hospital visit arrangement

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Visiting Patients at Massachusetts General Hospital

Mask and Screening Policy Update

Please note that our screening and masking policies have changed effective May 12, 2023 following the end of the COVID-19 Public Health Emergency.

Learn more about our mask and screening policies policies

Important Updated Visitor Policy (May 12, 2023)

• Call the patient care unit before visiting to make sure it is a good time for you to visit
• Use your phone to communicate with and support your loved one
• Ask a nurse about other options we can provide to help you stay in touch 

Our Visitor Policy

We ask all visitors to check their symptoms.  Please delay your visit to one of our facilities if: 

• You develop any of the following symptoms: Fever or chills Cough, congestion, or runny nose Vomiting or diarrhea New skin rash (with fever) OR
• You are diagnosed with or exposed to COVID-19 within 10 days of your visit.

Visiting Specific Patient Care Areas

• Children under the age of 18 may attend prenatal appointments as the single visitor permitted by hospital policy
• If a pregnant patient attends a prenatal appointment with an adult support person and a child the adult support person will be asked to stay out of the unit with the child(ren) – i.e. hallway, lobby, car
• A newborn that accompanies a patient for postpartum or lactation visits will not be considered a visitor. A visitor is welcome to attend these visits with the patient to support the mother and infant pair
• Laboring patients are permitted to have one birth partner and one visitor (2 total individuals)
• Postpartum patients are welcome to have one birth partner and two visitors (3 total individuals)
• While the birth partner may stay around the clock to support the postpartum patient, the visitors are welcome during visiting hours (11 a.m.– 8 p.m.)
• Children under the age of 18 may visit as one of the two visitors permitted per day for laboring, and postpartum patients. 
• Visitors under the age of 18 may visit only during regular hospital visiting hours: 11 a.m. – 8 p.m.
• Some procedural areas may be able to accommodate a small number of escorts in their waiting areas if social/physical distancing can be maintained
• One or both parents or other adult caregiver may accompany a pediatric patient to all procedural areas
• If there are any concerns with a support person for a patient with disabilities, please contact the MGB Office of General Counsel (OGC)
• Patients who require help with mobility or support
• Law enforcement officers working in an official capacity
• Pediatric patients (patients cared for by a pediatric provider or in a pediatric area) may be accompanied by one or both parents or adult caregiver
• Patients with disabilities
• Patients receiving end-of-life care
• Documented in Special Needs Tab in Epic at patient level
• Support person flag per encounter is no longer needed as long as Special Needs Tab is complete
• One visitor/support person per patient will be permitted in emergency departments; under extraordinary circumstances, facilities may need to restrict visitation
• Birth partners of obstetric patients
• Patients with disabilities 
• Pediatric patients (patients <22 years old) may be accompanied by one or both parents or guardians

Before visiting a patient, please speak with the patient's nurse or clinician to determine the best time to visit or to discuss the number of visitors or any unusual visiting circumstances that might require special arrangements.

Visitation privileges will not be limited or denied based on race, color, national origin, sex, religion, sexual orientation, gender identity or disability. Visitors may include a spouse, adult child, parent, close relative, friend, domestic partner, and both different-sex and same-sex significant others. Same-sex parents shall have the same access as different-sex parents for their minor children.

Information Desks

Information desks are located throughout the hospital buildings, near many of the major entrances. Desk staff members are knowledgeable and can help answer any questions. 

Patient Information/Patient Privacy

Patient privacy is important to Mass General. Patients have the right to limit access and confidentiality. Patients can indicate to the admissions or nursing staff that no information is to be shared about their condition and/or that they wish not to have visitors. If such a request has been made, it will be communicated to you. Learn more about our commitment to patient privacy .

Patient Status Inquiries and Telephone Calls

Patient information is available by calling 617-726-2070 . Your call will be forwarded to the patient's unit, where you can speak directly to the patient's nurse or clinician.

For patients in Intensive Care Units, only questions from immediate family members can be answered.

Waiting Room for Families

A family waiting room is available on the second floor of the Yawkey Building (Room 2E-2700). A small consultation room is available for family members to speak privately with a doctor. The room is open 8:00 am until 5:00 pm, Monday through Friday. After 5:00 pm (Monday through Friday), families can wait in the Blum Center, located on the first floor of the White Building (Room 110). The phone number for the Family Waiting Area is 617-726-2078 .

There are several  cafeterias  located within the hospital. Please view one of the  maps  to find the closest cafeteria or ask at the information desk.

Contact a Patient or Employee

Send mail to a patient or employee at Mass General by using one of the following addresses. Please do not send urgent or confidential information.

To Write to a Patient:

Attention: Patient Name Building and room number Massachusetts General Hospital 55 Fruit Street Boston, MA 02114-2696

To Write to an Employee:

Attention: Employee Name Mail Code, Building and room number Massachusetts General Hospital 55 Fruit Street Boston, MA 02114-2696

Mass General is committed to maintaining the rights, dignity and well-being of all patients. Learn about your rights as a patient.

Mass General Brigham Visitor Policy

Please refer to the Mass General Brigham Visitor Policy for additional information.

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Dos and Don'ts for Visiting Patients in the Hospital

JGI / Tom Grill / Getty Images

It might surprise you to know that hospital visitors can be safety hazards who potentially introduce problems to the patients they hope to cheer or assist. The problems may be directly related to physical harm, or may even be mental or emotional.

It can be difficult to visit a patient in the hospital, but you can have a positive influence on your friend or loved one's recovery if you follow some simple visitor guidelines. Knowing the dos and don'ts may give you the confidence you need.

Ask for permission to visit

Wash your hands

Consider allergies and restrictions on decorations and gifts

Turn off cell phone

Keep visit short

Leave if doctor or provider arrive

Visit if you might be contagious

Bring young children

Bring food without checking on restrictions

Cause stress

Avoid visiting

Smoke before or during visit

Dos for Hospital Visitors

Do ask the patient's permission to visit before you arrive . Ask them to be candid with you, and if they prefer you not visit, ask them if another day would be better, or if they would prefer you visit once they get home. Many patients love visitors, but some just don't feel up to it. Do the patient the courtesy of asking permission.

Do wash or sanitize your hands . Do this before you touch the patient or hand the patient something. After touching any item in the room, wash or sanitize your hands again. Infections come from almost any source and the pathogens can survive on surfaces for days. Don't risk being responsible for making your favorite patient even sicker than they already are.

Do wear a mask . Regardless of current hospital rules, wearing a face mask can help protect both the patient and visitor from airborne viruses. If you do not have a mask, the hospital should be able to provide you with one.

Do check before bringing balloons or flowers . If your patient shares a hospital room, you won't want to take either, because you don't know if the roommate has an allergy. Most solid color balloons are latex rubber, and some people are allergic to latex . When in doubt, take mylar balloons or don't take any at all.

Do consider alternative gifts . A card, something a child has made for you to give to the patient, a book to read, a crossword puzzle book, even a new nightgown or pair of slippers are good choices. The idea isn't to spend much money; instead, it's about making the patient feel cared for without creating problems that might trigger an allergic reaction.

Do turn off or silence your cell phone . Different hospitals have different rules about where and when cell phones can be used. In some cases, they may interfere with patient-care devices, so your patient can be at risk if you don't follow the rules. In other cases, it's simply a consideration for those who are trying to sleep and heal and don't want to be annoyed by ringtones.

Do stay for a short time . It's the fact that you have taken the time to visit, and not the length of time you stay, that gives your patient the boost. Staying too long may tire them out. Better to visit more frequently but for no more than a half hour or so each time.

Do leave the room if the doctor or provider arrives to examine or talk to the patient . The conversation or treatment they provide is private, and unless you are a proxy, parent, spouse, or someone else who is an official advocate for the patient, that conversation is not your business. You can return once the provider leaves.

Do follow all hospital policies and staff instructions . Most hospitals have set visiting hours, limits on the number of visitors in the room, and other rules you are expected to follow. Check the hospital's visiting hours and other policies prior to visiting.

Don'ts for Hospital Visitors

Don't enter the hospital if you have any symptoms that could be contagious . Neither the patient nor other hospital workers can afford to catch whatever you have. If you have symptoms like a cough, runny nose, rash or even diarrhea, don't visit. Make a phone call or send a card instead.

During flu season , it is not uncommon for hospitals to restrict visitors to spouses, significant others, family members over 18, and pastors, so it is worthwhile to call the hospital before your visit.

Don't take young children to visit unless it's absolutely necessary . Check with the hospital before you take a child with you. Many hospitals have restrictions on when children may visit.

Don't take food to your patient unless you know they can tolerate it . Many patients are put on special diets while in the hospital. This is especially true for those with certain diseases or even those who have recently had anesthesia for surgery. Your goodies could cause big problems.

Don't visit if your presence will cause stress or anxiety . If there is a problem in the relationship, wait until after the patient is well enough to go home before you potentially stress them by trying to mend that relationship.

Don't expect the patient to entertain you . They are there to heal, not to talk or keep you occupied. It may be better for them to sleep or just rest rather than carry on a conversation. If you ask them before you visit, gauge their tone of voice as well as the words they use. They may try to be polite, but may prefer solitude at this time instead of a visit.

