Multidimensional assessment of infant, parent and staff outcomes during a family centered care enhancement project in a tertiary neonatal intensive care unit: study protocol of a longitudinal cohort study.

BACKGROUND: The therapeutic advances and progress in the care for preterm infants have enabled the regular survival of very immature infants. However, the high burden of lifelong sequelae following premature delivery constitutes an ongoing challenge. Regardless of premature delivery, parental mental health and a healthy parent-child relationship were identified as essential prerogatives for normal infant development. Family centered care (FCC) supports preterm infants and their families by respecting the particular developmental, social and emotional needs in the Neonatal Intensive Care Unit. Due to the large variations in concepts and goals of different FCC initiatives, scientific data on the benefits of FCC for the infant and family outcome are sparse and its effects on the clinical team need to be elaborated. METHODS: This prospective single centre longitudinal cohort study enrols preterm infants ≤ 32 + 0 weeks of gestation and/or birthweight ≤ 1500 g and their parents at the neonatal department of the Giessen University Hospital, Giessen, Germany. Following a baseline period, the rollout of additional FCC elements is executed following a stepwise 6-months approach that covers the NICU environment, staff training, parental education and psychosocial support for parents. Recruitment is scheduled over a 5.5. year period from October 2020 to March 2026. The primary outcome is corrected gestational age at discharge. Secondary infant outcomes include neonatal morbidities, growth, and psychomotor development up to 24 months. Parental outcome measures are directed towards parental skills and satisfaction, parent-infant-interaction and mental health. Staff issues are elaborated with particular focus on the item workplace satisfaction. Quality improvement steps are monitored using the Plan- Do- Study- Act cycle method and outcome measures cover the infant, the parents and the medical team. The parallel data collection enables to study the interrelation between these three important areas of research. Sample size calculation was based on the primary outcome. DISCUSSION: It is scientifically impossible to allocate improvements in outcome measures to individual enhancement steps of FCC that constitutes a continuous change in NICU culture and attitudes covering diverse areas of change. Therefore, our trial is designed to allocate childhood, parental and staff outcome measures during the stepwise changes introduced by a FCC intervention program. TRIAL REGISTRATION: Clinicaltrials.gov, trial registration number NCT05286983, date of registration 03/18/2022, retrospectively registered, http://clinicaltrials.gov .

Virtual visits at the Helsinki Head and Neck Center during the COVID-19 pandemic: patient safety incidents and the experiences of patients and staff.

BACKGROUND: During the COVID-19 pandemic, health care had to find new ways to care for patients while reducing infection transmission. The role of telemedicine role has grown exponentially. METHODS: A questionnaire on experiences and satisfaction was sent to the staff of the Head and Neck Center of Helsinki University Hospital and to otorhinolaryngology patients treated remotely between March and June 2020. Additionally, patient safety incident reports were examined for incidents involving virtual visits. RESULTS: Staff (response rate 30.6%, (n = 116)) opinions seemed to be quite polarized. In general, staff felt virtual visits were useful for select groups of patients and certain situations, and beneficial in addition to face-to-face visits, not instead of them. Patients (response rate 11.7%, (n = 77)) gave positive feedback on virtual visits, with savings in time (average 89 min), distance travelled (average 31.4 km) and travel expenses (average 13.84€). CONCLUSIONS: While telemedicine was implemented during the COVID-19 pandemic to ensure patient treatment, its usefulness after the pandemic must be examined. Evaluation of treatment pathways is critical to ensure that quality of care is upheld while new treatment protocols are introduced. Telemedicine offers the opportunity to save environmental, temporal, and monetary resources. Nonetheless, the appropriate use of telemedicine is essential, and clinicians must be offered the option to examine and treat patients face-to-face.

Intra- and Extra-Hospitalization Monitoring of Vital Signs-Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators.

