Mock-Ups: Using Experiential Simulation Models in the Healthcare Design Process.

PURPOSE: The purpose of this article was to explore how different types of mock-ups are being used in the healthcare design process and present a methodology framework for the process. BACKGROUND: Historically, physical mock-ups have been used in healthcare design primarily to test construction techniques. Although this historic use of mock-ups assisted the design team in decision-making, newer forms of mock-ups have evolved that expand the input provided into decision-making. These newer techniques, rapid prototyping, early build-out, virtual reality, and enhancements to the traditional physical mock-up focus more on challenging the functionality of the space, testing new operational concepts, and increasing user input. METHOD: This methodology article utilized five case studies in which different types and combinations of mock-ups were used in the design process and then, the methodology compares the realism, immersion, and testability of each mock-up technique. RESULTS: For each mock-up type, the case studies described the purpose of the technique, the advantages and disadvantages, the most appropriate phase for its use in the design process, the estimated cost, and the process logistics. These components are compared to assist in developing a methodology for a variety of design situations. CONCLUSIONS: The findings related to different mock-up techniques are a valuable tool for healthcare design teams to use in selecting the most appropriate mock-up technique and the proposed methodology will assist in executing the mock-up process.

Decentralized Nurse Stations: A Methodology for Using Research to Guide Design Decisions.

PURPOSE: The purpose of this methodology is to define a process for facility planning teams to use to ensure research findings are used to guide decision making in the design process. BACKGROUND: Over the past decade and a half, research in health facility design has developed and the body of knowledge has grown significantly, but at the same time, the process for incorporating these findings into the design process has been less defined. This methodology evolved out of the desire to develop a structured process to integrate recent research findings into the planning and programming process at the user group and planning team level. METHOD: This two-phase methodology consists of, first, reviewing recent, relevant research on the topic, classifying the findings into positive and negative attributes and, then, summarizing the attributes by category on a summary table and in a brief narrative. The second phase consists of reviewing the research to identify operational and facility strategies that can be used to mitigate the inconsistent and negative attributes identified. RESULTS: In the case study, as a result of this process, one inconsistent attribute and three negative attributes were identified. In the second phase, potential research-based operational and facility strategies were identified to mitigate the inconsistent and negative attributes identified. This information served as the basis for making design decisions. CONCLUSIONS: This methodology presents an organized, efficient process for organizing and providing relevant research findings to a facility planning team to use in evaluating a new healthcare design concept and making research-based design decisions.

Total ankle replacement for rheumatoid ankle arthritis.

This article reviews total ankle replacement for rheumatoid ankle arthritis. The benefits of preserving the mobility of the ankle joint for the patient who has rheumatoid arthritis are undisputed. Recent reports have consistently shown that patient satisfaction following ankle replacement is high and prosthetic survival is more than 90% at five years and in many instances more than 80% at 10 years. Ankle replacement is contraindicated when there is severe coronal plane deformity.