If Bill Gates gave you a grant for several billion dollars and said design a hospital

warrior woman · Feb 12, 2004

WW I like how you think. In fact I was on a committee that developed the Video Inservice. You had to have stuff like Fire and infection control. So we had all the mandatory training lectures taped. You just checked it out at the library and then took a short written test when you turned it in. They had like 30 copies so no one had to wait.
A tube system is marvelous. I hven't ever worked at a hospital that didn't have one.

Thanks. I really appreciate that. I'm a firm believer in the 1 hour lunch period though. With the current 30 minute system, a nurse doesn't even have the opportunity to digest her food without being pulled back out on the floor for one reason or another, and that's just plain wrong. The floor should be fully staffed enough that a nurse should be able to take an hour lunch and still be covered in case an emergency comes up. This is for a 12 hour day of course. For an 8 hour day the lunch period sould be at least 45 mins long.

Sadie04 · Feb 13, 2004

Great thread! I would make necessary supplies like dressings, tape, tegaderm, linen, towels, etc easily accessible, and I like the idea of setting up the unit not as 2 long hallways, but in a circle with the nurses station in the middle. I'd make great-tasting, healthy food available 24/7, patient rooms would be comfortable, well lit, private and large enough for necessary equipment, and there would be enough computers and charting areas for everyone!!!

JacelRN, BSN, RN · Feb 13, 2004

This really is a great question.

My sister is a teacher and they are working with palm pilots with the students so that means no paperwork. She can zap a test or quiz out to each of their computers at their desk right from her palm pilot. She even takes notes and then after the computer begins to recognize her handwriting, it uploads it to Microsoft word. (This is the first I've heard of this so those of you with palm pilots, please forgive me :chuckle )

I would love to see something like this in the hospitals. Imagine we each carried a palm pilot and could chart anywhere in the hospital and it would not require the chart in hand. Technology amazes me so Bill Gates, this it right up your alley.

JacelRN

gwenith, BSN, RN · Feb 13, 2004

wow! what would one do with such empowerment? i would first make the facility attractive, clean, promising, user friendly by using inputs obtained through staff surveys, and gather excellent physicians (possibly pay their malpractice insc.) this would be a plus during this decade. next i would make sure that the facility would maintain diagnosis that belong with each other (ie. not mixing newborns and their moms with 78 year old females that yell all day and all night and did i say total care?). it would be nice to actually visit a hospital to see a new mom and baby and not have to journey through all the hallways of severely sick contagious people. i would keep surgery with surgeries and not have a 6 month old rsv across the hallway. there would be so much planning and so much enjoyment to build, but a headache to maintain. i would empower strong financial wizards to keep afloat and an excellent team to maintain the facility that would stay in continuous working conditions that met all the codes needed. update as needed. then there's the food issue. good food around the clock for staff and all, etc.. the most important thing would be to find staff that would love their jobs and plan to stay for some time. and to do that, one needs to make the work environment meaningful and safe, inticing and friendly. did i mention compitative wages? this is just some of my headaches i deal with every day, and i would love to make so many changes in my facility, but just a peon!!!
moho

you mix your patients!!!!:eek

we have dedicated midwifery hospitals and in the regional area midwifery wards - we never let infections mix - it is only at the smaller rural hospitals that we have a complete case-mix. where i currentlly work we still have "surgical" and "medical" wards separated with a dedicated oncology unit. the state goverment will even fly you from one center to another if your center does not have the specialty unit you require.

Roland · Feb 13, 2004

If nurses had one hour lunches then they should also have "napping rooms", where you could lie down for a half hour, in a comfortable, dark, quite place. In the Navy the ship became like a MORGUE because better than half of the people would eat a QUICK lunch and then take a nice nap. Such a practice went a long way in making the twelve (and sometimes sixteen) hour days MUCH more tolerable. I also believe that it would reduce errors that can harm patients. Speaking of sleep and errors NO medical intern or resident would be allowed to work more than about SIXTY hours a week at my hospitals. My wife recently talked to an intern who had been on for thirty six hours, and said he was working well over a hundred hours per week. How can hospitals tolerate the legal exposure of such a plainly foolish tactic? Sure it might make the doctors tough, but at what cost in terms of their health, and that of their patients?

eirthjona · Feb 13, 2004

You mix your patients!!!!:eek
We have dedicated midwifery hospitals and in the regional area midwifery wards - we never let infections mix - it is only at the smaller rural hospitals that we have a complete case-mix. Where I currentlly work we still have "surgical" and "medical" wards separated with a dedicated oncology unit. The state goverment will even fly you from one center to another if your center does not have the specialty unit you require.

:uhoh21: I agree with you that is just plain sceary. I am glad in a lot of ways that I am going to be working in Australia.

Roland · Feb 13, 2004

I would also set up high quality, twenty four hour child care (at low prices or even free under certain circumstances such as when you were called in on an emergency basis). Many Dr's and Nurses struggle with finding child care providers to meet the "odd hours" that their jobs require. Therefore, if my hospital provided it then we would probably reap benefits in terms of greater employee availability, reduced abcenses and lower staff turnover (how many of you have ever had to call in when your baby sitter, or care provider didn't show). Heck, you could do well with the concept of twenty four hour (standby) childcare in almost ANY major city, without regard to the hospital setting!

JACALA_CL · Feb 13, 2004

from the ground up. What would you do different? He gives you the authority to hire any personnel that you desire. The only catch is that your hospital will be evaluated in TWO years for efficacy and viability. IF it proves successful it will be a model for "national" emulation. On the other hand if it fails it will be a concession to the status quo. What sort of policies and innovations might you implement to improve nursing, physician, and allied health satisfaction in the context of also providing excellent patient care (even though you have several billion to work with, your hospital must also ultimately operate at a profit). It is said that true innovations are often to be found with those with the most hands on experience. This is an opportunity to express some of that experience into concrete plans (and who knows maybe it will get back to Mr. Gates).

i would have who ever was going to work in an area help design the area

ie nurse help design the wards, dietary aidse help design the kitchen, etc

the ordinary works in their area the most and therefore knows what would make things flow easier

adrienurse, LPN · Feb 13, 2004

I'm gonna link you to one of the best allnurses discussions ever. Some time ago, someone imagined what it would be like to design the perfect hospital where we'd all work the allnurses hospital! And since we're all super nurses and perfect in every way it would be the best hospital in the world.allnurses hospital!

warrior woman · Feb 13, 2004

Oh yeah, I would also have a PRIVATE gym for the nurses to work out in, so that after a tough shift they could work out, or blow off some steam. And make sure nurses areas are CLEARLY marked for nurses, and employees only, so that Pts. couldn't just barge in and bother you with a list of demands. We need our time too!!

Moho · Feb 16, 2004

You mix your patients!!!!:eek
We have dedicated midwifery hospitals and in the regional area midwifery wards - we never let infections mix - it is only at the smaller rural hospitals that we have a complete case-mix. Where I currentlly work we still have "surgical" and "medical" wards separated with a dedicated oncology unit. The state goverment will even fly you from one center to another if your center does not have the specialty unit you require.

:nono: Unfortunatly, yes we have been under some trial and error's (mostly error's). I have a very big problem with it and have voiced my opinion. That's why I can't get into management!!!!!!!! :chuckle

Moho

sharann, BSN, RN · Feb 16, 2004

We just had a remodel and no one asked ANY working nurses opinion (they asked the DON who never worked in most areas). An architect designed our new units and they look beautiful...on the surface, unfortunately they had overlooked a FEW teeny tiny things (like separate clean and dirty utility rooms)