Don't stay home because you assume your friend or loved one prefers you not visit . You won't know until you ask, and your friend or loved one will appreciate the fact that you are trying to help by asking the question.

Don't smoke before visiting or during a visit, even if you excuse yourself to go outdoors . The odor from smoke is nauseating to many people, and some patients have a heightened sense of smell while taking certain drugs or in the sterile hospital environment. At most, it will cause them to feel sicker, and if your friend is a smoker, you may cause them to crave a cigarette.

Johns Hopkins Medicine. Patient safety and quality .

By Trisha Torrey  Trisha Torrey is a patient empowerment and advocacy consultant. She has written several books about patient advocacy and how to best navigate the healthcare system. 

Hospital Flower Etiquette: A Guide to Sending Flowers with Care

When a loved one or friend is in the hospital, it's natural to want to show your care and support. 

One way to brighten their day is by sending them flowers. However, there's a proper way to go about it. 

Understanding how to send flowers to a hospital is essential to ensure your gesture is well-received and appreciated. 

In this blog, we'll guide you through the dos and don'ts of sending flowers to a hospital, making it easy to bring floral joy into someone's life during their stay.

Understanding How To Send Flowers To A Hospital

Sending flowers to someone in the hospital is a thoughtful and caring gesture that can lift their spirits and brighten their room. 

However, observing some etiquette is important to ensure your well-intentioned gift brings comfort rather than inconvenience. 

Here's what you need to know when sending flowers to a hospital.

Check Hospital Policies

Before ordering a bouquet, check the hospital's flower policies. Some hospitals restrict flower types and visiting hours for flower deliveries. 

You can find this information on the hospital's website or by calling their front desk. Knowing the rules in advance helps avoid any complications.

Allergies and Fragrance

While flowers are usually a delight, some people may have allergies or sensitivities to strong floral scents. Opt for mild fragrances or non-fragrant blooms to ensure your gift doesn't inadvertently cause discomfort.

Low-Maintenance Flowers

Hospital staff are busy, and patients might not have the energy or time to care for high-maintenance flowers. 

Select varieties that require minimal care, such as hardy potted plants or long-lasting cut flowers. This way, your gift will continue to bring joy without causing stress.

Keep It Compact

Hospital rooms are known for their limited spaces. Choose a compact flower arrangement that doesn't overcrowd the patient's room or disrupt medical equipment. A small vase or potted plant can significantly impact without creating a cluttered environment.

Latex Allergies

Being aware of latex allergies is essential, as some balloons and floral arrangements might contain latex materials. Avoid including latex balloons or items in your floral gift to prevent potential allergic reactions.

Timing Matters

When you send flowers to a hospital, timing matters. Flowers delivered during visiting hours ensure they can be enjoyed promptly. 

Additionally, consider the patient's condition. For example, if they are in the ICU or undergoing a procedure, it's best to wait until they are in a regular room.

Include a Thoughtful Message

A heartfelt message can add a personal touch to your gift. Express your well-wishes and let the recipient know you are thinking of them. A thoughtful card accompanying the flowers can make a significant difference.

Avoid Lilies

While lilies are stunning, they are often associated with funerals and may negatively affect some hospital patients. It's best to opt for other blossoms, like daisies, carnations, or chrysanthemums, which are cheerful and free from such associations.

By following these simple guidelines, you can ensure that your gesture of sending flowers to someone in the hospital is received with gratitude and appreciation.

Best Flowers for Hospital Visits

Choosing the right flowers for a hospital visit is crucial. You want to brighten the patient's day and provide comfort. Here are some of the best flowers to consider:

Cheerful Daisies

Daisies are known for their cheerful and optimistic appearance. They come in various colours, and their simplicity can bring a smile to anyone's face. Opt for a bouquet of daisies to bring sunshine to the hospital room.

Soothing Lavender

Lavender is not only visually pleasing but also known for its calming fragrance. A lavender bouquet or a potted lavender plant can help create a relaxing atmosphere in the room, promoting a sense of tranquility.

Vibrant Gerbera Daisies

Gerbera daisies come in a wide array of vibrant colours, making them an excellent choice to add brightness to the patient's environment. Their cheerful appearance is sure to uplift the spirits of your loved one.

Lively Carnations

Carnations are long-lasting and come in various colours, each with its unique meaning. Red carnations signify love, while pink represents admiration. Choose the colour that best expresses your feelings and well wishes.

Peaceful Chrysanthemums

Chrysanthemums, often associated with positive sentiments, can be a great choice for a hospital visit. They come in various colours and have a calming presence that can comfort the patient.

Potted Plants

Consider sending a potted plant rather than a traditional bouquet. Plants like snake plants, peace lilies, or succulents are easy to care for and can last long after the patient leaves the hospital. They serve as a lasting reminder of your care and support.

Remember that the best flowers for a hospital visit bring joy and comfort to the patient without overwhelming them. Personalize your choice based on the patient's preferences and the hospital's guidelines.

Hospital-Friendly Flower Arrangements

Simple and practicality should be your guiding principles when arranging flowers for a hospital visit. Here are some ideas for hospital-friendly flower arrangements:

• Small Vases or Containers.   Opt for small vases or containers that only take up a little space in the hospital room. A modest-sized arrangement is easier for the patient to manage and can be placed conveniently on a bedside table or windowsill.
• Avoid Spiky or Thorny Stems.   Steer clear of flowers with spiky or thorny stems, as they can be a safety hazard for patients and hospital staff. Choose blooms with soft, smooth stems for a hassle-free experience.
• Arrangements in Water Tubes.   Consider using water tubes to keep the flowers fresh and prevent spills. Water tubes are a practical solution that ensures your gift remains in excellent condition during the hospital stay.
• Non-Glass Containers.   For safety reasons, it's advisable to avoid glass containers. Opt for plastic or lightweight ceramic vases that won't shatter if they accidentally tip over.
• Portable Arrangements.   Create arrangements that are easy to transport when the patient is discharged from the hospital. This way, they can take the flowers with them to continue enjoying the beauty and your well wishes at home.
• Include a Care Guide.   If you choose to send potted plants, include a simple care guide. Patients may not be familiar with plant care, and your instructions can help them keep the plant healthy.

Your gesture of sending flowers to a hospital will be a source of joy and comfort for your loved one during their stay.

Brighten Hospital Stays with Heartfelt Floral Gestures

Sending flowers to someone in the hospital is a wonderful way to show your support and care. 

Following hospital flower etiquette, choosing the right blooms, and arranging them thoughtfully can brighten a patient's day and make their hospital stay a little more bearable. 

To explore a wide selection of hospital-friendly flowers and expert floral arrangements, visit   Terra plants and Flowers . 

Make your gesture of sending flowers to a hospital truly special with a touch of professionalism and warmth.

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Living with COVID-19: Visiting healthcare inpatient settings principles

Classification: Official Publications approval reference: C1606

Visiting healthcare inpatient settings while COVID-19 is in general circulation: principles

7 June 2022, Version 5. Updates to version 4 are highlighted.

Inpatients in healthcare settings can be more vulnerable to severe illness because of coronavirus (COVID-19) . We expect providers to facilitate visits, and to do so in a risk-managed way. This guidance supersedes and replaces the earlier guidance: Visiting healthcare inpatient settings while COVID-19 is in general circulation: principles 8 March 2022

It is important to recognise the contribution that visiting makes to the wellbeing and the person-centred care of patients; lack of access to visitors causes distress to them and their families.

Visiting should be accommodated for at least one hour per day and ideally for longer. Visiting policies also need to reflect that COVID-19 is in general circulation. The health, safety, mental health and wellbeing of our patients, communities and staff remain the priority.

This guidance sets out how NHS, and other healthcare organisations, should facilitate visiting across healthcare inpatient settings, including mental health, learning disability and autism, children and maternity. It is consistent with Coronavirus how to stay safe and prevent spread and infection prevention and control guidance.

Specific guidance for maternity services is available here , which all providers of maternity services are asked to follow. For visiting in care homes, follow government guidance .

These principles should also be applied in outpatient and diagnostic service settings and the emergency department where the patient may wish/need to be accompanied by somebody important to them. No patient should have to attend on their own unless it is their personal choice.

Local arrangements for visiting, including an advice leaflet for visitors , should be clearly communicated, e.g., on organisation websites and through social media.

• Anyone showing any symptoms of COVID-19 should not visit. This is essential for infection prevention and control .
• Anyone feeling unwell , should not visit.
• Where a face-to-face visit is not practical then virtual visits (see appendix for examples) should be supported and facilitated.
• Two visitors
• Patients may be accompanied where appropriate and necessary to assist their communication and/or to meet their health, care, emotional, religious, or spiritual care needs.
• Visitors, parents, guardians, siblings may be asked to wear a mask/face covering following a local risk assessment, including when entering and moving through the healthcare setting unless medically exempt for which evidence should be provided.
• visitors, parents, guardians, siblings will be asked to wear a surgical facemask if visiting a high-risk area or a patient with suspected/known COVID-19.
• Where a face-to-face visit is not practica l then virtual visits (see Appendix for examples) should be supported and facilitated.

