Unit V Article Critique Using the Waldorf Online Librarys Academic Search Complete database, please locate the following article: Morrill, P. W. (2013). Risk assessment as standard work in design. Health Environments Research & Design Journal (HERD), 7(1), 114-123. After reading the article and briefly summarizing the purpose for the study, answer the following questions: What is the authors main point? Who is the authors intended audience? Do the authors arguments support her main point? What evidence supports the main point? What is your opinion of the article? Do you agree with the authors findings? What evidence, either from the textbook or additional sources, supports your opinion? What benefits and challenges were associated with the hospitals use of the failure modes and effects analysis (FMEA) process? Your paper should be a minimum of two pages, not counting the title page and references. Make certain that all references and in-text citations are formatted according to APA style. Information about accessing the Grading Rubric for this assignment is provided below.

Risk Assessment as Standard Work in Design Patricia W. Morrill, PMP, EDAC ABSTRACT OBJECTIVE: This case study article examines a formal risk assessment as part of the decision making process for design solutions in high risk areas. The overview of the Failure Modes and Effects Analysis (FMEA) tool with examples of its application in hospital building projects will dem onstrate the benefit of those structured conversations. RESULTS: In both cases, participants uncovered key areas of risk enabling them to take the necessary next steps. While the focus of this article is not the actual design solution, it is apparent that the risk assess ment brought clarity to the situations resulting in prompt decision making about facility solutions. BACKGROUND: This article illustrates how two hospitals used FMEA when integrating operational processes with building projects: (1) adja- cency decision for Intensive Care Unit (ICU); and (2) distance concern for handling of specimens from Surgery to Lab. CONCLUSIONS: Hospitals are inherently risky environments, therefore, use of the formal risk assessment process, FMEA, is an opportunity for design professionals to apply more rigor to design decision making when facility solutions impact operations in high risk areas. KEYWORDS: Case study, decision making, hospital, infection control, strategy, work environment METHODS: Both case studies involved interviews that exposed facili- ty solution concerns. Just-in-time studies using the FMEA followed the same risk assessment process with the same workshop facilitator involv- ing structured conversations in analyzing risks. AUTHOR AFFILIATIONS: Patricia W. Morrill is the President of PM Healthcare Consulting, LLC, in Caledonia Wisconsin. PREFERRED CITATION: Morrill, P. W. (2013). Risk assessment as stan- dard work in design. Health Environments Research & Design Journal, 7(1). 114-123. CORRESPONDING AUTHOR: Patricia W. Morrill, President of PM Health- care Consulting, LLC, P.O. Box 287, Caledonia, WI 53108; pmorrilla prhcconsulting.com: (262) 639-6700 Tealthcare environments are ironically and yet inherently laden with risk. Staff must be diligent in disposing of needles, solutions and bio- hazardous waste in appropriate receptacles. The high rate of hospital-ac- quired infections (HAIs) has increased the exposure of patients and healthcare staff to noxious cleaning solutions and chemically treated surfaces. These are well-known, day-to-day potential hazards that patients and staff encounter. Healthcare facility designers must stay abreast of new products on the marker to alleviate the spread of infection from surface materials. This article examines the benefits of addressing potential physical environment risks as standard work in design projects. Standard work is defined as a step-by-step description of the actions and tools needed to complete a task (Touissant & Gerard, 2010). For the purposes of this article, "task involves the facility planning process. Standard work is estab- lished through analysis, observation, and employee involve- ment Employees are involved because the people closest to By incorporating risk assess the work understand it best (Manos & Vincent, 2012). As we strive to improve healthcare delivery processes, we can simul- standard work, design profe taneously seek better facility solutions that support safer envi can increase rigor of info ronments. By incorporating risk assessment as standard work, design and decision ma design professionals can increase rigor of informed design and decision making Background This case study article describes two examples of how risk assessments have been used in hospital design projects. Hospital A is a replacement critical access hos- pital with a total capacity of 25 beds accommodating medical/surgical, critical care, and obstetric patients. Hospital B is a rural integrated hospital and clinic with a phased replacement project with 50 beds. In early 2000-at the urging of The Joint Commission-hospitals started using the Failure Mode and Effects Analysis (FMEA) to analyze medication errors. FMEA is a model used to prioritize potential defects based on their severity, expected frequency, and likelihood of detection (MoreSteam.com, 2013), with broad potential for application, including in design. John Reiling, past CEO of St. Joseph's Hospital in West Bend, Wisconsin, that opened in 2005, authored several articles about the design process used to focus on safety. The use of fail- ure mode and effects analysis, patient focus groups, mock-ups with employee evaluation, and checklist safety design principles (latent conditions and active failures) helped St. Joseph's create