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One size fits all? Mixed methods evaluation of the impact of 100% single room accommodation on staff and patient experience, safety and costs

One size fits all? Mixed methods evaluation of the impact of 100% single room accommodation on staff and patient experience, safety and costs
One size fits all? Mixed methods evaluation of the impact of 100% single room accommodation on staff and patient experience, safety and costs
BACKGROUND AND OBJECTIVES: There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore the impact of all single rooms on staff and patient experience; safety outcomes; and costs.

METHODS: Mixed methods pre/post 'move' comparison within four nested case study wards in a single acute hospital with 100% single rooms; quasi-experimental before-and-after study with two control hospitals; analysis of capital and operational costs associated with single rooms.

RESULTS: Two-thirds of patients expressed a preference for single rooms with comfort and control outweighing any disadvantages (sense of isolation) felt by some. Patients appreciated privacy, confidentiality and flexibility for visitors afforded by single rooms. Staff perceived improvements (patient comfort and confidentiality), but single rooms were worse for visibility, surveillance, teamwork, monitoring and keeping patients safe. Staff walking distances increased significantly post move. A temporary increase of falls and medication errors in one ward was likely to be associated with the need to adjust work patterns rather than associated with single rooms per se. We found no evidence that single rooms reduced infection rates. Building an all single-room hospital can cost 5% more with higher housekeeping and cleaning costs but the difference is marginal over time.

CONCLUSIONS: Staff needed to adapt their working practices significantly and felt unprepared for new ways of working with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms.
human factors, infection control, nurses, patient safety, patient satisfaction
2044-5415
1-17
Maben, J.
482f92f0-6339-42dd-9ee5-3fbc08d1e6f0
Griffiths, P.
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Penfold, C.
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Simon, M.
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Anderson, J.E.
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Robert, G.
b11c119f-eaef-42ac-817c-1a9f60b905f5
Pizzo, E.
d87071b9-cebf-405f-9e86-16a2f8c00498
Hughes, J.
d6a276c8-a7e5-46d9-9b3a-e7be07d4ddfc
Murrells, T.
5968b6c0-e5ec-46b5-8dd3-57a747573b99
Barlow, J.
a79fb2a6-04e7-400e-a67e-8625743bef60
Maben, J.
482f92f0-6339-42dd-9ee5-3fbc08d1e6f0
Griffiths, P.
ac7afec1-7d72-4b83-b016-3a43e245265b
Penfold, C.
7a92b4c9-f2fb-4b70-8348-02a3a1e68a55
Simon, M.
e4faadf3-74bb-4f7d-b406-ab05cb919600
Anderson, J.E.
c2b4bbf1-94c7-4e4a-944a-3b31d8a54aa3
Robert, G.
b11c119f-eaef-42ac-817c-1a9f60b905f5
Pizzo, E.
d87071b9-cebf-405f-9e86-16a2f8c00498
Hughes, J.
d6a276c8-a7e5-46d9-9b3a-e7be07d4ddfc
Murrells, T.
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Barlow, J.
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Maben, J., Griffiths, P. and Penfold, C. et al. (2015) One size fits all? Mixed methods evaluation of the impact of 100% single room accommodation on staff and patient experience, safety and costs. BMJ Quality and Safety, 1-17. (doi:10.1136/bmjqs-2015-004265). (PMID:26408568)

Record type: Article

Abstract

BACKGROUND AND OBJECTIVES: There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore the impact of all single rooms on staff and patient experience; safety outcomes; and costs.

METHODS: Mixed methods pre/post 'move' comparison within four nested case study wards in a single acute hospital with 100% single rooms; quasi-experimental before-and-after study with two control hospitals; analysis of capital and operational costs associated with single rooms.

RESULTS: Two-thirds of patients expressed a preference for single rooms with comfort and control outweighing any disadvantages (sense of isolation) felt by some. Patients appreciated privacy, confidentiality and flexibility for visitors afforded by single rooms. Staff perceived improvements (patient comfort and confidentiality), but single rooms were worse for visibility, surveillance, teamwork, monitoring and keeping patients safe. Staff walking distances increased significantly post move. A temporary increase of falls and medication errors in one ward was likely to be associated with the need to adjust work patterns rather than associated with single rooms per se. We found no evidence that single rooms reduced infection rates. Building an all single-room hospital can cost 5% more with higher housekeeping and cleaning costs but the difference is marginal over time.

CONCLUSIONS: Staff needed to adapt their working practices significantly and felt unprepared for new ways of working with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms.

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Accepted/In Press date: 18 August 2015
e-pub ahead of print date: 25 September 2015
Keywords: human factors, infection control, nurses, patient safety, patient satisfaction
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 381783
URI: http://eprints.soton.ac.uk/id/eprint/381783
ISSN: 2044-5415
PURE UUID: 01c25b02-bd22-4799-919c-e51751292587
ORCID for P. Griffiths: ORCID iD orcid.org/0000-0003-2439-2857

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Date deposited: 09 Nov 2015 11:40
Last modified: 15 Mar 2024 03:37

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Contributors

Author: J. Maben
Author: P. Griffiths ORCID iD
Author: C. Penfold
Author: M. Simon
Author: J.E. Anderson
Author: G. Robert
Author: E. Pizzo
Author: J. Hughes
Author: T. Murrells
Author: J. Barlow

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