BACKGROUND: In recent years, due to the epidemiological transition, the burden of very complex patients in hospital wards has increased. Telemedicine usage appears to be a potential high-impact factor in helping with patient management, allowing hospital personnel to assess conditions in out-of-hospital scenarios. METHODS: To investigate the management of chronic patients during both hospitalization for disease and discharge, randomized studies (LIMS and Greenline-HT) are ongoing in the Internal Medicine Unit at ASL Roma 6 Castelli Hospital. The study endpoints are clinical outcomes (from a patient's perspective). In this perspective paper, the main findings of these studies, from the operators' point of view, are reported. Operator opinions were collected from structured and unstructured surveys conducted among the staff involved, and their main themes are reported in a narrative manner. RESULTS: Telemonitoring appears to be linked to a reduction in side-events and side-effects, which represent some of most commons risk factors for re-hospitalization and for delayed discharge during hospitalization. The main perceived advantages are increased patient safety and the quick response in case of emergency. The main disadvantages are believed to be related to low patient compliance and an infrastructural lack of optimization. CONCLUSIONS: The evidence of wireless monitoring studies, combined with the analysis of activity data, suggests the need for a model of patient management that envisages an increase in the territory of structures capable of offering patients subacute care (the possibility of antibiotic treatments, blood transfusions, infusion support, and pain therapy) for the timely management of chronic patients in the terminal phase, for which treatment in acute wards must be guaranteed only for a limited time for the management of the acute phase of their diseases.

Daily huddle best practice: An Evidence-Based guide.

BACKGROUND: Daily huddles positively influence staff satisfaction and perception; standardization of a daily huddle should be prioritized to benefit from its effects. AIM: The aim of this project initiative was to implement an evidence-based, standardized daily huddle on an inpatient medical-surgical oncology unit. IMPLEMENTATION PLAN: A searchable question was developed, and the identified literature was critically appraised and synthesized for evidence-based recommendations. The recommendations for the structure and content of a daily huddle were implemented using a standardized format. OUTCOMES: Pre-implementation and post-implementation staff perception and satisfaction surveys yielded positive results. Improvements in effective communication and staff satisfaction were identified. IMPLICATIONS FOR PRACTICE: An effective daily huddle is essential for communicating pertinent information that can affect workflows and patient safety, as well as promoting teamwork and staff satisfaction.

A mixed-methods study of quality differences between applied documentation approaches in nursing homes.

BACKGROUND: Several approaches to nursing documentation exist. Some address standardised terminology and daily monitoring, whereas the structural model approach focuses on open-ended text information and special incidents. This study aims to identify quality differences between available documentation approaches from the perspectives of nursing professionals in Germany. METHODS: Between October 2018 and May 2019, a convenience sample of German nursing home practitioners was surveyed concerning the quality of their documentation techniques. The quality measurement was developed from the findings of a literature review on indicators that define successful nursing documentation. Selected indicators were structured according to Donabedian's quality dimensions of structure, process, and outcome. A mean score was calculated for each quality dimension. Non-parametric tests were employed to discover whether organisational and person-related conditions affect score values. The framework method was used to analyse textual data. RESULTS: Responses from 250 nursing care practitioners show significant differences between users of different documentation approaches in the outcome dimension. Nurses who worked with the structural model were slightly more satisfied with their documentation approach than users of other approaches. In addition, differences between subgroups were identified depending on the mode of the tools employed for nursing documentation, participation in training, and length of time spent using the present documentation tool. Qualitative data reveal that digitalisation, unequal task distribution, and appreciation and motivation are critical topics in nursing homes. CONCLUSIONS: The results indicate that regular opportunities to reflect on challenges in documentation activities might increase nurses' perceptions of documentation as a valuable part of nursing care. Training might serve this purpose for users of non-structural model approaches. Regardless of the specific recording techniques employed, more investment in digital infrastructure is required.

ReImagine: Amulti-Disciplinary Quality Improvement Plan to Work at Top of Scope.

BACKGROUND: There is a growing need for quality, community care models centered on the care of the child with medical complexity. This quality improvement project was conducted in a community-based medical daycare program within a large, metropolitan, pediatric hospital network of care location. A multi-disciplinary team, led by a clinical nurse specialist, occupational therapist, and early childhood special education teacher, addressed staff frustrations and low morale related to barriers to working at top of scope and feelings of a chaotic care and learning environment for children. AIMS: To improve staff satisfaction through a decrease in perceived barriers to practicing at top of scope and to refocus each discipline's role. A secondary aim was to improve child engagement through restructuring the therapeutic and learning environment and reducing distractions to better meet the unique needs of the children the program serves. METHODS: This quality improvement (QI) project used multiple methods, including staff surveys, child observations and timecard review, to measure the project's impact on ability to work at top scope, child engagement and staff satisfaction. RESULTS: The QI project resulted in positively impacting work culture and structure by increased time professional staff practiced at the top of scope, decreased perceived barriers to do so, improved overall job satisfaction and improved child engagement. CONCLUSION: Increased multidisciplinary collaboration and increased structure promoted an enhanced learning environment, healthier staff environment, and a more fiscally responsible program. There is little knowledge about medical daycares and further investigations in this setting is warranted.