Additional considerations to support visiting at end of life This section relates to people who are ill enough that they could die within the next few days, recognising this can be difficult to determine with accuracy. Sometimes a patient dies very suddenly or unexpectedly. Families need to be reassured that if they are not present when their loved one dies, staff will always be with and comfort their patient.

Adults who are dying

• A compassionate approach is essential in balancing the importance of close family members (including children), and others important to the dying person, being able to spend precious time with them and say goodbye, with the need to manage infection risk and maintain the safety of the visitor, staff and other patients. Organisations should, in conjunction with the local incident team, use their own risk- based assessment to decide to what extent more relaxed visiting arrangements can be facilitated.
• It may be especially important for the dying person (or their family) to receive spiritual, emotional, or religious support at this time. This can be assessed and provided by the healthcare chaplain, who is part of the multidisciplinary team. The healthcare chaplain can assess and provide this or contact an external faith leader if required.).
• Staff require training and preparation to sensitively support visitors of people who are dying and support to manage the impact of this on their own wellbeing. Health Education England offers some practical learning around end-of-life communication .
• The principles in this guidance apply to the inpatient healthcare setting. When people are dying in their own home, health and care staff can support by advising on the latest infection, prevention and control guidance, including handwashing, social distancing and minimising the number of visitors at any one time, to manage infection risk for others in the household. Follow government guidance for visiting in care homes.
• An individualised approach needs to be taken on a case by case basis to manage the balance between compassionate visiting and infection risk management.

Children and young people who are dying

• The same compassionate approach is needed when a child or young person is dying. Healthcare teams always make every effort to ensure that parents/siblings, guardians, or carers can be present.
• If the parents/siblings, guardians, or carers are suspected of being infected with COVID-19 it may be possible to enable visiting by moving the child or young person to a separate location or providing the parents/siblings, guardians, or carers with appropriate PPE. Staff will ensure the parents/guardians are updated if they cannot visit and allow other family members or people close to the child to visit instead.

Appendix: Approaches to virtual visits

• Many organisations have enhanced family liaison arrangements to help patients stay in touch with those important to them. These also provide updates to one close family contact, or somebody important to the patient, and should be encouraged. In Intensive Care Units organisations may wish to consider establishing dedicated support teams to facilitate this communication.
• Organisations should promote awareness of local arrangements so that staff and volunteers can communicate and signpost to these as necessary.
• passing messages between the patient and those important to them, supported by hospital staff and voluntary services
• having central email arrangements, with laminated messages/photographs delivered to patients
• taking delivery of a phone for patients from their families/friends
• giving staff internet connected kit to facilitate contact between patients and the people important to them
• providing physical symbolic tokens to physically connect the patients and the people important to them.
• wherever possible, the patient’s views on virtual visiting are sought, honoured, and documented
• potential risks to patient confidentiality are understood and mitigated
• visitors are prepared for what they will see when virtually visiting the care setting
• good infection prevention and control measures, including frequent cleaning of mobile devices, based on National infection Prevention and Control Manual for England .
• storage of patients’ personal devices in line with the healthcare setting’s guidance on safe keeping of property.

How to organise transport to and from hospital

It depends if it's an emergency or not.

In an emergency

In a medical emergency, call 999 and ask for an ambulance. You will not have to pay to be taken to hospital in an emergency.

A medical emergency is when someone is seriously ill or injured and their life is at risk.

Read about when to call 999 .

Non-emergency hospital visits

You'll normally be expected to make your own way to hospital if it's not an emergency.

Hospital parking can be expensive and limited, and you may not be able to leave your car there overnight. So you may want to ask a friend or relative to take you to hospital and collect you after you've been discharged.

You can search for your local hospital to check its parking facilities.

Non-emergency patient transport services

Some people are eligible for non-emergency patient transport services (PTS). These services provide free transport to and from hospital for people including:

• those whose condition means they need additional medical support during their journey
• those who find it difficult to walk
• parents or guardians of children who are being transported

PTS may not be available in all areas. To find out if you're eligible for PTS and how to access it, you'll need to speak to your GP or the healthcare professional who referred you to hospital.

Claiming for hospital transport costs

You may be able to claim for the cost of transport to hospital through the Healthcare Travel Costs Scheme (HTCS) if you're referred for specialist NHS treatment or tests.

Read more about the Healthcare Travel Costs Scheme (HTCS) , including who's eligible, what the conditions are and how to make a claim.

Page last reviewed: 15 May 2023 Next review due: 15 May 2026

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Hospital Admitting Privileges: Do They Matter for Your Primary Care?

May 31st, 2022 | 5 min. read

By Jim Mumper, M.D.

If you are searching for a new primary care physician , you’re probably asking several questions about things that matter in your decision-making process.

• Do you like the doctor’s personality?
• Does the doctor have the experience you need?
• Will they be accessible?
• Where is the office located?
• Do they take your insurance?

You may also wonder if their gender matters , compare a D.O. to an M.D. , or explore a family physician vs. an internal medicine physician . 

You might also be concerned about something called hospital admitting privileges. They might not be the top consideration on your list, but when it comes to you and your family, you prepare for everything.

You ask yourself — what can my primary care physician do for me or my family in the event of a trip to the emergency room?

For most people, that’s where the concept of hospital admitting privileges enters the picture.

But what exactly are hospital admitting privileges?  Are they still used by primary care physicians today? Is it important for your doctor to have hospital admitting privileges?  And how do concierge medicine practices handle hospital visits by their patients?

Let’s get you some answers.

What are hospital admitting privileges?

Hospital admitting privileges are the rights granted to a doctor by a hospital to admit patients to that particular hospital.

The basic premise with primary care physicians is that, if you need to go to the hospital, your PCP can admit you to any hospital that has granted them privileges.

It might not be the closest hospital to your home or the best hospital in the area, but rather one where they have established privileges. Maybe it’s the one where they used to work. Maybe it’s the hospital across the street. Or it might be one that is operated by the same parent company as their primary care practice.

Regardless, the concept of admitting privileges is that your doctor would be able to admit you with some paperwork and a quick phone call.

They would then be able to come to the hospital — often once in the morning and once at night on “rounds” — to coordinate your care. They would order tests, prescribe medications, and schedule procedures.

At least that’s the concept.

How are hospital admitting privileges used today?

Over the last 20+ years, the model for patient care in hospitals has changed. As such, the prevalence of hospital admitting privileges for primary care doctors has declined.  They are now mostly a thing of the past.

This is because both hospitals and primary care physicians realized it was too difficult to provide the level of patient care required today.

Caring for patients at a hospital requires different skills than at a primary care physician’s office and vice versa. It’s in the best interests of the patient to separate the roles. 

For primary care doctors, making rounds at the hospital in the morning or at night also took away from their already limited time and availability to see their other patients at the office.

How could they justify keeping people waiting in their lobby for appointments while they spend a couple of hours at the hospital?

It also was unfair to the patient, as test results and medication adjustments at the hospital had to wait until your doctor returned and could review information. If they weren’t coming back until the following morning, it could be a long 24 hours of waiting for your next update.

These situations gave rise to the role of a “hospitalist.” There were zero hospitalists in the late 1990s. Now, there are more than 50,000 hospitalists in the United States. More than 75% of hospitals in the United States have hospitalists.

Hospitalists are the point person for patient care at the hospital and effectively serve as the primary care physician for a patient during their hospital stay. They — along with emergency room staff, other doctors, and hospital administrators — decide who gets admitted and when.

The days of a primary care physician admitting one of their patients thanks to their privileges are over.

Is it important for your primary care doctor to have hospital admitting privileges?

Not anymore. With the rise of the hospitalist role, admitting privileges for primary care physicians are few and far between.

If they still have them, they aren’t particularly useful. They won’t help you “cut the line” to get admitted before any other patients at the ER.

In addition to hospitalists who run the show at the hospital, ER doctors and nurses are still obligated to admit the most urgent patients first. No admitting privileges are going to replace that responsibility.

Hospital Care and Concierge Medicine      

While hospital admitting privileges are no longer prevalent, it doesn’t mean your doctor cannot be an integral part of your care at the hospital. That much is true for both traditional and concierge doctors .

With proper authorization in accordance with HIPAA regulations, you can authorize the hospital to share information with your doctor. You or your family member can also contact your doctor to provide the information themselves.

With concierge medicine, the difference comes in the access you might have and the availability of a doctor to quarterback your care in the hospital.

With fewer patients, a concierge medicine physician could have the time to speak with you or the hospital staff about your care as opposed to just running from appointment to appointment.

In addition, emergencies don’t strike only during business hours. Most concierge practices offer some version of 24/7/365 access . Some offer a nurse hotline, some hire a third-party service that triages calls from across the country, and others, like PartnerMD, guarantee one of their docs from your city will be on-call.

With concierge medicine, you can expect to connect with someone quickly no matter if it's 3:00 p.m. on a Saturday afternoon and your child suffers an injury on the soccer field or if it's 2:00 a.m. on a Sunday night and a loved one is being rushed to the hospital.

