Transitions in the Workflow of a Psychiatric Hospital Unit During the Covid-19 Pandemic and Design Implications

Raquel Ruiz, Purdue University

Abstract

As in many other aspects of society, the COVID-19 pandemic imposed a stress test on the entire healthcare system. Hospitals faced complex challenges, including making adaptations to each unit's specific characteristics and needs. Inpatient psychiatric units differ substantially from other hospital units, creating unique problems and considerations to safely manage patients, families, and healthcare staff during a pandemic. As research is done to improve our infrastructure for future pandemics, facilities with psychiatric units have unique design considerations. This thesis aims to examine the effects of the COVID-19 pandemic on the workflow of a psychiatric unit and its possible implications on future design requirements. Specifically, looking at transitions, i.e., what areas remained unchanged, what changes were made but have not persisted, and those that persisted, and what needs to be improved to better function in the next pandemic. The methodology used in this study included an examination of current design requirements and specifications and the workflow in a facility of this type. To maintain the facility's and staff's privacy, the specific unit is identified as Unit-A. A construction firm provided access to drawings, and engineers were interviewed to elucidate specific design/performance requirements. The methodology also included interviews of nurses and administrative staff actively engaged within Unit-A throughout the pandemic. A workflow was established based on the information collected before and during the pandemic. An analysis of the interviews and the workflow revealed: (i) the highest demands were placed on the direct-care staff, and (ii) policies implemented by the hospital without special consideration for the psychiatric unit caused unintended strain on the workflow. These significant findings suggest that each hospital should have a unique pandemic plan to accommodate their respective units. Obtaining more input from those directly impacted will improve the resiliency of the workflow. These findings also suggest that design specifications need to more effectively incorporate the needs of the professional staff, such as including a larger number of spaces for the healthcare staff in the hospital compared to current standards.

Degree

M.Sc.

Advisors

Ramirez, Purdue University.

Subject Area

Medical personnel|Medicine|Mental health

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