Making hospitals healthy

WITH hospital-acquired infections claiming more American lives each year than AIDS, breast cancer or automobile accidents, it seems the very facilities built to heal us have themselves become dangerous places.

Two million patients each year suffer from a hospital-acquired infection, the federal Centers for Disease Control and Prevention say, and nearly 100,000 of them die as a result. Architects believe that doesn't have to be the case.

The right physical environment -- single-patient rooms; well-designed ventilation systems and air filters; easy-to-clean, nonporous surface materials; and plenty of sinks for washing hands -- could reduce the spread of infection, they say. They even have research supporting the concept, known as evidence-based design. Now hospitals across the country, including many in California, are using this information to reduce infections from the ground up. The Center for Health Design, a research and advocacy organization based in Concord, Calif., is currently working with 50 hospitals to design safer facilities. And some of Southern California's largest medical center replacement projects, including Los Angeles County-USC Medical Center and UCLA Medical Center, have incorporated elements of evidence-based designs. These include private patient rooms, ubiquitous hand-washing sinks and alcohol hand-sanitizing dispensers, isolation rooms for highly infectious patients and emergency departments with negative air pressure, which pulls infectious air away from other parts of the hospital.

"Private rooms are the most important design element that reduces the spread of infection between patients," says Richard Van Enk, director of infection control and epidemiology for Bronson Methodist Hospital in Kalamazoo, Mich. Bronson is a pioneer of evidence-based design and was among the first hospitals in the United States to build a facility with all private patient rooms.

The hospital's new design also incorporates two sinks in each patient room, one of which is dedicated for the exclusive use of the healthcare worker. Many easily cleaned surface materials such as water-based low VOC (volatile organic chemical) paint, plastic counter coverings and linoleum floorings with antimicrobial properties were also used throughout the hospital.

Bronson measured the difference in infection rates between its old, multi-bed-room facility and new, private-room facility, which opened in December 2000, and discovered that the infection rate had dropped by approximately 11%. "The major change in that facility was the use of private rooms," Van Enk says.