Title |
One size fits all? Mixed methods evaluation of the impact of 100% single-room accommodation on staff and patient experience, safety and costs
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Published in |
BMJ Quality & Safety, September 2015
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DOI | 10.1136/bmjqs-2015-004265 |
Pubmed ID | |
Authors |
Jill Maben, Peter Griffiths, Clarissa Penfold, Michael Simon, Janet E Anderson, Glenn Robert, Elena Pizzo, Jane Hughes, Trevor Murrells, James Barlow |
Abstract |
There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore the impact of all single rooms on staff and patient experience; safety outcomes; and costs. Mixed methods pre/post 'move' comparison within four nested case study wards in a single acute hospital with 100% single rooms; quasi-experimental before-and-after study with two control hospitals; analysis of capital and operational costs associated with single rooms. Two-thirds of patients expressed a preference for single rooms with comfort and control outweighing any disadvantages (sense of isolation) felt by some. Patients appreciated privacy, confidentiality and flexibility for visitors afforded by single rooms. Staff perceived improvements (patient comfort and confidentiality), but single rooms were worse for visibility, surveillance, teamwork, monitoring and keeping patients safe. Staff walking distances increased significantly post move. A temporary increase of falls and medication errors in one ward was likely to be associated with the need to adjust work patterns rather than associated with single rooms per se. We found no evidence that single rooms reduced infection rates. Building an all single-room hospital can cost 5% more with higher housekeeping and cleaning costs but the difference is marginal over time. Staff needed to adapt their working practices significantly and felt unprepared for new ways of working with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 65 | 46% |
United States | 7 | 5% |
Australia | 7 | 5% |
Canada | 6 | 4% |
Spain | 4 | 3% |
Timor-Leste | 1 | <1% |
Denmark | 1 | <1% |
Korea, Democratic People's Republic of | 1 | <1% |
Switzerland | 1 | <1% |
Other | 1 | <1% |
Unknown | 48 | 34% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 67 | 47% |
Practitioners (doctors, other healthcare professionals) | 41 | 29% |
Scientists | 26 | 18% |
Science communicators (journalists, bloggers, editors) | 8 | 6% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 2 | 1% |
Switzerland | 1 | <1% |
Unknown | 197 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 31 | 16% |
Student > Master | 31 | 16% |
Student > Ph. D. Student | 20 | 10% |
Student > Bachelor | 17 | 9% |
Student > Postgraduate | 12 | 6% |
Other | 44 | 22% |
Unknown | 45 | 23% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 43 | 22% |
Medicine and Dentistry | 39 | 20% |
Social Sciences | 12 | 6% |
Engineering | 8 | 4% |
Design | 7 | 4% |
Other | 35 | 18% |
Unknown | 56 | 28% |