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Bendale Acres, a Long Term Care Facility wants to enhance the safety and comfort of their residents and staff by redesigning their nursing units. The nursing stations serve as a reception desk, an examination room, and a site for resident file storage and medication storage. They are looking for systems with similar functionality as the nursing station that improves primarily, accessibilty, ergonomics, and sightlines. Following the client's request for the redesign of the nursing station, our design team is proposing a new nursing station to replace the current design.
The new design must allow nurses to monitor any activity in the hallways and monitor people moving in and out of the elevators. The stations must provide space to store medicine, resident files and medical equipment. It must also provide a place for regular physical check-up. This design should be as inexpensive as possible. It should maximize sightlines of nursing stations and allow better accessibility for the nurses. The design should minimize the amount of construction and demolition to ensure comfort of the residents. It should be aesthetically pleasing and improve the general ergonomics of the nurse and doctor work environment. The design must not violate any safety or building codes as outlined by the Ministry of Health and the City of Toronto. We have also investigated the physical and human environment of the nursing station to further define the conditions the design will operate in.
After brainstorming and assessing our results, our team came up with five alternative designs that met all the constraints. These designs include the Multiple Nursing Stations, The Portable Nursing Station, The Ergonomically Improved and Surveillance System Station, The Glass Wall Replacement Station and The Rounded Glass Wall Station. After evaluating our alternatives, we concluded that a hybrid of the design consisting of a rounded glass station and a remote station would be the most appropriate solution as it best meets the functions, objectives and constraints of the problem. This design allows for improved ergonomics and sightlines, gives room for storage space, allows team to see into filing and medicine rooms and is very aesthetically pleasing.
Next, we outlined a plan for a detailed design that includes what we will be presenting next and any outstanding decisions we still have to make. The report outlines the basic implementation instructions. We preformed a life cycle assessment and economic analysis. In the economic analysis, we considered the intial, ongoing and final costs, as well as any economic benefits of the design.
All five stages of the human factors (physical, psychological, team, organizational and political) were considered. The report outlines how the design meets each factor. For example, on the psychological level, the design affects the resident's sense of comfort and security. We also considered the design's social impacts.
Lastly, we prepared an updated project management plan with details on upcoming project milestones. Our next step will be to present the final design specification (FDS) to the client. This report will specify the proposed design in greater detail with respect to the environment, economic, social and other factors that affect it. The Final Design Specification report outlining these details will be available on April 28th, 2010.
Bendale Acres Long Term Care Facility values a culture of safety, so that the environments of its residents, visitors, volunteers, students and staff promote safety, comfort and well-being.  In order to enhance the safety and comfort of her residents and staff, Sheri Cotton, the administrative assistant at Bendale Acres has asked for the redesign of the nursing units. The nursing stations in each of the nursing units at Bendale Acres are inappropriately located and sized. They are looking for designs that improve the layout of the Nursing Stations in order to maximize ergonomics and efficiency. The new design must allow nurses to monitor any activity in the hallways and monitor people moving in and out of the elevators. The stations must provide space to store medicine, resident files and medical equipment. It must also provide a place for regular physical check-up. This design should be as inexpensive as possible. It should maximize sightlines of nursing stations and allow better accessibility for the nurses. The design should minimize the amount of construction and demolition to ensure comfort of the residents. It should be aesthetically pleasing and improve the general ergonomics of the nurse and doctor work environment. Bendale Acres is home to a wide demographic community with residents ranging in age from 23 to 105 years old and of many different cultural backgrounds. Sixty-six percent of residents suffer from cognitive impairments, and some exhibit exit-seeking behaviours. Some residents require the aid of a walker or wheelchair. The redesigned nursing units should be suitable to this demographic. The design must not violate any safety or building codes as outlined by the Ministry of Health and the City of Toronto. It must not interfere with the residents' daily activities. Lastly, the design should improve the safety of the residents as much as possible.
1.2 Identification of Stakeholders
The following chart outlines the major stakeholders and their specific concerns with regards to the project (See appendix F for an audience analysis of client). It should be noted that the client is composed of a board of employees consisting of nurses, managers, administrators and other staff who work at Bendale Acres. It should be noted that all stakeholders are concerned with safety, and have some other general concerns specific to them as well. The stakeholders have been divided into primary stakeholders (those directly using the design), secondary (those who control the design), and tertiary (those who approve or are not directly related to the design.
Nurses and Doctors
Concerned with being able to observe residents from most parts of the unit, increasing the safety of the residents, as well as being able to carry out their work in a more ergonomic and efficient space.
