Safety by design: Starting from the ground up

It takes more than competent and caring physicians, nurses and medical staff to prevent errors. At St. Joseph's Hospital in Wisconsin, patient safety was built into the building design itself.

By Kevin B. O'Reilly, AMNews staff. March 27, 2006.

"It may not seem like it, but we're actually pretty busy today," said Mike Murphy, RN, during a recent tour of St. Joseph's Hospital in West Bend, Wis.

He's right. The place doesn't seem busy. Compared with other hospitals, the 80-bed, $55-million facility that opened in August 2005 seems most notable for what it lacks. There's no overhead paging system going off. Nurses and physicians aren't racing from room to room and floor to floor. They're not chatting loudly at a central station. Rolling carts don't make a racket on hard tile floors, and there's no harsh fluorescent lighting to sting the eyes and depress the spirit. In the rooms, there are no bickering patient roommates or cramped families.

That St. Joseph's, 40 miles north of Milwaukee, didn't sound busy was not a matter of chance but its designers' intention. Noise reduction was one of 12 patient-safety principles at the heart of what seems to be a new concept in health care construction.

Since the Institute of Medicine's 1999 report, "To Err is Human," estimated medical errors kill between 44,000 and 98,000 Americans each year in hospitals, physicians and other health care leaders have attacked the problem on multiple fronts, including stepping up investment in information technology and reporting errors to encourage system changes. But when it comes to incorporating patient-safety precepts into health care infrastructure design, St. Joseph's appears to be a pioneer.