PartnerMD, Hospital Admitting Privileges, and Hospital Care

PartnerMD doctors encourage patients to notify them as soon as possible of a hospital visit. Once notified, our doctors can serve as a trusted resource during a hectic situation.

The PartnerMD difference comes down to the relationships our doctors develop with their patients.

With fewer patients and longer appointments, our doctors have the time to get to know their patients on a deeper level. This allows them to be prepared with helpful information well before any visit to a hospital.

Armed with in-depth knowledge of your health history, our physicians can be an advocate for you during a hospital visit. 

This knowledge could make your hospital care more efficient. Instead of the hospital trying needless tests and medications that cost you time and money, our doctors can provide the kind of background knowledge to help the hospital doctors and nurses efficiently treat whatever is going on.

Whether you’re having a planned surgery — a knee replacement for example — or facing a sudden emergency, PartnerMD doctors can assist with hospital care in several ways:

• Pre-surgery prep: Your doctor can answer any questions you might have ahead of the procedure and prepare you for what to expect at the hospital. We can also recommend questions to ask while at the hospital to alleviate any concerns you may have.
• Emergency advice: In the case of a sudden emergency, the 24/7/365 access you have to a PartnerMD physician can be crucial. You should always call 9-1-1 upon any sudden emergency, but we can be an on-call resource once on the way or at the hospital and help interpret or explain the care you are receiving.
• Hospital advocate: PartnerMD’s doctors can also speak directly to the doctors at the hospital to quarterback your care and provide relevant background information. This could help cut through the noise and standard procedures to get you the efficient care you need.
• Post-Visit care: The PartnerMD difference is even more apparent after a sudden hospital visit. Some insurance, like Medicare, requires you to visit your primary care physician within a certain amount of time after a hospital stay. Even if your insurance doesn’t require a visit, it is good practice to visit your doctor after a hospital visit to discuss the next steps and ask any additional questions. After all, you went to the hospital. It’s something to be taken seriously. PartnerMD’s same-day or next-day appointments mean a post-hospital visit can happen quickly. Our 30-minute appointments mean you will be able to spend time with your doctor and talk extensively about what happened, instead of rushing through the appointment in 7 minutes.

We know any trip to the hospital is a stressful time. Hospital doctors and nurses work extremely hard to provide you with the care you need.

However, you may have questions or concerns you are uncomfortable bringing up at the hospital, or that the hospital staff may not have time to discuss in detail.

That’s where having a true partner in health at your side can make a difference. If you’re interested in learning more about PartnerMD, download our free “Understanding Concierge Medicine” eBook .

Jim Mumper, M.D.

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• United Christian Hospital
• Patient Information

Visiting Arrangement

Patient's visitors.

• Unless patient disagrees, the HA Hospital may disclose patient's ward / bed number to persons requesting to visit patient in Hospital.
• During patient's stay in Hospital, our staff may receive enquires in person or via telephone by patient’s friends, relatives or florists to deliver bouquets / gifts, who would like to know if patient has been admitted to Hospital and if so, the ward / bed number patient is staying in. Such information would be disclosed unless patient expressly objects to the disclosure. In such case, patient should request and complete the relevant form, and return to our Admission Office / ward staff after completion. Under our current system, both the fact of patient’s Hospitalization and patient’s ward / bed number would not be disclosed. We regret that we cannot permit selective disclosure of such information.

Visitors' Information and Visiting Hours

• Comply with the admission regulations 1 – 12 .
• No visit for all isolation wards.
• Special arrangement may be arranged in case of needs raised by patients or patient's relatives.
• No more than two visitors per patient at each time.
• Do not bring along children under age 12 for patient visit.
• There may be special visiting arrangements for paediatric and critically-ill patients.
• Wash hands thoroughly when entering and leaving the Hospital.
• Perform body temperature check and monitor your health situation before visiting the Hospital.
• Do not visit patients or clinical areas if you have respiratory infection symptoms, diarrhea, vomiting or skin rash.
• Put on a surgical mask when having respiratory symptoms or when entering patient care areas.
• Our Hospital may implement contingency measures on visiting arrangement during the Activation of the Serious and the Emergency Response Level. Please refer to our latest announcement.

• Bureaus and Offices
• Contact HRSA
• Site Visit Protocols and Guides
• Health Center Program Site Visit Protocol

Continuity of Care and Hospital Admitting

In this section:

Documents the Health Center Provides

Compliance assessment.

Primary Reviewer: Clinical Expert

Secondary Reviewer: N/A

Authority: Section 330(k)(3)(A) and 330(k)(3)(L) of the Public Health Service (PHS) Act; and 42 CFR 51.c.303(a) and 42 CFR 56.303(a)

Health Center Program Compliance Manual Related Considerations

• Health center’s internal operating procedures and documentation of any arrangements with non-health center providers or entities for tracking of patient hospitalization and continuity of care.
• Health center provider hospital admitting privileges (for example, hospital staff membership, provider employee contracts) that address delivery of care in a hospital setting to health center patients; OR
• All formal arrangements that address health center patient hospital admissions (for example, provisions in hospitalist contract, transfer agreements, supporting procedures, or other documentation of inpatient care coordination with the health center).
• Sample of 5–10 health center patient records 1 for patients who were hospitalized or who had Emergency Department (ED) visits within the past 12 months. Ensure each record clearly documents the health center’s entire hospitalization tracking process, from admission and follow-up through closure. Note: Use live navigation of the Electronic Health Record (EHR), screenshots from the EHR, or other patient record formats. 

Select each element below for the corresponding text of the element, site visit team methodology, and site visit finding questions.

The health center has documentation of:

• Health center provider 2  hospital admitting privileges (for example, provider employment contracts or other files indicate the provider(s) has admitting privileges at one or more hospitals); and/or
• Formal arrangements between the health center and one or more hospitals or entities (for example, hospitalists, obstetrics hospitalist practices) for the purposes of hospital admission of health center patients.

Site Visit Team Methodology

• Interview health center clinical leadership (for example, CMO, Clinical Director) about processes for ensuring continuity of care for patients that require inpatient hospitalization.
• Health center provider hospital admitting privileges that address delivery of care in a hospital setting to health center patients; OR
• All formal arrangements that address hospital admissions of health center patients.

Site Visit Findings

• Documentation of health center provider hospital admitting privileges (if any health center providers are responsible for admitting and following hospitalized patients); or
• Formal arrangements with other providers or entities (such as a hospital, hospitalist group, obstetrics practice, or other health center) that address health center patient hospital admissions?

Response is either: Yes or No

If Yes OR No, an explanation is required specifying the health center’s arrangement(s) for hospital admissions.

The health center has internal operating procedures and, if applicable, related provisions in its formal arrangements with non-health center provider(s) or entity(ies) that address the following areas for patients who are hospitalized as inpatients or who visit a hospital’s emergency department (ED): 3

• Receipt and recording of medical information related to the hospital or ED visit, such as discharge follow-up instructions and laboratory, radiology, or other results; and
• Follow-up actions by health center staff, when appropriate.
• Review the health center’s internal operating procedures and documentation of any arrangements with non-health center providers or entities to assess tracking of patient hospitalization and continuity of care provisions.
• Interview health center staff about continuity of care.

If No was selected for any of the above, an explanation is required.

The health center follows its operating procedures and formal arrangements as documented by:

• Evidence of follow-up actions taken by health center staff based on the information received, when appropriate.
• Have a health center clinical staff member navigate the reviewer through 5–10 health center patient records.
• Interview relevant health center staff about access to medical information related to hospital and ED visits and associated follow-up actions by health center staff.

Note: For a health center with no hospitalized patients in the past 12 months (for example, a newly-funded health center that recently started its operations), review operating procedures and interview health center staff to respond to these questions.

1. Health centers may choose to provide samples of patient records before or during the site visit. If patient records will be provided during the site visit, this should be communicated to the site visit team before the site visit to avoid any disruption or delay in the site visit process.

2. In addition to physicians, various provider types may have admitting privileges, if applicable, based on scope of practice in their state (for example, nurse practitioners, certified nurse midwives).

3. Health center patients may be admitted to a hospital setting through a variety of means (for example, a visit to the ED may lead to an inpatient hospital admission, or a health center patient may be directly admitted to a unit of the hospital, such as labor and delivery).

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Public hospitals to relax visiting arrangements

Greater china.

Guide to Conducting Healthcare Facility Visits

by Craig Zimring, Ph.D. Georgia Institute of Technology

Published by The Center for Health Design, 1994

INTRODUCTION

A major medical center is building a new diagnostic and treatment center that will include both inpatient services and expensive high technology outpatient services The center is considering whether to provide day surgery within the diagnostic and treatment center or in a freestanding outpatient facility. They are facing a dilemma. If they locate the day surgery center separately, they can use lower-cost construction. If they combine the functions, they can use the spare capacity that will likely become available in the inpatient operating rooms. This is especially important as outpatient procedures become increasingly complex. The center wishes to evaluate sites that currently operate in fully separate facilities versus ones that provide separate outpatient and inpatient reception and recovery facilities, but share operating rooms.

