Transcript Group_7_Powerpoint - Health Systems Institute

Light Impact
Health Care Environment of the Future
Group 7
Geetanjali Ningappa, Jeff Jopling,
Adriana Fuentes, Luxmi Saha, Lars Christensen
Light is very critical in Health Care settings
Visually
Emotionally
Biologically
Importance of Light in Hospitals
• Affects Patients well-being
• Increases visual performance of the staff
resulting in enhanced work performance
• Healing Property; Light therapy is used as
treatment to cure many diseases
• Induces alertness in staff
• Errors by staff is reduced
• Reduces number of falls by patients
Visual Impacts of light
Enabling Performance of Visual tasks
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Light enables us to see things ahead of us
Higher levels of light helps reduce staff error
Age related performance errors are reduced
Day lighting is preferred for fine color
discrimination
Visual Impacts of Light
Sleep quality of residents and number of
fall incidents during night time
• Patient falls reported inspite of wall
mounted luminaire over the bed
o can not reach the switch or can not see the
switch in the dark
• Light near the head disrupted the sleep of the
patient at night
Emotional Impacts of Light
Affecting Moods and perceptions
• affects behavior and performance at work
• Daylight has better impact in a work
environment than the artificial lighting
• Patients exposed to bright daylight experienced
lesser perception of light
Emotional Impacts of Light
Exposure to Colored light
• long exposure to a particular color is not
advised
o Causes over saturation
• creates an emotional state of mind
Biological Impacts of Light
Controlling body's Circadian System
• Higher levels of light suppress Melatonin causing
alertness
• Daylight is a better source as it provides higher
levels of light at eye level
• Very important to staffs as they work in night shifts
• Controlling the Circadian system helps combat
o depression
o sleep
o circadian rest activity rhythms
o length of stay
Biological Impacts of Light
Facilitating direct absorption for critical
chemical reactions within the body
• Light radiation is directly absorbed by
body stimulating chemical reactions in the
blood and other tissue
o Vitamin D metabolism
o Jaundice prevention
Right selection of light critical
• Factors important in selection of light:
o Technical needs
o Soft lighting for relaxing
o Night lighting
o Location, Intensity and Controllability of light
• Natural light is the best preference due to its
natural healing properties and economy.
Family and Communication
Family and Communication
Family
• 'a group of persons with close familial, social or emotional
relationship to the patient.'
• religious, cultural and social factors influence who is
considered family, and how those family members
understand illness.
• family members are more than just visitors - they, too,
experience the processes of care...
• ...and can suffer from anxiety, PTSD and/or depression as a
result
Effective Communication
• Communication
o 'As a result of treatment and the seriousness of the
illness, the ICU patient's body sends signals that the next
of kin neither recognize or understand.' (Eriksson 2010)
• Aspects of good communication
o appropriate timing, style, and wording
o message effectively received and understood
o allow family to stay during times of crisis
o support and appreciate family's contributions in caring for
the patient.
Role of Communication in Family Satisfaction
• Satisfaction - influenced by gap between needs and
expectations and perceived fulfillment of those expectations.
• Need to make health professionals aware of the needs and
expectations of patients and their families.
End of Life Communication
Why is needed?
• One out of five or 22% of Americans die in an ICU
• Need for clinicians and families to make decisions about
withdrawing or withholding life supporting therapies has
become standard
• 54% of family/patients may misunderstood patients
diagnosis or treatment if meetings last less than 10 minutes
• Perceived to lack hospitality towards dying patients and their
family members
• Doctor communication is not taught in an ICU
Good Communication
Advantages
Good communication makes a difference.
• improved clinical outcomes:
o Reducing psychological trauma symptoms
o Reducing depression and anxiety
o Decreased length of stay
o More frequent referral to hospice
o earlier orders for DNR and withdrawal of life support
 Improving quality of death and dying
• Critical care training may also change significantly if there is
some data that demonstrates improvement of patient/family
outcome as a result of communication skill training
Assessing Communication in the ICU
• Validated tools primarily based on questionnaires can
assess communication and satisfaction:
o critical care family needs inventory (CC-FNI)
o critical care family satisfaction survey (CC-FSS)
o family satisfaction in the ICU (FS-ICU)
• Results from individual ICU used to drive improvements in
that same ICU
• Next steps:
o develop means of tracking effective communication over
time.
o further develop tools for NICU and PICU settings
Electronic Communication
What is the need?
• Advances in information technology have led to an increase
in the options for mode of communication
• Increasing need for patients to read doctors' notes which
can help on:
o Understanding their health
o Foster communication
o Ease and promote shared decision making process
o Lead to better health patients' outcomes
Electronic Communication
Results
Positive:
• Communication improvement through:
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internet portals with secure electronic messages
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display medications, tests results, problems lists and facilitate
communication refills
ease on appointment scheduling
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• Efficiency in relating laboratory findings and doctors notes
• Helps remind patients what happened during visits
Negative:
• More questions raised about doctors' writing
• Doctor's concerned about patients reactions from notes
Conclusion:
• Current literature suggests positive results may be greater
than negative
Things to Consider
• Role that the built environment plays in facilitating or
hindering communication
o Make patient rooms less obviously dominated by loud,
mechanical medical devices
o Allow for 'open access' to the unit
• Effective discussion of prognosis and goals of care
o Family members use various types of information from a
wide array of sources for prognostication
• Shared decision making based on patient's and family's
values and preferences
o Develop patient-specific triggers for palliative care
consults