There is a new nursing station model that is getting a fair amount of “air play” recently. The “Porch” model was first published by Knoll in February 2012. But since the original article, it has also been written up in a recent article in HealthCare Design and was part of a recent webinar series based on patient care. The concept is being discussed, which is a positive sign for any concept.
The idea in a nutshell, create a nurse station solution that minimizes distractions, but continues to supply interaction. Distractions to a nurse’s routine can contribute to errors, inefficiencies, patient safety, staff stress, and this list can go on and on. The rub is how to minimize distraction but maintain the nurse interaction with patients and staff. The Porch concept attempts to find the balance by integrating the nursing area into the patient room. This Porch allows visual contact with the patient through windows and doors, but the doors can be closed to reduce distractions during times when concentration is needed, such as medication prep and updating patient records.
I do like the concept, but I have two concerns:
- Creation of the integrated Porch floor plan requires a radical change to patient room design. I am not saying this is a bad thing; just that architectural acceptance (buy-in) of the concept is required.
- With the nurse patient ratio approaching 1-6, I have concerns about how a “station per room” or even a “station per two rooms” concept would be created. And, if the Porch is placed in only some rooms, and not others, does this lead to a nurse spending more time with just one/two patients over the other four patients?
We need out-of-the-box thinking and I believe any concept is worth investigation. The first hurdle for any design comes soon after the first publication; does the concept continue to be discussed by the industry? In the Porch concept, it has and still continues to be discussed. The next major hurdle for any new concept is to create a pilot project. This is the true litmus test. Is the concept strong enough to convince an end-user to create the concept at their facility? At this point it is a wait and see situation.