Examining the average scores of nursing teamwork subscales in an acute private medical ward.

BACKGROUND: Healthcare is delivered by multidisciplinary healthcare teams who rely on communication and effective teamwork to ensure safe patient care. Teamwork builds on employee cohesion and reduces medical and nursing errors, resulting in greater patient satisfaction and improved healthcare. Effective teamwork not only improves efficiency and patient safety but leads to a healthier and happier workplace, reducing burnout among healthcare professionals. The purpose of this paper is to describe the findings of a pilot project on an acute medical ward in Western Australia. The aim was to understand the participants perceived level of teamwork to support future work practices and ultimately patient care. METHODS: This study used a descriptive survey research method to measure nursing teamwork in a clinical environment. The Nursing Teamwork Survey (NTS) measures the levels of nursing teamwork in acute healthcare facilities. Items for the NTS were generated on theoretical grounds, based on teamwork behaviours, offering a practical explanation of teamwork dynamics. RESULTS: The survey incorporated five subscales. The response rate to the survey was 90 % (n = 45) with an overall average result on the survey being (m = 2.97) on a 0-4 Likert scale. The validated NTS has provided participants the opportunity to consider nursing teamwork with regards to their position and perceived responsibilities towards patients and team members. CONCLUSION: The findings highlight areas for consolidation and improvement in teamwork. Introducing teambuilding strategies and acting on results of this survey may support enhanced communication and teamwork influencing nursing care and patient outcomes. Findings recommend that activities to improve teamwork and ensuring teambuilding strategies are implemented to improve effective communication in an acute medical care setting would have significant impacts on staff satisfaction.

Personalized Care Plans: Are They Effective in Decreasing ED Visits and Health Care Expenditure Among Adult Super-Utilizers?

PROBLEM: Super-utilizers comprise 4.5% to 8% of all ED patients, but account for 21% to 28% of all ED visits. Excessive use of the emergency department contributes to increased health care costs, recurrent and unnecessary ED workup, decreased emergency readiness, and reduced staff morale. METHODS: The impact of personalized care plan implementation was evaluated using a within-subjects pre-post design. The number of ED visits for each enrolled patient (N = 65) were analyzed before and after personalized care plan enrollment at 90, 180, and 365 days. A post-hoc analysis was completed for each ED visit that resulted in a disposition of discharge. Total and average charges from the ED visits were analyzed to determine the intervention's effect on health care expenditure. Staff was anonymously surveyed to assess perceived efficacy and level of satisfaction with the intervention before completion of data collection. RESULTS: Median ED visits had a statistically significant decrease over 90, 180, and 365 days. There was also a decrease in median, average, and total ED charges for all time points. ED staff perceived the personalized care plans to be an effective intervention and were satisfied with their implementation. DISCUSSION: Personalized care plans effectively decreased the number of ED visits, reduced health care expenditure, and were well-received by the staff.

Impact of the Dementia Care in Hospitals Program on acute hospital staff satisfaction.

BACKGROUND: To evaluate the impact of the Dementia Care in Hospitals Program (DCHP) on clinical and non-clinical staff job satisfaction, level of confidence and comfort in caring for patients with cognitive impairment (CI). Staff perceptions of how organisational support and hospital environment met the needs of patients with CI were also assessed. METHODS: The DCHP was implemented across four acute hospital sites across Australia. Clinical and non-clinical staff received training on CI screening and communication strategies for patients with CI. A staff satisfaction survey was administered pre- and post-implementation of the DCHP. RESULTS: One thousand seven hundred forty-eight staff received DCHP education and 1375 staff participated in the survey. Self-reported confidence and level of comfort in caring for patients with CI significantly improved following implementation. Staff also reported increased job satisfaction and organisational support at all hospital sites. CONCLUSIONS: The DCHP implementation within an acute hospital setting was found to show an improvement in staff confidence, comfort, and job satisfaction when caring for patients with CI. This study has significant implications for the improvement of care for patients with CI as well as staff retention and job satisfaction. Further research is required to determine whether these improvements are sustained in the longer term.

Understanding the Relationship Between Staff and Job Satisfaction, Stress, Turnover, and Staff Outcomes in the Person-Centered Care Nursing Home Arena.

