October 16, 2014
Meredith Brelo

When I started my cancer journey, it was a few weeks in before I actually had my first treatment.  The doctor I chose is associated with a hospital that has offices at the main campus and a satellite campus.  Most of my appointments have occurred at a satellite campus, with pretty much everything other than surgery occurring there.  It is a nicer newer MOB in the suburbs. The times that we have had to go to the main campus it is very large and busy, and could be completely overwhelming.

I have had two separate surgeries so far at the main downtown campus.  The first was on an outpatient basis to place my porta-cath, and was in the new hospital tower.  This building is beautiful and a project that we dream about.   The waiting room is full of natural light, with lots of nooks to feel more private.  The pre/ post procedure area had three wall bays with windows at the headwall.  The exterior glass is the expensive art glass that always gets VE-ed out of our projects.  I couldn’t see the view from my stretcher, but the light was nice.  Speaking to the nurses they apparently don’t like the pattern on the glass because it “obstructs the view” and new doctors and nurses think the pattern is stick-on and are always trying to peel it off.  

I remember the unit being relatively quiet, and my nurse charted on a wall-mounted workstation between my bay and the corridor.  Brad was able to accompany me back and stay with me the whole time until I went to surgery. After being in recovery, I was released quickly, and we drove home. 

Lesson learned:

  • Access to exterior light.  Even though the choice of glass wasn’t popular with the staff, the light was great.  I was in a three wall bay and I felt plenty of privacy, but I also felt like if something was wrong, I was still visible to the staff.  I feel like in pre-post, three wall bays are great, if we can trade the cost of private rooms for access to exterior glass, even better.

A few weeks later I had my next surgery in the older part of the hospital.  The waiting was a little more cramped, but we weren’t in the waiting area for long.  Brad wasn’t allowed to accompany me back this time until after my IV was started.  The only reason I can think for the difference, other than it was a different unit, was space.  Maybe they feel with the tray and supplies, family takes up too much room when they are getting things started.  This unit was much louder and felt much busier.  I did notice that the schedulers were at the nurses’ station, calling with follow ups form the previous day’s surgeries, and instructions for the next day’s surgeries.  I don’t know if it was the level of surgery, the noise, or that Brad wasn’t allowed back with me, but this time I was much more nervous.  My anesthesiologist came to verify my information, and take me back to surgery.  I got off the stretcher and walked myself into the OR.  The nurses helped me to climb up on to the tableThe nurse and I were having a nice conversation but was knocked me out mid-sentence.  As soon as I was awake, I was moved from the PACU to Phase 2 recovery.  Brad was allowed back to see me, but they hustled him off to pick up my prescriptions at the pharmacy pretty quickly.  I had a harder time recovering this time.  I had to walk and go to the bathroom to be released, but I had a really hard time with nausea from the anesthesia this time.  I felt rushed and pressured to get out of there.  I don’t think it was really from my nurse, but just from the amount of hustle and bustle around me.  Granted, I did want to get out of there and go home.  But I also wanted to roll over and go to sleep.  The nurse gave me more medicine for my nausea, and then we did make it home that evening.  But I have to say, my first surgery experience was much nicer than my second.  Maybe I’m a snob for new buildings.

 Lesson learned:

  •  Noise does make a huge impact on patient satisfaction.  Talk to your users about what is happening at the nursing stations.  If there are schedulers, try to keep them more isolated from patient care areas. 

The next week I started my infusions at the newer, suburban MOB.  I had twenty weeks of infusions. There was a blood draw area (which I never saw used), the vitals area, and 2 “quick” curtained bays for shorter infusions.  Then there was a glass wall to the nurses’ station.  On the other side of the nurses’ station there were five, three walled bays for longer infusions, and then four curtained bays that were more “social”.  By social, you could leave your curtains open and visit with your neighbors if you so wished.  Most people brought a family member or a friend with them, so they didn’t really socialize with the other patients.  The first 8 weeks of my infusions, I was in the 3 walled “longer infusion” bays.  They each had an exterior window, a TV and a guest chair.  The only time we watched the TV was during world cup, otherwise it stayed off the whole time. Brad came with to most of my infusions (with friends filling in the rest).  His primary concern was access to whatever plug, so that he could keep his laptop plugged. 

The only times I really interacted with other patients was when I was in one of the two “quicker” curtained bays.  These two bays had recliners with heat and massage, and it wasn’t as loud as the area by the TV.  The waiting area for the infusion chairs was directly in front of these two bays though.  So if you didn’t have your curtain drawn, or drawn all the way, whoever was waiting for a chair to open up, was sitting there looking right at you.  

Lesson learned:

  • The “social” area had the nourishment area right next to it.  The bay next to the ice maker was the worst of all the bays and the last to get filled. 
  • I don’t think the flow was as it was envisioned in user groups, either it didn’t work, or there was a new manager that wanted to do things a little differently than the manager involved in design. I appreciate the different areas, longer infusions, quicker infusions, social, private, etc… But as designers we have a way to make it more flexible.
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