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Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls

Simon, M, Maben, Jill, Murrells, T. and Griffiths, P. (2016) Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls Journal of Health Services Research and Policy, 21 (3). pp. 147-155.

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Abstract

Objectives

A wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. However, studies have been limited to the US with limited evidence from elsewhere. The aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital.

Methods

A natural experiment investigating the move to 100% single room accommodation in acute assessment, surgical and older people’s wards. Move to 100% single room accommodation compared to ‘steady state’ and ‘new build’ control hospitals. Falls, pressure ulcer, medication error, meticillin-resistant Staphylococcus aureus and Clostridium difficile rates from routine data sources were measured over 36 months.

Results

Five of 15 time series in the wards that moved to single room accommodation revealed changes that coincided with the move to the new all single room hospital: specifically, increased fall, pressure ulcer and Clostridium difficile rates in the older people’s ward, and temporary increases in falls and medication errors in the acute assessment unit. However, because the case mix of the older people’s ward changed, and because the increase in falls and medication errors on the acute assessment ward did not last longer than six months, no clear effect of single rooms on the safety outcomes was demonstrated. There were no changes to safety events coinciding with the move at the new build control site.

Conclusion

For all changes in patient safety events that coincided with the move to single rooms, we found plausible alternative explanations such as case-mix change or disruption as a result of the re-organization of services after the move. The results provide no evidence of either benefit or harm from all single room accommodation in terms of safety-related outcomes, although there may be short-term risks associated with a move to single rooms.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Faculty of Health and Medical Sciences
Authors :
NameEmailORCID
Simon, MUNSPECIFIEDUNSPECIFIED
Maben, Jillj.maben@surrey.ac.ukUNSPECIFIED
Murrells, T.UNSPECIFIEDUNSPECIFIED
Griffiths, P.UNSPECIFIEDUNSPECIFIED
Date : 24 January 2016
Identification Number : 10.1177/1355819615625700
Copyright Disclaimer : This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).
Uncontrolled Keywords : health facility moving; hospitals; patient safety; quality of health care
Depositing User : Claudio Svaluto
Date Deposited : 14 Nov 2017 11:16
Last Modified : 13 Dec 2017 09:11
URI: http://epubs.surrey.ac.uk/id/eprint/844896

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