BACKGROUND: The provision of quality care in nursing home (NH) facilities is an ongoing challenge, and the literature indicates that the quality of care (QOC) is often suboptimal. While it is highly recommended that NH facilities adopt a culture of person-centered care (PCC) to ensure quality care, the outcomes of this shift on staff working in NH settings has not been well studied. The purpose of this article was to understand the theoretical relationship between staff and job satisfaction, stress, turnover, and staff outcomes in PCC NH settings, by utilizing Cohen-Mansfield's (1995) comprehensive occupational stress model. METHODS: An integrative review of the electronic databases of research published in English between 2000 and 2015 was conducted. RESULTS: A review of 11 papers suggested that job satisfaction in the nursing workforce is positively related to consistency in QOC delivery and increased quality of life among residents in NHs. Management support and PCC practices positively correlate with improved QOC, staff satisfaction, and staff retention. CONCLUSIONS: This review showed that PCC intervention and training representing the key concept of workplace resources has a positive impact on NH staff job stress and satisfaction. CLINICAL RELEVANCE: Supporting the NH workforce through PCC training is essential for promoting job satisfaction and reducing job-related stress as well as turnover, which in turn will improve QOC delivered to the residents living in NHs.

The goldilocks effect: the rhythms and pace of hospital life.

BACKGROUND: While we have made gains in understanding cultures in hospitals and their effects on outcomes of care, little work has investigated how the pace of work in hospitals is associated with staff satisfaction and patient outcomes. In an era of efficiency, as speed accelerates, this requires examination. DISCUSSION: Older studies of pace in cities found that faster lifestyles were linked to increased coronary heart disease and smoking rates, yet better subjective well-being. In this debate we propose the Goldilocks hypothesis: acute care workplaces operating at slow speeds are associated with factors such as increased wait lists, poor performance and costly care; those that are too fast risk staff exhaustion, burnout, missed care and patient dissatisfaction. We hypothesise that hospitals are best positioned by being in the Goldilocks zone, the sweet spot of optimal pace. CONCLUSION: Testing this hypothesis requires a careful study of hospitals, comparing their pace in wards and departments with measures of performance and patient outcomes.

Improving the personalisation of care in a district nursing team: a service improvement project.

Service users can benefit in a variety of ways from a personalised approach to care. This service improvement project aimed to improve personalisation for patients being cared for by a community nursing team in the south of England. A plan, study, do, act (PDSA) approach to the project was undertaken with a community nursing team. Both quantitative and qualitative data showed improvement once the focus on personalisation had been improved. Patient and staff satisfaction scores improved and a documentation audit showed the focus on personalisation had increased. Qualitative data suggested that personalisation had also saved staff time, although this measurement was not included in the project. A focus on personalisation can be beneficial for staff and service users.

Flexible visiting positively impacted on patients, families and staff in an Australian Intensive Care Unit: A before-after mixed method study.

BACKGROUND: The admission of a relative to intensive care is stressful for families. To help them support the patient, families need assurance, information and an ability to be near their sick relative. Flexible visiting enables patient access but the impact of this on patients, families and staff is not clear. OBJECTIVE: To assess the impact of flexible visiting from the perspective of patients, families, and Intensive Care Unit (ICU) staff. METHODS: A before-after mixed method study was used with interviews, focus groups and surveys. Patients were interviewed, family members completed the Family Satisfaction in ICU survey and ICU staff completed a survey and participated in focus groups following the introduction of 21h per day visiting in a tertiary ICU. The study was conducted within a philosophy of family-centred care. RESULTS: All interviewed patients (n=12) positively evaluated the concept of extended visiting hours. Family members' (n=181) overall 'satisfaction with care' did not change; however 85% were 'very satisfied' with increased visiting flexibility. Seventy-six percent of family visits continued to occur within the previous visiting hours (11am-8pm) with the remaining 24% taking place during the newly available visiting hours. Families recognised the priority of patient care with their personal needs being secondary. Three-quarters of ICU staff were 'satisfied' with flexible visiting and suggested any barriers could be overcome by role modelling family inclusion. CONCLUSION: Patients, families and ICU staff positively evaluated flexible visiting hours in this ICU. Although only a minority of families took advantage of the increased hours they indicated appreciation for the additional opportunities. Junior staff may benefit from peer-support to develop family inclusion skills. More flexible visiting times can be incorporated into usual ICU practice in a manner that is viewed positively by all stakeholders.

Healthy work environment--a challenge?

