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1. SERVICE DESCRIPTION:
o Location: 5th Floor – North Wing
o 32 Bed Rehabilitation unit serves rehabilitation patients whom do not require ventilator or hemodynamic monitoring. Unit supports patients transferring from Acute Care units and possibly external transfer patients (TBD)
o On unit Rehab Services department that supports care needs of unit (need to determine if patients from other units will use the rehab area
o Patients will have direct access to outdoor roof gardens
2. HOURS OF SERVICE:
24/7 365 days a year
3. CAPACITY
o 8 Private (8 rooms) – includes 1 VIP Suite and 1 Negative pressure Isolation Room
o 16 Semi Private (8 rooms)
o 8 Four Bed (2 Rooms)
o Rehab Area to support 32 beds
4. USE OF SPACE & ACCESS (SEE SPACE PROGRAM FOR DETAILS)
Primary Patient Groups Served:
o The units will include and support patients with the following diagnosis
o Orthopedics/Trauma
o Neurosciences (Neurology & Neurosurgery)
o Cardiology
o CT surgery
o Endocrinology & Chronic Diseases
Patient Rooms
o Patient Rooms will accommodate the distinct needs of Rehab patients.
o One private room will include negative pressure for private/airborne infection
o A VIP room will have adjacent space for family members and patient amenities.
o Semi Private and 4 bed rooms will have curtains for privacy
o All room will accommodate a minimum of 2 visitors per patient
o All patient rooms will include a patient bathroom and shower. A shower that accommodates a stretcher. This shower area will have hand held wand that can be used for long-term bedridden patients.
o All rooms will provide television access for each patient
o Some special treatments may be performed in the patient’s room based on patient condition. Routine physical and occupational and speech therapy will be done at the in the floor based rehab center.
o Consideration should be given to equipping some rooms for hemodialysis at the bedside, responsive to chronic disease patient needs
o Consideration should be given to in-ceiling lifts will be placed in some rooms to accommodate needs of patients with special needs or considerations
o Provision for in room charting needs to be provided based on technology plan
Rehab Services Space (See Space Program for detail)
o Physical Therapy – treatment tables, mat tables, exercise & testing equipment, ultrasound, parallel bars, stairs
o Occupational Therapy – treatment tables, mat tables, ADL area including bathroom and shower
o Speech Therapeutics – private sound proof rooms with equipment
o Staff Work area central to gym area
o Storage and equipment
Primary Ancillary Services on the unit include:
o Physical Therapy
o Occupational Therapy
o Speech Therapeutics
o Pulmonary and Cardiac Rehab
o Pharmacy – workspace or workroom
o Social Worker- office/workspace
Unit Flow
o Reception (control) desk clerk will be located at the entry of the unit for assisting visitors with way finding to the patient room, monitoring visitors and staff coming onto the unit.
o PATIENTS – RN accompanies patients coming from other IP Units via patient elevators. Safe Handoff procedures will be observed. Other staff may assist as needed. Patients from other units using the IP Rehab area will access directly via the patient elevators. No Outpatients will use the unit.
o STAFF – All staff will arrive via the staff elevators.
o Unit staff will proceed to the staff break/locker room. Lockers will accommodate all healthcare staff.
o Team report will be given in the report/conference rooms or in the team stations.
o Staff not based on the unit (physicians, ancillary, support, et.al.) will use staff elevators or stairs and proceed to the unit control desk to confirm presence on the unit
o VISITORS - Visitors to the unit arrive from the public elevators arrive in the center of the floor at the control desk.
o Seated waiting space – TBD. Seating accommodations in each patient room for 2 – 3 family members with each patient
o Children under 10 years of age will not be permitted in patient rooms.
o A family toilet will be provided with a baby changing station in the family waiting area.
o MATERIALS/DIETARY – All supplies will use the supply elevators to access the unit. Staff will report to the control desk to verify presence on the unit
o ENVIRONMENTAL SERVICES – Housekeeping staff coming to the unit will use staff elevators. All trash will be removed via the soiled services elevator.
