Thesis (M.S.)--University of Nevada, Reno, 2004. / "December 2004." Includes bibliographical references (leaves 57-61). Online version available on the World Wide Web.

According to a recent study, about 30 percent of U.S. real estate projects are canceled midstream, while more than half run up to 190 percent over budget and 220 percent over the initial time estimate. The reasons for this are manifold but poor decisions during the initiation and early planning of the project can be pointed to as main causes. Most poor decisions stem from lack of information, bad judgment, and lack of communication and transparency between what the client expects and what the project team can deliver. Proper project planning procedures and methods will lead to proper contingency planning, management of partner relationships and contracts, management of dynamic change and associated risks that can, and most probably will, occur in the course of the project. The role of the owner cannot be overstated in all of these targets. Historically, the owners of healthcare facilities have a once in a lifetime involvement in the planning, design and construction (or major renovation) of their facility. The interaction with planners, public bodies, architects, engineers, and other entities is a daunting prospect for which an owner will seek help from specialized firms that represent the owner. This guide may serve as a healthcare project planning guide for owners, and in particular CEOs, to navigate the process. It will prepare the owner to recognize the major tasks and decision steps throughout project planning, while keeping the focus on the desired outcome. Any owner should recognize that the slogan: if you dont know what you want, you will not get what you need is as true today as it ever was. This guide will include research, best practices from industry experts, and a case study on the New Orleans public healthcare planning process post-Hurricane Katrina.

Hospital sound environments are complex and hard to understand. One of the most important factors in these environments is the effective communication between staff members in regards to patient care and successful communication depends in part on the hospital’s sound environment. In this study, objective sound measurements as well as occupant perceptive data were collected at three hospitals. Sound pressure levels; including maximum, peak, minimum and equivalent levels were recorded in these hospitals, in addition to active impulse response measurements. Acoustic descriptors of the sound environment such as spectral content, level distributions, energy decay and temporal patterns were examined. The perception of the hospital soundscape (sound environment) was evaluated through surveys of the staff, patients and visitors to units. It was found that noise levels in all patient rooms and work areas were significantly higher than guidelines laid out in previous literature and by professional organizations. This work contributes to the field by broadening the metrics used to quantify hospital acoustic environments. In addition, this work added to the field by providing the most rigorous acoustic field measurement set published to date. This was done to create an accurate portrayal of the hospital soundscape environment.

In this research, the issue of evacuating people from large public facilities has been studied. The focus has mostly been on the evacuation of hospitals. For the hospital evacuation planner, it is necessary to know how long it would take to evacuate the premises. To approach this problem, the entire evacuation process has been modeled as a queuing situation using a simulation language called SLAM. The evacuation time is affected by many variables such as the number of elevators in the building, the number of ambulances available to transport patients, and the number of staff available to assist in moving patients. All these variables have been incorporated in the model as servers of the queuing process and the simulation is carried out. The model has been applied to a case study of the evacuation of the Medical College of Virginia Hospitals in Richmond, VA. The sensitivity of the model to different system parameters has been studied and the relationships have been plotted. / Master of Science

Patient falls are the most commonly reported "adverse events" in hospitals, according to studies conducted in the U.S. and elsewhere. The rate of falls is not high (2.3 to 7 falls per 1,000 patient days), but about a third of falls result in injuries or even death, and these preventable events drive up the cost of healthcare and, clearly, are harmful outcomes for the patients involved. This study of a private hospital, Dublin Methodist Hospital, in Dublin, Ohio analyzes data about patient falls and the facility's floor plans and design features and makes direct connections between hospital design and patient falls. This particular hospital, which was relatively recently constructed, offered particular advantages in investigating unit-layout-related environmental factors because of the very uniform configuration of its rooms, which greatly narrowed down the variables under study. This thesis investigated data about patients who had suffered falls as well as patients with similar characteristics (e.g., age, gender, and diagnosis) who did not suffer falls. This case-control study design helps limit differences between patients. Then patient data was correlated to the location of the fall and environmental characteristics of the locations, analyzed in terms of their layout and floor plan. A key part of this analysis was the development of tools to measure the visibility of the patient's head and body to nurses, the relative accessibility of the patient, the distance from the patient's room to the medication area, and the location of the bathroom in patient rooms (many falls apparently occur during travel to and from these areas). From the analysis of all this data there emerged a snapshot of the specific rooms in the hospital being analyzed where there was an elevated risk of a patient falling. While this finding is useful for the administrators of that particular facility, the study also developed a number of generally applicable conclusions. The most striking conclusion was that, for a number of reasons, patients whose heads were not visible from caregivers working from their seats in nurses' stations and/or from corridors had a higher risk of falling, in part because staff were unable to intervene in situations where a fall appeared likely to occur. This was also the case with accessibility; patients less accessible within a unit had a higher risk of falling. The implications for hospital design are clear: design inpatient floors to maximize a visible access to patients (especially their heads) from seats in nurses' stations and corridors.