PURPOSE: In Sweden, leave due to sickness was high during the 1990s. The Swedish Social Insurance Agency was able to decrease sick days in the period between 2000 and 2010 but sick days are rising again in Sweden, mostly due to psychological problems among women and partly due to their work environment. It is important to find methods to identify poor work settings to prevent absenteeism due to sickness. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH: The authors created a web questionnaire focusing on the organizational setting and its impact on employee wellbeing--reported as mental energy, work-related exhaustion and work satisfaction. The questionnaire measures good and poor work environment factors to help managers improve organizational settings. The questionnaire was validated qualitatively and quantitatively. FINDINGS: It is possible to measure individual wellbeing in an organizational context at an early stage. The authors followed a company undergoing organizational change and identified groups at risk of developing illness. PRACTICAL IMPLICATIONS: Managers uncertain about employee mental status can measure employee wellbeing easily and cost effectively to prevent illness. ORIGINALITY/VALUE: The authors created a method, statistically evaluated, to proactively identify good and poor work environments to promote healthy co-workers.

Designing a data-driven decision support tool for nurse scheduling in the emergency department: a case study of a southern New Jersey emergency department.

INTRODUCTION: A health system serving Burlington and Camden Counties, New Jersey, sought to improve labor productivity for its emergency departments, with emphasis on optimizing nursing staff schedules. METHODS: Using historical emergency department visit data and operating constraints, a decision support tool was designed to recommend the number of emergency nurses needed in each hour for each day of the week. RESULTS: The pilot emergency department nurse managers used the decision support tool's recommendations to redeploy nurse hours from weekends into a float pool to support periods of demand spikes on weekdays. Productivity improved significantly, with no unfavorable impact on patient throughput, and patient and staff satisfaction. DISCUSSION: Today's emergency department manager can leverage the increasing ease of access to the emergency department information system's data repository to successfully design a simple but effective tool to support the alignment of its nursing schedule with demand patterns.

Decreasing the length of stay in phase I postanesthesia care unit: an evidence-based approach.

Patient length of stay (LOS) in the postanesthesia care unit (PACU) Phase I and Phase II influences patient throughput, staff nurse satisfaction, and financial expenditure. The purpose of this project was to determine if re-education of nursing staff would decrease the LOS in Phase I PACU. The goals of the leadership team were to implement a plan that would result in a decreased LOS, decreased financial expenditure, increased patient throughput, and a change in culture of the work environment. Methods included re-education of nursing staff on American Society of Perianesthesia Nursing (ASPAN) Standards for patient care in Phase I and Phase II PACU. In addition, a pre-survey of the nurses was completed to determine their knowledge of the ASPAN Standards and how they perceived their work environment. Data were collected on the LOS in Phase I for two groups of patients who underwent cystoscopy with stent implantation and hernia repair. The LOS data were collected before and after the staff education. Results of this re-education initiative revealed improved patient throughput, decreased operating room hold time, reduced perioperative expenditure, and an increase in staff nurse satisfaction. An unanticipated result was increased scores on patient satisfaction surveys after the educational initiative.

Relaxation Methods to Reduce Occupational Stress.

BACKGROUND: Healthcare providers putting their patient's health before their own has negative consequences. Utilizing evidence-based research, nurse leaders can implement practices to positively affect employee health. This project assessed the utilization of a workplace relaxation room to reduce occupational stress. METHOD: Multiple methods were used to recruit participants. Participants completed pre/post surveys (demographic, PSS-10, GallupQ12, and open-ended questions) via email. The relaxation room contained stress reducing items for staff to utilize while at work. Data was collected using Qualtrics Survey software. FINDINGS: Data from the PSS-10 and GallupQ12 did not reveal statistically significant results. The participants responses to the open-ended questions did indicate a positive impact. CONCLUSIONS/APPLICATION TO PRACTICE: While the aims of the project were not met during the intervention, the open-ended responses indicated that for the employees who participated in the project, the intervention was a positive addition to the workplace.

Emergency department staff opinion on newly introduced phlebotomy services in the department. A cross-sectional study incorporating thematic analysis.

OBJECTIVES: The demand for ED services, both in terms of patient numbers and complexity has risen over the past decades. According to reports, there has been an increase in the ED patient presentation rate from 330 per 1000 to 334 per 1000 between 2018-2019 and 2022-2023. Consequently, new care models have been introduced to address this surge in demand, mitigate associated risks and improve overall safety. Among these models is the concept of 'front loading' clinical care, involving the initiation of interventions at the point of arrival. The present study evaluates the impact of introducing phlebotomists at triage. METHODS: We conducted a cross-sectional survey using purposive sampling at a single quaternary metropolitan ED with an annual census of greater than 90 000, encompassing all clinical staff in the ED. The survey data were analysed quantitatively and complemented by a thematic analysis. RESULTS: The response rate for the questionnaire was 61% (n = 207), with good representation from all ED craft groups. Nearly all the staff (99.5%) reported being aware of the presence of phlebotomists in the ED, whereas only 57% of the staff reported working in triage (P = 0.05, 0.00 to 0.04). 'Valuable/vital resource' featured as a common response. Early decision-making, patient safety, staff and patient satisfaction emerged as consistent themes. CONCLUSIONS: Staff expressed satisfaction that patient care now begins in the waiting room, especially after extended waiting periods prior to cubicle allocation. They assert that this improvement significantly enhances timely treatment and disposition decisions, as well as overall patient satisfaction.

