1. ICU Observations April 19, 2015 Frank Crittenden Victor Ondego Lauren Hess

2. 2 Northside

3. 3 Patient Room

4. 4

5. 5 Patient Beds

6. 6 Nurse Area

7. 7 Observations related to problem Family Services –Designated family space –Culture focused on families –Extra “amenities” Communication at Intake –Gathering more information

8. 8 Piedmont Hospital – Patient Room

9. 9 Piedmont Hospital – Patient Beds

10. 10 Piedmont Hospital – Nurse Area Family issue – staff spending too much time on the computer No work area inside the room

11. 11 Piedmont Hospital – Family Zone

12. 12 Piedmont Hospital – Family Services/Amenities No sleep chairs in patient rooms Only a few private sleep areas –Some private rooms can be reserved Most families sleep in waiting lounge

13. 13 Piedmont Hospital – Family Services/Amenities No showers on units –Inconvenient alternate location – through tunnel in fitness center across Peachtree Street –Limited hours No lockers No laundry facilities

14. 14 Piedmont Hospital – Family Communications Informal – no set protocol or communication documents Intake –Family waits in lounge while patient is brought to room for clinical assessment and first orders –Family is brought to room for initial update Ongoing communication is ad hoc No ICU-specific reference materials

15. 15 Piedmont Hospital – Observations related to problem Little or no accommodation for families in the patient room Family amenities scattered, if available Family communication is ad hoc – relying on the quality and experience of the individual nurses and clinicians

16. 16 Scottish Rite

17. 17 Scottish Rite NICU* and PICU* observations –Pin-wheel set up – good 1:1 visibility (NICU) –Noise reduction parameters incorporated –Family can visit @ bedside 24 hrs a day except for 2 hour shift change period –Typically 2 patients: 1 nurse based on acuity and proximity –Other visitors can visit during normal business hours - can stay longer with parents and nurse consent *NICU – Neonatal intensive care unit *PICU – Pediatric intensive care unit

18. 18 Scottish Rite NICU* and PICU* observations –Privacy concerns –Directing families into the unit –Better space for family members –Infection control *NICU – Neonatal intensive care unit *PICU – Pediatric intensive care unit

19. 19 Scottish Rite CIRU* observation –Much looser visitation policy than the NICU and PICU as this is considered a medical, surgery unit and not necessarily an ICU –Better visitor accommodation within room Chair plus longer couch for sleeping *CIRU – Comprehensive inpatient rehabilitation unit

20. 20 Scottish Rite General family accommodations –General information Guest services liaison –Family services Interpretation, wireless internet, laundry, sleeping, exercise –Food and drinks Discounted cafeteria rates –Parking Discounted parking rates for extended stays –Patient rooms Flexible visitation policy