A large interiors firm has been contacted to conduct a visit of several new children’s hospitals in the Northwest. Eager to get the commission from this major hospital corporation to renovate the interior of a large children’s hospital, the firm arranges visits of hospitals it has designed as well as two designed by other firms.

An architecture firm is renovating a large medical laboratory in an existing building which has a minimal 11-foot-3-inch floor-to-floor height. Concerned that the client may not understand the implications of this tight dimension-which means that the fume hood ventilation system can not easily be installed within this space-the architects arrange visits of other labs with similar floor-to-floor heights, change in healthcare and society is rapid and increasingly unpredictable, bringing an unprecedented level of risk for healthcare organizations facing new projects. This guide discusses a specific tool that healthcare organizations and design professionals can use to help manage uncertainty: the facility visit. In almost every healthcare project someone-client, designer, or client-design team-visits other facilities to help them prepare for the project. A probing, well structured, and well run visit can highlight the range of possible design and operational alternatives, pinpoint potential problems, and build a design team that works together effectively over the course of a design project. It can help a team creatively break their existing paradigms for their current project and can provide a pool of experience that can inform other projects. All of these can help reduce risk for healthcare organizations.

However, current facility visits are often ineffective. They are frequently conducted quite casually, despite the rigor of much other healthcare planning and design. Visits are often costly—$40,000 or more-yet they often fall short of their potential. Sites are often chosen without careful consideration, little attention is given to clarifying the purpose or methods of visits, there is often little wrap-up, and frequently no final report is prepared. Not only is the money devoted to the visit frequently not used most effectively, the visit presents important opportunities to learn and to build a design team. These opportunities are too often squandered.

This guide focuses on what a facility field visit can accomplish and suggests ways to achieve these goals. Although a facility visit may occur in a variety of circumstances, including the redesign of the process of healthcare without any redesign of the physical setting, this guide focuses on situations in which architectural or interior design is being contemplated or is in process.

SCOPE OF THE RESEARCH

The goals of this project were to learn about the existing practice of conducting healthcare facility visits, to learn about the potential for extending their rigor and effectiveness, and to develop and test a new approach. We interviewed over 40 professionals in the fields of healthcare and design from every region of the US, including interior designers, architects, and clients who had participated in design projects, and healthcare professionals who conduct visits of their own facilities. We sampled professionals from large and small design firms, and from large and small medical organizations. To get a picture of both “average” and “excellent” practice we randomly selected members from professional organizations such as the AIA Academy on Architecture for Health and the American Society of Hospital Engineers, and augmented these with firms and individuals who were award winners or were recommended to us by top practitioners. We developed a multi-page questionnaire that probed the participants’ experiences with visits, including their reasons for participating, their methods, and how they used the information produced. We faxed each participant the questionnaire, then followed up with an interview on the phone or in person. The interviews averaged about one-and-a-half hours in length. Every person we initially contacted participated in an interview. Everyone in our sample had participated in some sort of visit of healthcare facilities within the past year.

After conducting the interviews we developed, field tested, and revised a new facility visit method, which is presented in this guide. Throughout this process we conferred with select members of the Research Committee of The Center for Health Design and the Project Advisory Board.

GOALS OF FACILITY VISITS

There are many reasons for doing a facility visit and many different kinds of visits. However, visits roughly fall into three categories: specific visits, departmental visits and general visits. Specific visits focus on particular issues such as the design of patient room headwalls, nursing stations, or gift shops; departmental visits focus on learning about the operations and design of whole departments such as outpatient imaging or neonatal intensive care; general visits are concerned with issues relevant to a whole institution, such as how to restructure operations to become patient-focused. Usually, departmental and general visits occur during programming or schematic design; specific visits often occur during design development, when decisions are being made about materials, finishes and equipment.

More broadly, there are several general reasons for conducting visits: learning about state-of-the art facilities; thinking about projects in new ways; and creating an effective design team.

LEARNING ABOUT STATE-OF-THE-ART FACILITIES

Visit participants want to learn what excellent organizations in their field, both competitors and other organizations, are doing. Participants are often particularly interested in learning how changes in business, technology or demographics, such as increased focus on outpatient facilities or increased criticality of inpatients, might affect their own operations and design. For example, in Story 1, below, a UK team was interested in grafting US experience onto a UK healthcare culture. In another example, hospital personnel at Georgia’s St. Joseph’s Hospital visited five emergency rooms over the course of several weeks before implementing an “express” service of their own. According to planner Greg Barker (Jay Farbstein & Associates, CA) they “use site visits as a method of exposing the clients to a broader range of operating philosophies and methods.” This gives the clients and design professionals a common frame of reference on which to base critical operational and design decisions.

William Headley, North Durham Acute Hospitals, UK

Traditionally, hospital design in the UK has been established centrally, with considerable emphasis placed on standard departmental areas and on a standardized planning format known as “Nucleus.” The 20-year-old Nucleus system is based on a standard cruciform template of approximately 1,000 square meters housing a multitude of departments, which can be interlinked to provide the nucleus of a District General Hospital.

Durham wished to develop a hospital that in its vision would meet the challenges of the 21st Century, and produce a custom-designed hospital solution built to suit the needs of the patient, not just individual departments.

The brief has, therefore, to be developed from a blank sheet of paper and not from standard guidelines. It is also the Trust’s objective to have the brief developed by staff from the bottom up. The purpose of the study tour was to allow frontline staff the opportunity to experience new ideas firsthand and talk to their medical counterparts about some of the philosophies of patient-focused care and to input their findings into the briefing process. We acknowledged the differences in the US and UK healthcare systems, but were interested in ensuring that best US practices, including the patient focused approach, facilities design, and the use of state of the art equipment, was studied and subsequently tailored to suit the new North Durham hospital.

THINKING ABOUT A PROJECT IN A NEW WAY

Participants who are currently engaged in a design or planning project are concerned with using visits to advance their own project. They use a visit to analyze innovative ideas and to help open the design team to new ideas. At the same time they are interested in building consensus on a preferred option. In Story 2, below, a hospital serves as a frequent visit host because it shows how special bay designs can be used in neonatal intensive care, and participants can consider how these designs apply to their current project. Other visit organizers see a visit as an opportunity for focusing the team on key decisions that need to be made, or to help the team focus in a systematic way on a range of strategic options and critical constraints. The visit exposes each team member to a variety of ways of accomplishing a similar program of requirements and thus starts the debate on how to achieve the best results for the facility being designed.

Georgia Brogdon, Vice President Operations, Gwinnett Women’s Pavilion, GA

We get visitors at our facility about once per month. Right now the NICU (neonatal intensive care unit) is the most frequently visited location. The main reason is that Ohmeda uses our unit as a showcase for a special design of NICU bays. People want to see it because most think that Hill Rom is the only vendor of this type of equipment.

Early on, we were also one of the only state-of-the-art LDR facilities around. So if people wanted to visit an LDR unit, they had little choice but to come here. Now, however, people come to see us because we are a freestanding yet still attached facility. Over time the visits have evolved away from the design of the facility and more into programming, services, and operational issues.

We give three types of visits: 1) overview visits for lay people who just want to come see the area; 2) functional visits for other hospital people or architects who want to see the LDR design, mother/baby floor, NICU design, etc.; 3) operational flow visits to learn how the LDR concept impacts operations. In general, we start the visitors wherever the patient would start in the facility.

To arrange a successful visit of our facility, we need to know the interests of the visitors; then we can focus the schedule on that. Also knowing who they are bringing is helpful. You need to have their counterparts available. The types of information needed to conduct facility visits are: 1) what specific operational information to ask for in advance-size, number of rooms, number of physicians, staffing, C-section rate, whether they are a trauma center; 2) how to prepare for the visit; 3) who to bring. We’ve found that periodically the visitors are disappointed because they didn’t bring enough people. Better to have too many than not enough.

CREATING AN EFFECTIVE DESIGN TEAM

Participants use visits as an opportunity for team building. Many visits are conducted early in a design project by a team who will work together for several years. The visit provides participants a useful opportunity to get to know each other and to build an effective team. As Story 3 illustrates, clients often look to a visit to see how well designers can understand their needs; designers use it as a way to learn about their clients and to mutually explore new ideas. A visit can also provide an opportunity for medical programmers to work with designers and clients. This is particularly important if programming and design are done by different firms.

Many visit participants focus on interpersonal issues: spending several days with someone helps build a personal relationship that one can rely on during a multi-year project. A visit also provides the opportunity to achieve other aspects of team building: clarifying values, goals, roles and expertise of individual participants; and identifying conflicts early so they can be resolved. One result for some teams is that it establishes a common vocabulary of operational and facility terms translated to the local healthcare facility.

Bing Zillmer, Director Engineering Services, Lutheran Hospital, La Crosse, WI

Conducting a facility field visit is an opportunity to have that one-on-one contact and find out if the architect “walks the talk or talks the walk.” The biggest benefit is in finding out how the visit team of the architectural firm has been assembled: to see their level of participation, and how they have interacted with and listened to the clients and the hosts. What we look for in a consultant is not a “yes man”; we look for someone who knows more about existing facilities than we do. Our key concerns are how the team worked together, how they listened.