5. Information & Communication Technology
o Unrestricted wireless telecommunication access
o All systems must interface with each other
o Wireless on Wheel Carts used at bedside and computers at team workstations.
o All monitoring systems throughout hospital will be same technology as intake/PACU.
o Pneumatic tube system – Need to study
o Call light system for patient use should be low volume and communicate with nursing work station
o Staff communication will be automated (e.g.vocera or spectralink). It will be used to communicate with other healthcare staff on the unit
o Communication system for transporters is needed to facilitate patient flow.
o Emergency paging system that can communicate emergent needs to appropriate personnel without using overhead paging.
o RFID for all equipment – Need to study
Medical Records
o Records – on-line medical records will be maintained on each patient via the _______________system. All paper medical records will be kept in a binder that will be maintained in a portable cart at the point of care location. Medical Records will be responsible to deliver these records the evening before and pick up post op.
6. SUPPORT SERVICES
Pharmacy
o All unit stock medication delivery and stocking will emanate from the Central Pharmacy. Unit based medication cabinets (Pyxis) are located in the medication room(s) on the unit. Controlled substances, IV solutions and stat medication per pharmacy policy. Pyxis will be restocked based on pre determined par levels and per pharmacy guidelines. Stat medications will be delivered in person or by PTS
o Emergency drug box will be available at each medication station.
o Pharmacy support from 8AM – 8PM Monday through Friday. No satellite pharmacy is expected or planned for the area
Respiratory
• Work space and supply/equipment cabinet will be provided
• Space will be provided for oxygen storage cylinders – need to define requirement (used for patient transport)
Lab Specimens
o Routine urine, blood, sputum and stool samples will be collected by unit staff and transported by pneumatic tube or in person. Central Lab results will be available per computer as per routine or stat specimens
Materials Management
o Materials Management delivers all supplies ordered electronically or via a manual par level or exchange cart system (need to determine). Designated clean utility or supply rooms are referenced in the space program
o Restocking of unit supplies should be completed by materials management staff or designated staff within the area for product control.
o There needs to be a method established for patient charging of items used.
o Bedside supplies will need to contain shelves and baskets with dividers to stock supplies that are used routinely on every patient.
o Equipment such as wheelchairs, stretchers, IV poles, IV pumps, transport monitors etc will have RFID according to technology purchased and be stored in equipment spaces or clean utility rooms
o Specialty items and/or have a low volume of usage will be stored in Inventory Control and distributed/delivered to the Nursing / staff station via the pneumatic tube system. Nursing/patient-care staff will request supplies via, phone, computer and/or pneumatic tube requisition process.
o Clean and Sterile Supplies - General clean and sterile supplies are ordered through the Materials Management department and delivered along with general supplies.
o Emergency code carts will be returned to materials based on expiration dates or if used in a code situation. Replacement of carts will be available immediately upon return of used or expired cart. Daily code cart checks will be performed per hospital policy by charge RN or designee.
Linen
o Material Management staff will transport the exchange linen items by cart to the department. Linen will be provided by materials management staff based on a unit PAR level. Bulk linen carts will be delivered to the material staging area (Clean Utility Room) and accessed by EVS staff distributed/replenished daily.
o Soiled linen will be transported to a soiled utility room for removal from unit
Environmental Services
o Janitorial Supplies and Equipment - general use janitorial supplies will be kept in the Housekeeping closet on the unit as required to maintain the unit
o Each room will be cleaned daily with terminal cleaning upon discharge including bed cleaning.
o Staff and patient toilets will be checked throughout the day to replenish supplies (soap/tissue) and cleaned at least every day shift.
o Paper products, soap, and alcohol based dispensers will be replenished daily
o Environmental service will sweep and mop as necessary during day/evening shift. Main areas and corridors of the unit will be maintained every evening
o Trash will be emptied every shift and as needed.
o Designated housekeepers from 0600 – 2200.
o Housekeeping will be available by mobile communication device and will have a tracking mechanism for location and communication.
Waste Materials
o Waste materials are separated into liquids, medical waste, solid waste and sharps. Sharp containers and trash receptacles are located in all patient rooms, med rooms, and utility rooms. Environment Service personnel collect these materials on a daily basis.
Food Service and Nourishment:
1) Food Service and Nourishment
ACTION/FUNCTION WHO WHEN
1. Food trays arrives from main production kitchen by cart to galley kitchen via transport elev
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