the safest room they could envision (Reiling, Hughes & Murphy, 2008). Begun in the 1940s by the U.S. military, FMEA was further refined by the aero- space and automotive industries. The purpose of the FMEA is to take actions to eliminate or reduce failures (American Society for Quality, 2013a). Failures in healthcare have become increasingly transparent via website reporting of infec- rions and satisfaction comparison ratings. Healthcare reform has exposed the high incidence and unacceptable cost of preventable infections and injuries. Six Risk Assessment as Standard Work in Design Patricia W. Morrill, PMP, EDAC ABSTRACT OBJECTIVE: This case study article examines a formal risk assessment as part of the decision making process for design solutions in high risk areas. The overview of the Failure Modes and Effects Analysis (FMEA) tool with examples of its application in hospital building projects will dem onstrate the benefit of those structured conversations. RESULTS: In both cases, participants uncovered key areas of risk enabling them to take the necessary next steps. While the focus of this article is not the actual design solution, it is apparent that the risk assess ment brought clarity to the situations resulting in prompt decision making about facility solutions. BACKGROUND: This article illustrates how two hospitals used FMEA when integrating operational processes with building projects: (1) adja- cency decision for Intensive Care Unit (ICU); and (2) distance concern for handling of specimens from Surgery to Lab. CONCLUSIONS: Hospitals are inherently risky environments, therefore, use of the formal risk assessment process, FMEA, is an opportunity for design professionals to apply more rigor to design decision making when facility solutions impact operations in high risk areas. KEYWORDS: Case study, decision making, hospital, infection control, strategy, work environment METHODS: Both case studies involved interviews that exposed facili- ty solution concerns. Just-in-time studies using the FMEA followed the same risk assessment process with the same workshop facilitator involv- ing structured conversations in analyzing risks. AUTHOR AFFILIATIONS: Patricia W. Morrill is the President of PM Healthcare Consulting, LLC, in Caledonia Wisconsin. PREFERRED CITATION: Morrill, P. W. (2013). Risk assessment as stan- dard work in design. Health Environments Research & Design Journal, 7(1). 114-123. CORRESPONDING AUTHOR: Patricia W. Morrill, President of PM Health- care Consulting, LLC, P.O. Box 287, Caledonia, WI 53108; pmorrilla prhcconsulting.com: (262) 639-6700 Tealthcare environments are ironically and yet inherently laden with risk. Staff must be diligent in disposing of needles, solutions and bio- hazardous waste in appropriate receptacles. The high rate of hospital-ac- quired infections (HAIs) has increased the exposure of patients and healthcare staff to noxious cleaning solutions and chemically treated surfaces. These are well-known, day-to-day potential hazards that patients and staff encounter. Healthcare facility designers must stay abreast of new products on the marker to alleviate the spread of infection from surface materials. This article examines the benefits of addressing potential physical environment risks as standard work in design projects. Standard work is defined as a step-by-step description of the actions and tools needed to complete a task (Touissant & Gerard, 2010). For the purposes of this article, "task involves the facility planning process. Standard work is estab- lished through analysis, observation, and employee involve- ment Employees are involved because the people closest to By incorporating risk assess the work understand it best (Manos & Vincent, 2012). As we strive to improve healthcare delivery processes, we can simul- standard work, design profe taneously seek better facility solutions that support safer envi can increase rigor of info ronments. By incorporating risk assessment as standard work, design and decision ma design professionals can increase rigor of informed design and decision making Background This case study article describes two examples of how risk assessments have been used in hospital design projects. Hospital A is a replacement critical access hos- pital with a total capacity of 25 beds accommodating medical/surgical, critical care, and obstetric patients. Hospital B is a rural integrated hospital and clinic with a phased replacement project with 50 beds. In early 2000-at the urging of The Joint Commission-hospitals started using the Failure Mode and Effects Analysis (FMEA) to analyze medication errors. FMEA is a model used to prioritize potential defects based on their severity, expected frequency, and likelihood of detection (MoreSteam.com, 2013), with broad potential for application, including in design. John Reiling, past CEO of St. Joseph's Hospital in West Bend, Wisconsin, that opened in 2005, authored several articles about the design process used to focus on safety. The use of fail- ure mode and effects analysis, patient focus groups, mock-ups with employee evaluation, and checklist safety design principles (latent conditions and active failures) helped St. Joseph's create the safest room they could envision (Reiling, Hughes & Murphy, 2008). Begun in the 1940s by the U.S. military, FMEA was further refined by the aero- space and automotive industries. The purpose of the FMEA is to take actions to eliminate or reduce failures (American Society for Quality, 2013a). Failures in healthcare have become increasingly transparent via website reporting of infec- rions and satisfaction comparison ratings. Healthcare reform has exposed the high incidence and unacceptable cost of preventable infections and injuries. Six