Dennis C. Lagatta, Vice President, Ellerbe Becket, Washington, DC

The main reason for conducting a visit is to settle an issue with the client. The clients usually have only two frames of reference: the current facility and the one where they were trained. These two frames of reference are hard to overcome without a visit. We conduct visits to help settle an issue between various groups within the institution. The visit process tends to be a good political way to illustrate a problem or a solution to a problem. A good example is when you have a dispute between critical care physicians and surgeons. Both parties may be unwilling to compromise. Usually a visit will be a good way to defuse this conflict.

James W. Evans, Facilities Director, Heartland Health System, St. Louis, MO

Responding to the question, what kinds of team-building activities were conducted before the actual visit took place? The functional space program stage is where you start building a team. Functional space programming is a narrative of what you want to do. If the programming includes a laboratory or some other specialty area, you would also want to have the consultant (if you are using one) involved in this process. Between blocks and schematics is when you want to go on any visits. By working together and staying together through big and small projects, you develop a lot of rapport and credibility.

Les Saunders, Nix Mann And Associates, Architects, Atlanta, GA

In the case of marketing visits, we try and present our unique abilities to our clients and to get to know each other better, Our visits are generally tailored to what the client group is trying to accomplish. Our functional experts will go on the visit so they can get to know the client and try to enhance “bonding.”

Facility visits allow healthcare organizations and design professionals to address several important trends in healthcare.

• A visit allows a team to understand the experience of stakeholders who they do not currently serve, and to examine the design and operations of facilities that are more customer-oriented.
• Social changes are resulting in some stakeholder groups gaining importance, such as outpatients involved in more complex procedures, higher acuity inpatients, older people, or non-English speakers.
• A visit can provide quantitative and qualitative data that support future decision making.
• Tighter budgets, shorter design and construction schedules and more complex projects are requiring design teams to form more quickly and work more effectively.
• A visit can be an effective tool for building a design team early in a design project.

FALLING SHORT OF THEIR POTENTIAL

In a design project, the client healthcare organization generally pays for a visit, either directly or as a part of design fees. Do healthcare organizations usually get good value for their investment? Do visits generally achieve their ambitious goals of learning about competition and change, moving the design project along, and building teams? We found very different answers. Despite the usual rigor of healthcare planning and programming, many current visits are very casual. Whereas some planners of visits do careful searches of available facilities to fit specific criteria, most choose sites to visit in other ways— sites participants happen to already know because they have been written about in magazines, or sites where there is a contact that someone on the team knows. Though these ways of choosing sites may be appropriate, they raise a question as to whether most participants are visiting the best sites for their purposes.

In many cases visit teams simply do not spend much time structuring the visit. Most teams do not even meet in advance to decide the major foci of the visit. We did not find many groups who use checklists or sets of questions or criteria when they go into the field. Whereas some teams compile the participants’ notes, and one team actually created a videotape in a large project, most teams do not create any kind of written or visual record of their visit. Many teams hold no meeting at the end to discuss the implications of the visit, although many participants felt that they emerged in subsequent programming or design meetings.

Despite the apparent casualness of these visits, designers and clients alike almost without exception felt they were a valuable resource.

Simply visiting a well-run facility can be vivid and exciting. It is fascinating to see how excellent competitors operate, to talk to them and learn of their experience. (It is also an excellent opportunity for administrators and designers to get away from their daily routine and talk to professional counterparts.)

But there are large opportunity costs in the way most current visits are run, and they represent considerable lost value for the healthcare organization, designer, and design project.

COMMON PITFALLS

Opportunity costs of current visits come from several common pitfalls.

LOW EXPECTATIONS LEAD TO LIMITED BENEFITS

Often, participants see field visits as a way to get to know other team members and simply to see other sites, but have no clear idea about what information can be helpful to the project at hand. They don’t think through how the visit can help the goals of their project or organization.

TOO BUSY TO PLAN

The planner of a visit faces multiple problems. Often the visit is seen as a minor part of the job of most participants and doesn’t get much attention in advance; schedules and participants may change at the last minute. In many cases, no one is assigned to develop the overall plan of the visit, and to ask if the major components-choice of sites, choice of issues to investigate, methods for visits, ways of creating and disseminating a report-match the overall goals of the organization and project. This is especially ironic because participants are often advocates of careful planning in other areas.

TOO FOCUSED ON MARKETING

Many visits, and especially designer-client visits, are billed as data gathering but are in fact aimed at marketing. A design firm may literally be marketing services or may be trying to get a client to accept a solution that they have already developed: marketing an idea. This may lead to an attempt to create a perfect situation in the facility being visited, one without rush, bustle, or everyday users and the information they can provide. For designer-client teams, we heard many designers complain that they couldn’t control their clients, that they couldn’t keep them focused on prearranged ideas or keep them limited to prearranged routes. (This is often the result of not enough advance work aimed at understanding what interests the participants have and not enough time spent building common goals.)

CLOSING THE RANGE OF DESIGN OPTIONS TOO EARLY

Many visits occur early in the design process or when an organization is considering significant change, a perfect time to consider new possibilities or address issues and solutions not previously considered. This timing, and the chance to see and discuss new options in a visit, presents an opportunity for a design team to open its range of choices and consider novel or creative alternatives. However, many visit participants feel strong pressures to “already know the answer” when they start the visit. Many designers and consultants feel that their clients do not want them to genuinely explore a range of options, that they were hired because they know the solution. Similarly, some medical professionals establish positions early to avoid seeming foolish or uninformed. As a result, the team may choose sites that bring only confirmation, not surprise, and people will be interviewed who bring a viewpoint that is already well established. This is not simply a matter of the individual personalities of people who set up visits, but rather a problem of the design of teams and the context within which they operate. It is often important for a design firm to show a client the approach it is advocating and for them to jointly explore its suitability for the client’s project. However, if the client expects a designer to know the answer before the process starts, rather than developing it jointly with the client, the designer is forced to use the visit to exhort rather than to investigate.

TOO LITTLE STRUCTURE FOR THE VISIT

Whereas no one likes to be burdened with unnecessary paperwork before or during a visit, it is easy to miss key issues if there is not an effort to establish issues in advance, with a reminder during the visit. Seeing a new place, with lots of activity and complexity, makes it easy to miss some key features. Many team members come back from visits with a clear idea of some irrelevant unique feature such as the sculpture in the hallway, rather than the aspect of the site that was being investigated.

INTERVIEWING THE WRONG PEOPLE

Often, out of organizational procedure or courtesy, a site being visited will assign an administrator or person from public relations to be the primary guide. It is almost always preferable to interview people familiar with the daily operations of the department or site.

MISSING CRITICAL STAKEHOLDERS

Almost every healthcare facility is attempting to become more responsive to customers, both patients and “internal” customers such as staff. Patients often now have a choice of healthcare providers, and staff are costly to replace. Despite these trends, many visits miss some key customer groups such as inpatients, outpatients, visitors, line staff, and maintenance staff. It is very important that these groups or people who have close contact with them be represented in visits.

A DESIGNER PROVIDING TOO MUCH DIRECTION DURING A DESIGNERCLIENT VISIT

In an effort to control the outcome, a designer may attempt to ask most of the questions during interviews. In addition to the problem of focusing exclusively on “selling” ideas described above, clients do not like to feel that their role is usurped.

MISSING OPPORTUNITIES FOR TEAM BUILDING

Teams are most effective when everyone understands the values, goals, expertise and specific roles of others on the team. Teams are also most effective when the team understands the process and resources of the team, the nature of the final product, how the final product will be used: who will evaluate it, and by what criteria the success of the product will be evaluated. Although management consultants routinely recommend making such issues explicit at the beginning of team building, we found few visit teams that deal with these issues directly. Many teams do not even get together before a visit to discuss these issues.

NOT ATTENDING TO CREATING A COMMON LANGUAGE

Multidisciplinary design teams often speak different professional languages and have different interests and values. Designers are used to reading plans and thinking in terms of space and materials; healthcare administrators are used to thinking in terms of words and operational plans. Unless a field visit team is conscious about making links between space and operations, there can be little opportunity to establish agreement.

LACK OF AN ACCESSIBLE VISIT REPORT

Most current visits produce no report at all; some produce at least a compilation of handwritten notes. We heard a repeated problem: no one could remember where they saw a given feature.

CHAPTER 1:  MAJOR TASKS

The healthcare facility visit process has three major phases, divided into specific team tasks that are conducted before, during, and after a visit. These phases, and the 13 major tasks that comprise them, are below. The process we propose is quite straightforward, but compared to most current visits it is more deliberate about defining goals, thinking through what will be observed, preparing a report, and being clear about the implications of the visit for the current design project.

PREPARATION

TASK 1. SUMMARIZE THE DESIGN PROJECT

In this task the project leader or others prepare a brief description of the goals, philosophy, scope, and major constraints overview of the design project that the visit is intended to aid. It should include the shortcomings that the design project is to resolve: space limitations, operational inefficiencies, deferred maintenance, etc.