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Architecture; and, (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1982. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH. / Bibliography: leaves 100-107. / The thesis is a study of the security problems due to street crime in the Longwood Medical Area of Boston. The first part of the thesis defines the theories and practices of environmental security .planning, the urban design synoptic approach to crime prevention. The environment is examined in its totality -- the physical, social, economic, and psychological characteristics, all of which are considered. The synoptic approach incorporates some of the traditional forms of crime prevention: the punitive (minimally), corrective and mechanical approaches with emphasis on the spatial perspective and the utilization of physical design strategies to deter crime. A "crime analysis model" is developed which focuses on five components: the offender, the journey to crime, the target, natural surveillance and organized surveillance. The second part is the case study of the Longwood Medical Area (LMA) for which the crime analysis model forms the structure. The currently practiced monolithic approach to crime prevention which primarily restricts itself to the utilization of organized surveillance (private security guards) and limits itself to the defined geographical boundaries of the LMA is examined. This monlithic approach is aggravated by the lack of inter-institutional-community tensions all of which result in an unsatisfactory security planning strategy. The main recommendation of the thesis focuses on a basic conceptual change to a synoptic approach in the security planning of the Longwood Medical Area. A number of recommendations applying to specific situations are given. / by Miriam Gail Garmaise. / M.C.P. / M.S.

The retention of historic structures and the information which they contain, the basic goals of historic preservation, has occurred with increasing frequency in the twenty-year period following the passage of the National Historic Preservation Act of 1966. Admittedly, the ideal scenario involves the retention and reuse of architecturally or historically important structures. However, occasionally notable buildings are found which are located upon sites earmarked for new construction or which have deteriorated to a condition which makes restoration or adaptive reuse not economically feasible. Adequate documentation prior to the destruction of such buildings not only preserves the information therein contained, but also may encourage reuse of some structures by making the owner aware of their contribution to the streetscape, to local history or to the architectural history of a community or region.Although parameters for adequate documentation exist at the national level for national landmarks, state and local standards are vague at best, leaving both the professional and the non-professional preservationist to determine the level of documentation and the amount of research required. Difficult at best for the professional, documentation in the absence of guidelines frequently proves disastrous for the non-professional.This thesis is the product of a documentation project conducted between September 1984 and October 1985 to provide "adequate documentation" for a client of the College of Architecture and Planning at Ball State University, Muncie, Indiana. Having no established guidelines or precedent to follow, and instructed to produce "adequate documentation" for 28 structures at six Indiana State Hospitals, the documentation team learned much during the fourteen-month process of producing both written and graphic documentation.The author presents this descriptive analysis of one component of the documentation process - the preparation of the 331-page written text which accompanied photographs and H.A.B.S. drawings. While each project differs, the Indiana State Hospital Project established a precedent which may be referred to By the C.A.P. when faced with similar projects in the future.

Healthcare facility designers are acknowledging the connection between environment and well-being. They, along with environmental psychologists and landscape architects, are trying to define how environment can influence health status. Research on therapeutic outcomes has helped define specific design guidelines for a garden intended to help hospital patients and staff. One aspect that has not been fully investigated, however, is the spirituality of these spaces. Often in hospital settings prayer goes hand in hand with medicine, especially in faith-based health ministries like St. Vincent Randolph Hospital (SVR). To overlook the importance and value of the spiritual aspect in a healthcare setting would be to miss the core of what SVR stands for. The purpose of this project is to identify guidelines for therapeutic gardens that support the physical, spiritual and mental health and well being of patients at St. Vincent Randolph Hospital and to apply these guidelines to the design of a garden for the patients, families, associates, visitors and the surrounding community. / Department of Landscape Architecture

Thesis (B.A. Hons.))--University of Adelaide, Dept. of Psychology, 1978.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2008. / Title from first page of PDF file (viewed Aug. 1, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 120-127).