Concerned with their safety in the nursing units, as well as with the overall aesthetics of the unit (their living quarters).
HF, SI, EI
Administrators, Managers and Other Staff
Concerned with the overall safety of the residents, as well as increasing the efficiency of their nursing units and the cost of the project which they must submit to the Ministry of Health.
City of Toronto
Concerned with the safety of residents and the cost, as the City owns the building and must pay for costs.
Ministry of Health
Concerned with ensuring building and safety regulations as set out in their documents are met, as well as with the overall cost of the project as they must approve the budget.
Family and Friends of Residents
Concerned with the safety and well-being of the residents in the nursing units.
HF: Human Factors, $: Economical Impact, EI: Environmental Impact, SI: Social Impact
There are several functions identified for the nursing units. The design team will work to satisfy these primary and secondary functions to increase the security and functionality of them. Also, some unintended uses have been considered by the team (see Appendix A).
The primary functions describe the basic performance that the design should have.
Allow nurses to monitor resident's behaviour in the hallways.
Allow nurses to monitor people moving in and out of the elevators.
Provide a place to store medicine, resident patient files and medical equipment.
Provide a space for regular physical check-up
These functions are the prerequisites that allow the design's primary functions to perform.
Provide a space for people to work inside of.
Provide space which can be used as storage.
There could be unexpected functions, either positive or negative, that the design will perform in actual usage.
1. Provide a temporary storage area for patients' personal effects, such as mails, books, etc.
2. Provide a place for the residents and visitors to give feedbacks about nursing service.
The team has identified a number of objectives which the design should fulfill in order to satisfy the problem to the highest degree (see Appendix A). The design
Should keep costs to a minimum
Should utilize systems which are already in place
Should maximize sightlines of nursing stations and floor
Should effectively and efficiently store files and equipment
Should minimize construction or demolition (if any) to prevent major movement of residents
Should allow better accessibility for nurses
Should improve the general ergonomics of the nurse and doctor work environment
Not all of the following constraints apply to a nursing station; however, if the current nursing station is to be designated for another purpose (thereby moving the nursing station elsewhere), it may need to abide by these constraints, depending on whether the space is to be accessible to residents.
There are various parts of the design which must be met in order for the design to be considered or approved in any manner. These include:
Must comply with all codes and standards set out by the ministry of health (see Appendix A and B) concerning:
Structural constraints- for example, paths of travel should be a minimum of 1100mm wide 
Accessibility constraints-for example, counters of a nursing station must have at least one section useable by persons in wheelchairs at a maximum height of 865mm 
Codes with regard to working conditions
Lighting requirements- for example, lighting levels at keyboards should be evenly distributed at no less than 200 lux 
Budget must be reasonably low (while no cap is given, must be approved by the Ministry of Health)
Must keep design within hired staff (cannot hire new staff)
Must allow residents to continue daily routines without interruptions (i.e. due to construction) and cannot interfere with their comfort
Must not incite paranoia or fear in residents with cognitive impairments
Must not add extra safety hazards
Must comply with the constraints of the structure (i.e. cannot destroy load bearing walls, etc.)
1.6 Service Environment
The service environment describes the location where the design will be implemented (see Appendix A for interview notes and Appendix C for floor plans).
There is one nursing station on each floor of Bendale Acres Long Term Care Facility (six floors total). The nursing station contains shelving along the walls which store patient files. A side room within the station contains medicine and basic medical equipment. The front desk overlooks two elevators which are for residents and visitors. There is no view of the hallways leading to patient rooms. The nursing station has a wide doorway facing the main hallway. The area is at approximately room temperature (20 to 25 degrees Celsius).
The nursing station overlooks a variety of residents and visitors. These residents enter the nursing stations for examinations and prescriptions. The residents are aged eighteen and over and of different backgrounds. The current age range is 23-105 years (Appendix A), and many residents are French speaking or Ismali . Sixty-six percent (Appendix A) of residents suffer from cognitive impairments, and some exhibit exit-seeking behaviours. Some residents require the aid of a walker or wheelchair. Six to eight staff are on duty per floor during daylight hours. In the night, there are three staff per floor. There are no staff members permanently situated in nursing stations. The staff includes security, nurses and caretakers.
The nursing station contains a desktop and telephones. The laptops connect to the internet by a wireless device. It is important to note that there are no cameras in the building. Thus, no video surveillance systems exist in the nursing stations. There are several power sockets within the nursing station.
1.7 Client Ethics and Values