The overview helps focus the facility visit, and can be provided to the host sites to help them understand the perspective of the visit. This summary should be brief, only a few pages of bulleted items, but should clearly identify the strategic decisions the team is facing. For example, a team may be considering whether to develop a freestanding or attached woman’s pavilion. It is also important to identify key operational questions in the project summary. Focusing on design solutions too early may distract the team from more fundamental questions that need to be resolved. The purpose of the summary is to establish a common understanding of goals, build a common understanding of constraints, and allow the visit hosts to prepare for the visit.

The summary of the design project may focus on several topics:

• How do these critical purposes link to key business imperatives, such as “broadening the base of patients” or “allowing nurses to spend more time delivering patient care”?
• What measurable or observable aspects of the design relate to these key purposes? For example, one team may be interested in whether carpeting leads to increased cleaning costs or increased infection rates; another team may be interested in visitor satisfaction with a self-service gift shop.

Key issues in summarizing the design project:

• It should identify the full range of stakeholders who affect the current design.

Note: Many visits ignore this critical up-front work. Depending on the schedule and scope, the summary can be circulated to the team in advance of the brainstorming meeting.

TASK 2. PREPARE BACKGROUND BRIEF

More than most building types, healthcare facilities have a large body of literature providing descriptions of new trends, research, design guidelines, and post-occupancy evaluations. Many design firms and healthcare organizations have this material in their library or can get it from local universities or medical schools. In this task the visit organizer creates a file of a few key articles or book chapters describing the issue or facility type being visited. These are then distributed to the team, allowing all team members to have at least a minimal current understanding of operations and design.

The team leader also prepares an Issues Worksheet. This is a one-page form that is distributed along with the Background Brief to all members of the visit team prior to their first meeting. (See Figure 2 for a sample Issues Worksheet.) It encourages them to jot down what is important to them, and to discuss issues with their coworkers. It works most effectively when the visit organizer adds some typical issues to help them think through the problem. Participants should be encouraged to bring the Worksheet with them to the team meetings.

Key issues in preparing the Background Brief:

• Providing a few current background articles on the kind of department, facility, or process being visited helps create at least a minimum level of competence for the team and helps establish a common vocabulary prior to the visit.
• The Issues Worksheet, along with the Project Summary and Background Brief, allows participants to develop a picture of the project and to brainstorm ideas.

TASK 3. PREPARE DRAFT WORK PLAN AND BUDGET

Once the team leader or others have summarized the design project and prepared the Background Brief, a draft work plan outlining the major components of the field visits can be prepared. At this stage, it is important to establish a tentative budget for the visit. It is also important to make sure that the major components of the draft work plan, such as choosing visit sites and developing critical issues, match the overall goals of the organization and project. The draft work plan provides a tentative structure for the field visits, which can be modified by other team members.

Key issues in preparing the draft work plan:

TASK 4. CHOOSE AND INVITE PARTICIPANTS

The effectiveness of the team is, of course, most directly related to the nature of the participants. Field visit teams are sometimes chosen for reasons such as politics, or as a reward for good service, rather than for their relevance to the project. For healthcare organizations field visit teams are usually most successful if they mix the decision makers who will be empowered to make design decisions with people who have direct experience in working in the area or department being studied. For design firms, teams are often most successful if they include a principal and the project staff. In both of these cases, the team combines an overall strategic view of the organization and project with an intimate knowledge of operational and design details.

Key issues in choosing participants:

• Participants should be chosen with a clear view of why they need to participate and what their responsibility is in planning, conducting and writing up the visit.
• Site hosts say that teams larger than about seven tend to disrupt their operations.

TASK 5. CONDUCT TEAM ISSUES SESSION

It is usually advisable to hold a team meeting early in the visit planning process to: 1) clarify the purposes and general methods of the field visit; 2) build an effective visit team by clarifying the perspective and role of each participant; 3) ‘identify potential sites, if the visit sites have not already been selected. Some resources and methods to select sites are discussed further in the next section, “Critical Issues in Conducting Facility Visits.”

The issues session is often a “structured brainstorming” meeting aimed at getting a large number of ideas on the table. (This is particularly important during departmental and general visits, and if team members don’t know each other.) The purpose is opening the range of possible issues rather than focusing on a single alternative.

This meeting is typically aimed at building a common sense of purpose for all team members, rather than marketing a preconceived idea. This meeting also serves the purpose of making critical decisions regarding the choice of sites and identifying who at the sites should be contacted.

Each participant should bring his or her Issues Worksheet along to the meeting. The initial task is to get all questions and information needs onto a flip chart pad or board before any prioritization goes on. Then the leader and group can sort these into categories and discuss priorities. These categories and priorities may be sorted in the form of lists which include: 1) a list of critical purposes of the departments or features being designed; 2) a list of critical purposes of the departments or features being evaluated at each facility during visits; 3) a list of existing and innovative design features relevant to these purposes. The critical purposes of the departments or design features at existing facilities can be charted at different spatial levels of the facilities, such as: site, entrance, public spaces, clinical spaces, administrative and support areas. Some typical architectural design issues are provided in the appendix.

The issues session may be run by the leader or the facilitator. Because one of the purposes of this meeting is to get balanced participation, it may be useful to have someone experienced in group process run the meeting, rather than the leader. His or her job is to make sure everyone participates, allowing the leader to focus on content.

This meeting may also provide an early opportunity to identify potential problems in conflicting goals, values or personalities on the team. For instance, a healthcare facility design project may have significant conflicts between departments, or between physicians and administrators. The meeting may also allow the team to agree on basic business imperatives and to be clear about the constraints that are of greatest importance to them, such as “never having radioactive materials cross the path of patients.”

Key points in running an issues session:

• Everyone should be able to participate without feeling “dumb.”
• The leader and group should try to understand the range of interests and priorities represented.
• Brief notes of the meeting should be distributed to all participants.

Note: This meeting is successful if participants feel they can express ideas, interests, and concerns without negative consequences from other members of the team. There is no such thing as a stupid question in this meeting.

TASK 6. IDENTIFY POTENTIAL SITES AND CONFIRM WITH THE TEAM

Based on the work plan which established the visit objectives and the desires, interests and budget of the team, the visit organizer chooses potential sites, and checks with the team. If possible, he or she provides some background information about each site to help the team make decisions.

The team may know of some sites they would like to visit, and these might have emerged in the issues session. Otherwise there are a range of sources for finding appropriate sites to visit: national organizations such as the American Hospital Association, as well as the American Institute of Architects Academy on Architecture for Health Facilities, and a range of magazines that discuss healthcare facilities. (See the section below entitled “Choosing Sites.“)

Different teams pick sites for different reasons. Some may pick a site because it is the best example of an operational approach such as “patient-focused care.” Others may look for diversity within a given set of constraints, such as different basic layouts of 250-bed inpatient facilities.

Many visit leaders complain that the team sometimes is distracted by features outside the focus of the tour, and particularly by poor maintenance. Wherever possible, it is advisable for the visit organizers to tour the site in advance of the group visit and to brief the hosts in person about the purposes of the visit. Although it is rare, some sites now charge for visits.

A key issue in choosing sites:

• The selection of sites should challenge the team to think in new ways.

Note: Sites are often chosen to provide a clear range of choices within a set of constraints provided by operations, budget, or existing conditions, such as “different layouts of express emergency departments” or “different designs of labor-delivery-post-partum-recovery rooms.”

TASK 7. SCHEDULE SITES AND CONFIRM AGENDA

The leader or facilitator calls a representative at each host site to schedule the visit. He or she confirms the purposes of the visit, confirms with the host sites the information needed before and during the field visit, and confirms who will be interviewed at the site. Healthcare facilities are sometimes more responsive to a request for a visit if they are called by a healthcare professional or administrator rather than a designer: if someone on the team knows someone at a site, he or she may want to make the first phone call. Many teams also find that if they arrange for a very brief visit, this may be extended a bit on site when the hosts become engaged with the team. When confirming the schedule for the visit with the host facilities, the visit organizer should specify that the visit team would prefer to interview people familiar with the daily operations of the department or site.

Key issues in scheduling sites:

Note: Sites are often proud of their facilities and often enjoy receiving distinguished visitors. However, they often find it difficult to arrange interviews or assemble detailed information on the spot.

TASK 8. PREPARE FIELD VISIT PACKAGE

Visits are more effective if participants are provided a package of information in advance: information about schedule, accommodations, and contact people; information about each site, including, where possible, brief background information and plans; a simple form for recording information; and a “tickler” list of questions and issues.

a) Prepare visit information package

The organizers should provide participants information about the logistics of the field visit: schedules, reservation confirmation numbers, phone numbers of sites and hotels.

b) Prepare site information package

The site information package orients participants to the site in advance of the visit. Depending on what information is available, it may include: plans and photos of each site; basic organizational information about the site (client name and address, mission statement, patient load, size, date, designers, etc.); description of special features or processes or other items of interest. Whereas measured plans are best, these are not often available. Fire evacuation plans can be used. A sample site information package is provided in the Appendix. Many teams find it useful to review job descriptions for the host site, and many organizations have these readily available.

c) Prepare Visit Worksheet

Facility visits are often overwhelming in the amount of information they present. It is useful for the organizers to provide the participants with a worksheet for taking notes. We have provided a sample worksheet as Figure 3 below, and blank forms are provided in the Appendix. The purpose of the checklist is to remind participants of the key issues and to provide a form that can easily be assembled into the trip report.

