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MCDM AG.COM | JA N UA RY/ F EBRUA RY 2018 | Medical Construction & Design 37 well-being is considered. Access and views to the outdoors enhance the work- ing environment. A patio space or outdoor seating area is ideal, but a similar eff ect can be achieved with large windows and artwork if an outdoor space is not an option. Giving staff places where they can collect their thoughts, refl ect, rejuve- nate and grow is essential to facilitating the kind of care that keeps patients coming back. Solutions + strategies To provide high-quality care, staff must be able to do their jobs effi ciently. To enable that effi ciency, work areas should be convenient and organized with workspaces in rooms, supply storage nearby and designated space for charting work and conferring with allied profes- sionals. Along with the emo- tional cleansing that takes place in the restorative spaces, data shows that hand-washing sinks outside the patient's view allow time for cleansing hands and minds between patients, and they enhance staff satisfaction. At Elmhurst Hospital, hand- washing sinks were placed behind the curtain so the staff is not yet on stage when entering the room. They can take a mo- ment upon entering the room, so that when they put gloves on and come around the curtain, they are fully present to interact with the patient. Nursing theo- rist Jean Watson, a board mem- ber at Planetree when Elmhurst Hospital was designed, created the "Theory of Human Caring." She wrote about the impor- tance of clearing the mind, at the same time as cleansing the hands, as a way to be fully pres- ent before greeting and treating the next patient. The Elmhurst project, an example that emphasized staff satisfaction, has achieved magnet status. Jean Lydon, the chief nursing offi cer, who participated in the design eff orts, remarked, "We were successful because we en- gaged our staff to work with the design architects, and our staff is very satisfi ed with the convenience of working on the units." Overall staff satisfaction increased after moving into the new hospital, from 77 percent in 2009 to 82 percent a year af- ter moving to the new hospital. And in 2017, a survey published by nurse.org rated Elmhurst's nurses the second-highest staff satisfaction scores out of 169 hospitals in Illinois. Patient satisfaction results were accounted for in the design. For example, patients perceived communication to be more eff ective if the staff was sitting down, at eye level with patients, so a seat was placed on the staff side of the patient room, which would always be available to staff . Staff satisfaction also fac- tored into the design through the employment of the 90/5 rule: 90 percent of supplies needed would be available within 5 seconds. Supplies that could not be stored in the patient's room were placed just outside the door in a stor- age area shared between two rooms. This made the work fl ow more effi ciently, cutting down on steps and allowing the staff to spend more time with patients. This, in turn, increased satisfaction for both patients and staff . Insight + analysis Other staff satisfaction mea- sures that have been eff ective included an under-counter cabinet in each patient room at the University of Chicago, (Illinois) where staff could dis- pose of red bag waste. In most hospitals, this is not available in the patient room; it must be carried to a soiled utility room for disposal, where staff wash their hands and return to work. Two-sided assist bathrooms, with the toilet away from the wall, providing staff access on both sides, were also popular with the staff . Not only is it eas- ier and safer for them to help patients, but staff injuries have gone down in two hospitals that have been designed this way. The staff feels validated when their needs are considered along with those of the patients in facility design. Reducing staff injuries and increasing retention by creating a safe and pleasant working environment addresses the concerns of hospital leaders as well. Keeping the staff satisfi ed also helps leaders provide the services that patients are expecting, which keeps them competitive in the marketplace. In order to achieve the highest standards of patient care, it is necessary to create a culture where the staff is invested in supporting those patient-care goals. If needs are being met, they will go out of their way to please their patients. The key to creating designs that work for both patients and staff is to envision the symbiotic relationship that exists between them. Hospital staff does their jobs because they want to help people, and their well-being is important to continue provid- ing top-notch care to patients. Optimal performance starts with caring for the staff that does the healing. When per- forming at their peak, patient satisfaction is ensured. Robert F. Sharrow, AIA, ACHA, EDAC, is vice president and principal with Albert Kahn Associates, Inc. He can be reached at robert.sharrow@akahn.com. Inspired by Planetree, the Elmhurst Memorial Hospital nurse stations were designed to encourage face-to-face collaboration.