively. The thinking behind this concept is that in the future there will be more and sicker patients, and that when nurses are closer to their patients, they can monitor them better.
The old ward design consisted of 20 or 30 rooms off a long corridor (or a double corridor). There was a nurses' room in the middle, and bed linen, sluice rooms, etc. were located in a central area or distributed between the rooms.
In the bed cluster model, the rooms are grouped into a "courtyard", with beds in seven to nine rooms, and the old nurses' room has been replaced by three decentralised work-stations. Shared "support rooms" (sluice rooms, conference rooms) are positioned between the various bed clusters, with stores for bed linen and consumables integrated into each cluster.
The researchers have found that a decentralized configuration saves the staff from enormous amounts of unnecessary walking along corridors. The environment becomes calmer, and the role of the nursing staff changes: part of what kept the nurses so busy before was walking to and fro between patients and to fetch equipment, but now the time they save can be devoted to patient care.
Several clusters in series is best
"What all the models have in common is a decentralized nurses' area, and bed areas divided into small groups, but their configuration and the way they are used are different. It is this effect we have been studying," says hospital researcher Marte Lauvsnes at SINTEF Technology and Society.
"A hospital like St Olavs in Trondheim has configured the bed clusters in the new centres in several different ways. One area has three clusters in series. Another is built in short wings that put two clusters next to each other, while a third is separate. The final configuration was dictated by building area constraints, and the solution is clearly not as good as when the clusters are arranged in series."