Enhancing Drug Management, Cost Savings, and Staff Satisfaction in Anesthesiology: A Quality Improvement Project in a Chinese Tertiary Hospital.

INTRODUCTION: In alignment with China's national directive for improved drug management in anesthesiology, the Affiliated Hospital of Qingdao University initiated a quality improvement project, aiming to tackle the prevailing challenges of inefficiencies in drug administration, escalating drug costs, and the notable communication gap between pharmacists and anesthesiologists. METHODS: We employed a Plan-Do-Study-Act methodology to establish a pharmacy team and execute a multidimensional pharmaceutical intervention. The interventions included the formulation of standard procedures, guidelines and regulations, assistance from an information system (including automatic dispensing cabinets and prospective prescription review system), communication feedback (via WeChat groups), and education for anesthesiology staff. The intervention spanned from April to September 2023, focusing on optimizing medication management, achieving cost savings, and enhancing the satisfaction of anesthesia team members, with an additional observation from October to December 2023. RESULTS: Following the interventions, improvements were observed in drug management practices. These enhancements included increased compliance with accounting procedures, more rigorous registration of controlled substances, and more effective disposal of liquid residues. There was no adverse events related to high-alert medications or look-alike drug usage errors. The introduction of automatic dispensing cabinets and a prospective prescription review system markedly improved work efficiency. The utilization of a WeChat group facilitated effective communication about unreasonable prescriptions and drug-related issues. Among the 29,061 patients who underwent surgery both before and after the interventions, significant reductions were observed both in the drug proportion and the per capita drug costs (P = 0.03, P = 0.014, respectively). The per capita drug cost decreased by 20.82%, from ¥723.43 to ¥572.78, consistently remaining below ¥600 throughout the 9-month observation period. The per capita cost of monitoring drugs including dezocine, butorphanol, haemocoagulase agkistrodon, penehyclidine, and ulinastatin experienced a significant reduction (P < 0.05). Additionally, in the satisfaction questionnaires returned, a remarkable 94.44% of anesthesiology staff expressed high satisfaction with the comprehensive pharmaceutical interventions. CONCLUSION: The quality improvement project has yielded remarkable positive outcomes, serving as a model worthy of reference and replication in similar healthcare settings.

Optimizing Nurse Workflow Efficiency: An Examination of Nurse Walking Behavior and Space Accessibility in Medical Surgical Units.

OBJECTIVE: This study aimed to investigate the effect of spatial adjacencies on nurses' walking patterns and the subsequent impact on staff satisfaction with perceived accessibility and adjacency-related issues. BACKGROUND: Recognizing the crucial importance of spatial adjacencies in healthcare facilities is essential, as they significantly affect staff morale, fatigue management, operational efficiency, error reduction, and overall patient care excellence, highlighting the need for objective assessments to evaluate the impact of facility layout and space configuration on workflow patterns and staff satisfaction in patient care units. METHODS: Integrating on-site observations with survey data, we explored how spatial adjacencies affect staff walking behavior and satisfaction in two med-surgical unit floors. RESULTS: The findings highlighted a significant frequency of movements between nurse stations, patient rooms, and medication areas. Regression analysis identified several contributing factors to staff satisfaction, including the proximity of supplies, team visibility, ease of access across departments, and the location of equipment rooms. Specifically, satisfaction with the proximity of supplies was positively associated with increased provider satisfaction with workflow, quality of care, and workplace. Additionally, valuable feedback from staff revealed concerns regarding break room placement, medication area functionality, and disparities in the availability of supplies. CONCLUSION: This study highlighted the critical need for carefully planned spatial adjacency strategies to enhance workflow efficiency and raise clinical staff satisfaction within healthcare facilities. The actionable insights gleaned from this research offer valuable direction to architects, healthcare administrators, and design professionals, enabling the creation of environments that positively resonate with healthcare providers and improve healthcare operations.