Disclosures: Elizabeth C. Esselman, MS3: Nothing to disclose

Objective: To analyze how evidence-based hospital design can be used to improve patient outcomes.

Design: Integrative review of quantitative studies

Setting: Tertiary Hospital

Participants: Not applicable

Interventions: Not applicable

Main Outcome Measures: Hospital length of stay, perceived level of pain, systolic and diastolic blood pressure

Results: Several studies in the acute care setting document a decreased length of stay, reduced pain and lower blood pressure in response to the natural environment. Patients recovering from surgery in rooms with windows with a view of nature had a shorter length of stay (7.96 days vs 8.70 days) and took fewer analgesics. After a myocardial infarction, patients in rooms with natural sunlight had reduced length of stay (2.3 vs 3.3 days) and viewing virtual nature scenes reduced perceived pain during bone marrow biopsy procedures with an odds ratio of better pain control of 4.76. Sunlight exposure was shown to decrease stress, pain, and analgesic use in spinal surgery patients. Sitting in a room with a view of trees promoted a decline in diastolic blood pressure following a simulated stressor and patients with plants in their room following a minor surgery had lower systolic blood pressure, lower pain ratings, and lower anxiety and fatigue ratings.

Conclusions: There is significant documentation that evidence-based hospital design can reduce hospital length of stay, decrease pain and improve vital signs. Given that such parameters determine patient functional outcome, discharge destination and insurance coverage, evidence-based hospital design should be considered for both new rehabilitation hospital designs and re-models.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/novel-approach-to-improving-acute-inpatient-rehabilitation-outcome-metrics-through-evidence-based-hospital-design/