Oxford Method Research Programme

Appendices

 

MILTON KEYNES GENERAL HOSPITAL
Thursday 15 July at 10am.
In attendance: John Marshall (Oxford Method), Nigel Spawton (Gray Baynes & Shew), Kathy Lee (Milton Keynes General Hospital), Ruth Hopkins (for Gray Baynes & Shew).

Ward 4 (Phase 1 - "L" shaped ward - 6M Oxford Method)

• 6 beds per bay, single sex. At bed head - trunking and gases. Much use of ambulatory equipment (hoists etc.) but space ok.
• Use of baths is much less - shower rooms preferred (except for gynae)

Ward 21 (Not Oxford Method. Temporary building - now permanent.

• Orthopaedics - a very large shower room for each 6 beds as Ward 4.
• 2 bays and 2 side rooms (with ensuite) - red.
• 2 bays and 2 side rooms - blue.
• Side rooms allocated on a "needs" basis - disabled and carers, HMP Category 1 or Infection.
• Side rooms also used for elective physiotherapy.
• Where glass has been used it has usually been necessary to obscure it.
• Space around beds up to current HTM. 3M bays.
• Glass fibre wall covering.

Ward 17 ( Phase 2 "T" shaped ward. Support on leg of T. )

• Used for Day surgery and 23 hour admissions.
• 1.8m "bed" bays used for trolleys and reclining chairs for recovery.
• 6.6m x 7.2m - poor observation due to curtaining.
• Single sided day lighting made ward dark.
• Children's Unit - 6 beds at 2.4m spacing.

Ward 19 ( Major surgery unit.)

• All admissions are pre assessed for suitability in a treatment room adjacent to the ward up to 6 months before admission.
• 23 hour ambulatory care ward - 24 beds.
• A temporary wall has been erected between corridor and bed bays but nursing staff advise doors remain open.
• Observation room - nearest to nursing station has 4 bed male and 4 bed female (major surgery etc.)
• 8 side rooms
• 6 and 4 bed bays
• Fill up male and female beds first

Side rooms last - used for HMP, MRSA, children, adolescents, pregnancies, breast cancer etc.
23 hour surgery admissions are growing at the expense of major long stay surgery. They are soon moving to a 40 bed unit.
Contacts:
kathy.lee@mkgeneral.nhs.uk (Design Facilitator) : Geoff Callan ( Project Manager, Milton Keynes General Hospital

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WEXHAM PARK HOSPITAL
Friday 16 July 2004 - File 5135/11
In attendance: John Marshall (Oxford Method), Nigel Spawton (Gray Baynes & Shew)
Maternity Block
Jane Ostler (Clinical Manager)

• Now 5 beds in lieu of 6 - Shower and toilet now close by - not at a distance.
• Loss of Dining Room - patients now eat by their beds.
• Babies are taken into the nursery for bathing as there isn't quite sufficient space. (4 beds would have been better)
• Regeneration trolleys are a feature of all units.
• Bed Bay width 2100 to 2200.
• Quite dark - not enough windows.
• Incredibly noisy
• Appeared full, even when not.
• Hard floors in place of carpets have caused accidents !
• Space
• Technical equipment won't get any bigger.
• Somewhere needed for fathers and birthing companions - particularly during induction.

Side rooms (5 beds) used for :

• Infection control, Bereavement rooms, Private rooms.
• Ultra Modern Units are more labour intensive on staff
• Open Rooms are preferred for sociability.
  
  

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STOKE MANDEVILLE HOSPITAL
Thursday 29 July 2004 - File 5135/11
In attendance: John Marshall (Oxford Method), Ken Cooper (RNT Director of Estates), Nigel Spawton (Gray Baynes & Shew) and Ruth Hopkins (for Gray Baynes & Shew)
Several changes of use over the years. Possible visits today to : Wards 21 to 23 (2m), Day Surgery Unit, John Hampden (Acute Mentally Ill providing respite for carers - now leased to Buckinghamshire Mental Health Trust), Eye Unit (Designed and built as GP Maternity Unit and Delivery Rooms converted to theatre.

Observations :
Ward 21 to 23 :

• Poor legibility (easy to get lost)
• Originally a Chest and Orthopaedic unit, then General Surgery. Now part of Admissions.
• Minor alterations have been very problematic. All services for above are in ceilings.
• Presence of asbestos. 600 x 600 ceiling tiles - screw holes give burden of asbestos fibre dust.
  NB: A fire at Battle Hospital caused ceiling tiles to crack across corners and fall out.
• Door frames sagged and doors dragged. The frames have been braced with steelwork.
• 6m unit was designed by David Brown.
• Originally obstetrics - some obstetric beds changed to Gynae. It is still a maternity unit.
• Brick and Pitched.

HBN now says Bed Bays should be min. 2.9 x 2.9m - for equipment and infection control.
Ward 8 (not Oxford Method) is used as the "cohort" ward for MRSA.
Some patients could be in 5 beds within 2 days !
There is unlikely to be a reduction in bed numbers required - despite shorter stay. It is not good practice to look at reducing bed numbers further.

PFI Hospital :

• People tend to ask for 1:1 single rooms.
• A 2 bed room is the worst of all - too quiet.
• Paradoxically a Nightingale Ward is good because of the noise level. They are also light and airy.
• Royal Bucks patients moved into Oxford Method buildings complained of poor air quality.

Visits :
Wards 21 to 23 - Opened 1976.

• Derbigum and Erisco Bauder roof
• Surgical Ward. Noisy and crowded.
• Nurse station with no view of bed bays. Facing into corridor.
• Lots of equipment in corridors (patient notes, trolleys etc. etc.)
• Medical Emergencies from time to time - 24 hrs only.
• Maternity
• 3m corridor. Feels too wide.

Eye Unit:

• Brick clad
• Very nice feel - good balance of light and ventilation.
• Good corridor width.
• Incorporating theatres, day rooms, quad, side rooms and bed bays.

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BIBLIOGRAPHY

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Patients’ sleep-wake rhythms in hospitals.	S.J. Closs	Nursing Times Occasional Paper, 1988, vol 84, no 1, p48-50, and no 2 p54-55.
Breaking down the barriers part 1: a question of space.	N. Draper & S. Shani	Hospital Development, 1993, May, vol 24, no 5, p14-17.
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All private room units.	H. McLaughlin	Modern Hospital, 1968.
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View through a window may influence recovery for surgery.	R. Ulrich	Science, 1984, vol 224, p420-421.
The Physical environment and patient care.	M. Williams	Annual Review of Nursing Research, 1988, vol 6, p61-84.
The Environmental psychology of the hospital; is the cure worse than the illness.	G.H. Winkel &C.J.Holahan.	Prevention in Human Services, 1985, Winter, vol 4, no 1/2, p11-33.
Patient Empowerment - Privacy, Dignity and the Mixed Sex Ward: Guidance for Best Practice.		North West Regional Office, NHS Executive, June 1995.
American Institute of Architects Conference Notes		International Conference on Health Facility Planning 2002.
“Business Case for Healing Environmental Design. The Inpatient Care Unit of Today and Tomorrow”
“Exploring the issues of sustainable design in Healthcare”		Top of Page