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How new Marin, Sonoma hospitals are being designed to ease caregiver burnout, turnover

Even before COVID-19 hit, the well-being of health care workers was tenuous. But the pandemic pushed their physical and mental capacities to unforeseen limits, resulting in high levels of burnout and turnover.

To help health care systems thrive in the long term, two North Bay hospitals are among those that have incorporated design elements into their new buildings that support their caregivers.

That begins by asking them what they need to help ease the stressful nature of their work.

Sutter Santa Rosa Regional Hospital sought input from nurses and other staff in helping design its new $173 million three-story tower that opened in early May, according to CEO Dan Peterson.

“They're going to come up with far better ideas than even any architects could come up with or any administrators, such as myself, because they're the ones doing the work,” Peterson said.

For example, wide doors that swing both ways were installed in the bathrooms of patient rooms so caregivers can move their patients in and out more easily. And the showers have trench drains, which are more efficient at allowing water to drain and lessen the chance of spilling onto the floors.

Some changes that may seem small, such as relocating the nurse call button from beside the patient’s bed to just inside the door, can help save time — and personal protective equipment.

That comes into play when a patient accidentally hits the call button.

“If it’s in a patient room with contact precautions or other infection precautions, the nurses have to put on various PPE to shut off the buttons that have been inadvertently tripped,” Peterson said. “It doesn’t happen all the time … but all of those little things add up at the end of the day.”

On June 15, the Harvard Business Review reported the design of clinical spaces has previously been focused on the well-being of the patient, but now “caring for the people who serve them is crucial to creating and maintaining a high-performing hospital system.”

The article looked at four hospitals that have made such changes, including two in Southern California. Loma Linda University Medical Center implemented an open-core design — a layout that gives caregivers larger work areas — in its expansion.

Montage Health, on the Monterey Peninsula, incorporated a garden-like environment and private patios into the design of its buildings to help workers connect with nature.

These elements can have a positive psychological impact on caregivers and were among the features included in MarinHealth Medical Center’s Oak Pavilion in Greenbrae, a $535 million facility that opened in December 2020.

“The main themes that we went for was that the (Oak Pavilion) would be more like a hotel than a hospital,” said Jason Haim, principal and executive director of Los Angeles-based architectural firm Perkins Eastman, which designed the hospital.

“We feel like that hospitality experience is a critical aspect to healing. It doesn't only apply to the patient; it very much involves the staff as well.”

The Oak Pavilion has spacious staff lounges and rest areas — features, Haim said, are typically “afterthoughts” in hospital designs.

“So, for hospitalists, as an example, they need sleep rooms,” he said. “And for certain managers, they want to be on the unit and they need an office or they do sensitive work, which requires a special consultation space.”

The open, airy design of the building includes plentiful solariums and access to exterior gardens — and it’s made a positive impact.

“Since the building opened, we have seen a noticeable difference in the physical and mental stress of our caregivers,” said Dr. Karin Shavelson, chief medical officer at MarinHealth.

“The ER staff and (physicians) really appreciate their new, less cramped space and often wonder how they ever pulled it off in the old space. They appreciate that there’s far more privacy for patients and their clinical teams in these larger private rooms.”

While some adaptations may seem like “nice to haves,” caregivers’ safety is driving a lot of decisions.

One of those changes is swapping out manual patient bed lifts for overhead motorized lifts, which can help reduce physical injuries to nurses that come from repetitive routine tasks like bending and stretching.

Sutter Santa Rosa Regional Hospital installed motorized lifts in all the patient rooms in its new tower. Peterson said that while this change is becoming more commonplace in hospitals, it’s rare for the lifts to be in every patient’s room.

"I think the most important thing we can do for (caregivers) right now to support a good workplace is to listen to them, and to do whatever we can to incorporate their feedback,” Peterson said. “I think the psychological toll on our health care workers over the last few years in particular … is largely underestimated and understated.”

Cheryl Sarfaty covers tourism, hospitality, health care and education. She previously worked for a Gannett daily newspaper in New Jersey and NJBIZ, the state’s business journal. Cheryl has freelanced for business journals in Sacramento, Silicon Valley, San Francisco and Lehigh Valley, Pennsylvania. She has a bachelor’s degree in journalism from California State University, Northridge. Reach her at cheryl.sarfaty@busjrnl.com or 707-521-4259.

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