How does a 100% single-room environment influence the experience of person-centred practice in an acute-care setting?

Abstract

1.0 BACKGROUND
Current building guidance for the NHS advocates 100% single-rooms inpatient environments. The research driving this has focused on patient safety and the reduction in healthcare-associated infections (HCAIs). There is little evidence of the impact of this design in adult acute care settings on the experience and delivery of person-centred care.
2.0 AIM AND OBJECTIVES
2.1 Research question
How does a 100% single-room environment influence the experience of person- centred practice in an acute-care setting?
2.2 Objectives
1. To explore, from the perspectives of patients/families, the experiences of care within a single-room, acute hospital environment.
2. To explore, from the perspectives of staff, the experiences of working within a single-room, acute hospital environment.
3. To determine the factors that influence the delivery of person-centred practice in a single-room, acute hospital environment.
3.0 DESIGN
An ethnographic study was undertaken in a district general hospital in Northern Ireland. Data collection included observations of practice (n=108.45 hours); patient interviews (n=9); and participatory reflective staff groups (n=3). A reflective journal was also kept by the researcher. Thematic analysis was used across all the data sources to identify the themes and subthemes.
4.0 RESULTS
Three main themes and ten subthemes became apparent:
• Limitations of the built environment, which included: Provision of amenities; Environmental design solutions; Tension between ensuring privacy and maintaining safety; Working environment
• Organising and delivering care, with subthemes of: Promoting a hotel culture; Task focused care; Spending time
• Nature of interactions, and the subthemes of: Feeling isolated and vulnerable; Engaging in meaningful conversations; Opportunities to socialise
5.0 CONTRIBUTION TO KNOWLEDGE
This work illustrates that changing the physical environment does have an impact on person-centred practice by:
 Providing a sharper focus of what constitutes a good experience of care
 Identifying that public expectations have been heightened about being treated as individuals
 Uncovering a sense of unease about who “owns” the space creating an additional barrier to delivering person-centred care

Date of Award	Mar 2020
Original language	English
Sponsors	Department for the Economy
Supervisor	Tanya Mc Cance (Supervisor) & Donna Brown (Supervisor)