Note: A successful worksheet directs participants to the agreed-upon focal issues without burdening them with unnecessary paperwork. Participants should understand the relationship between filling out the checklist and filling out the final report.

FACILITY VISIT

TASK 9. CONDUCT FACILITY FIELD VISIT

The actual site visit typically includes: 1) an initial orientation interview with people at the site familiar with the department or setting being investigated; 2) a touring interview where the team, or part of it, visits the facility being investigated with someone familiar with daily operations, asking questions and observing operations; 3) recording the site; 4) conducting a wrap-up meeting at the site. (Each of these steps is discussed individually below.) The interview sessions are focused on helping the team understand a wider range of implications and possibilities. If appropriate, the wrap-up session may also be used for focusing on key issues that move the design along.

Note: Participants often like to speak to their counterparts: head nurse to head nurse, medical director to medical director, etc., although everyone seems to like to talk to people directly involved with running a facility such as a head nurse. People who know daily operations are often more useful than a high-level administrator or public relations staff member.

a) Conduct site orientation interview

During the orientation interview the visit team meets briefly with a representative of the site to get an overall orientation to the site: layout and general organization; mission and philosophy; brief history and strategic plans; patient load; treatment load; and other descriptions of the site. Many teams are also interested in learning about experiences the healthcare organization had with the process of planning, design, construction and facility management: What steps did they use? What innovations did they come up with? What problems did they encounter? What are they particularly proud of? What do they wish they had done differently?

b) Conduct a touring interview

The touring interview was developed by a building evaluation group in New Zealand and by several other post-occupancy evaluation researchers and practitioners. (See the post-occupancy evaluation section of the Bibliography.) In the touring interview, the team, or a portion of it, visits a portion of the site to understand the design and operations. Conducting an interview in the actual department being discussed often brings a vividness and specificity that may be lacking in an interview held in a meeting room or on the phone. One of the great strengths of the touring interview is the surprises it may bring, and the option it provides to consider new possibilities or to deal with unanticipated problems. As a result, it often works best to start with fairly open-ended questions:

• What works well here? What works less well?
• What are the major goals and operational philosophy of the department?
• What is the flow of patients, staff, visitors, meals, supplies, records, laundry, trash?
• Can they demonstrate a sample process or procedure, such as how a patient moves from the waiting room to gowning area to treatment area?
• What are they most proud of?
• What would they do differently if they could do it over?

These questions also provide a nonthreatening way to discuss shortcomings or issues that are potentially controversial. The team may then want to focus on the specific concerns that were raised in the issues session.

A difficult, but critically important, thing to avoid in a touring interview is to become distracted by idiosyncratic details of the site being visited. Often operational patterns or philosophy are more important than specific design features that will not be generalized to a new project: how equipment is allocated to labor-delivery-recovery-postpartum rooms in the site being visited may be more important than the color scheme, even though the color may be more striking.

Large multidisciplinary teams are particularly hard to manage during a touring interview. A given facility may have a state-of-the-art imaging department that is of great interest to the radiologists on the team but may have a mediocre rehabilitation department. In these cases, some of the touring interviews may be focused on “what the host would do differently next time.”

Key issues in conducting the touring interview:

Note: It is important to include people familiar with daily operations on the touring interview, both on the team side and on the side of the site being visited. A frequent problem is that some stakeholder groups such as patients or visitors are not represented; special efforts should be taken to understand the perspectives of these groups.

c) Document the visit

The goals of the visit dictate the kinds of documentation that are appropriate. However, most visits call for a visual record, sketches, and written notes.

In most cases it is useful to designate one or more “official” recorders who will assemble notes and be sure photos are taken, measurements made, plans and documents procured, etc. For designer-client visits, it is often useful to have at least two official recorders to look after both design and operational concerns. However, because a team often splits up, most or all participants may need to keep notes.

It is quite rare for teams to use video to record their visit, although this seems to be increasing in popularity. Editing videos can be very costly: it may take a staff member several person-days in a professional editing facility to edit several hours of raw video down to a 10- or 15- minute length. However, this time may be reduced with the increased availability of inexpensive microcomputer-based editing programs.

Key issues in recording the facility:

Many departmental and general visit teams find it useful to photographically record key flows, such as patients, staff and supplies, and location of waiting rooms and other patient amenities.

Note: If the method of creating the documentation is established in advance it can easily be assembled into a draft report.

d) Conduct on-site wrap-up meeting

Whereas the visit interview is focused on opening options for the team and identifying new problems and issues, the wrap-up meeting is often more focused on clarifying how lessons learned on the visit relate to the design project, and how they begin to answer the questions the team established. It is often useful to have a representative of the host site present at the wrap-up meeting to answer questions, if their time allows.

Key issues in conducting wrap-up meetings:

TASK 10. ASSEMBLE DRAFT VISIT REPORT

A draft visit report may take many different formats. The simplest is to photocopy and assemble all participants’ worksheets and notes, retyping where necessary. Alternatively, the organizers or a portion of the team may edit and synthesize the worksheets and notes. Though more time consuming, this usually results in a more readable report. A somewhat more sophisticated version is to establish a database record that resembles the form used to take notes on-site in a program such as FoxPro, Dbase, or FileMaker Pro. Participants’ comments can be typed into the database and sketches and graphics can be scanned in and attached.

These are then provided to all participants.

A key issue in assembling the draft report:

• Simplicity is often best; simply photocopying or retyping notes is often adequate, especially if photos and sketches are attached.

TASK 11. CONDUCT FOCUS MEETING

Upon returning home, the team conducts a meeting to review the draft trip report and to ask:

Unlike the issues session held early in the visit planning process, which was primarily concerned with bringing out a wide range of goals and options, this meeting is typically more aimed at establishing consensus about directions for the project.

A key issue in conducting the focus meeting:

• The purpose of the focus meeting is to establish the lessons learned for the design project.

Note: The leader should carefully consider who is invited to the focus meeting. This may include others from the design firm, consultants, healthcare organization, or even representatives from the site.

TASK 12. PREPARE FOCUS REPORT

The focus report briefly summarizes the key conclusions of the visit for the visit team and for later use by the entire design team. It is an executive summary of the visit report which may provide a number of pages of observations and interview notes.

Key issues in preparing the focus report:

• The focus report should be a clear, brief, jargon-free summary.

TASK 13. USE DATA TO INFORM DESIGN

The key purpose of a facility visit is to inform design. Whereas this can occur informally in subsequent conversations and team meetings, it is best achieved by also being proactive. For example, the team can:

Key issues in using data to inform design:

• Reports and materials collected on visits should be available to all participants in the design process and should be on hand during subsequent meetings. A central archive of materials should be available and should be indexed to allow easy access for people involved in future projects.

CHAPTER 2:  TOOL KIT

TASK CHECKLIST

The team leader prepares a brief summary of the goals, philosophy, scope, and major constraints of the design project to help focus the field visit.

• Prepare a list of design or operational features related to these critical purposes.

The team leader prepares a file of a few key articles or book chapters that provide descriptions of new trends, research, design guidelines and post-occupancy evaluations of the facility type, department or issue being studied. He or she also prepares Issues Worksheets for team members to make notes on prior to the initial issues brainstorming session.

• Assemble current literature on existing facilities. Prepare the Issues Worksheet.

The draft work plan clarifies the values, goals, process, schedule and resources of the visits.

In this task the team leader builds a team. The ideal team combines a view of the overall strategic perspective of the organization and project with an intimate knowledge of daily operations.

The team issues session has three purposes: 1) clarify the purposes and general methods for the field visit; 2) build an effective team; 3) identify potential sites. The issues session is often a “structured brainstorming” meeting aimed at getting a large number of ideas on the table, and at understanding the various perspectives of the team.

• Clarify the resources available to the team and the use of the information collected.

TASK 6. IDENTIFY POTENTIAL SITES AND START FACILlTY VISIT PACKAGE

Based on visit objectives and the desires, interests and budget of the team, the visit organizers choose potential sites and check with the team. If possible they provide some background information about each site.

• If field investigation sites are already selected, provide fact sheets about each site to the participants.

In this task, the purposes and schedule of the visit are confirmed with the sites. This should occur at least two weeks before the visit.

The field investigation package includes the following components, which are used for conducting the visit:

• Tour information package (tour itineraries, transportation and accommodation details, list of contact people at each facility).
• Site information package (description of the sites, background information, facility plans).
• Site Visit Worksheets for notetaking.

TASK 9. CONDUCT FIELD VISIT

The interview sessions are focused on opening: helping the team understand a wider range of implications and possibilities. If appropriate, the wrap-up session may also be used for focusing on key issues that move the design along. Conduct site orientation interview.

• Collect any additional information from the host site.
• Conduct touring interview with people familiar with daily operations and a range of stakeholders.
• Document the visit through notes, sketches and photos.
• Conduct on-site wrap-up meeting with team members.

The draft report is a straightforward document allowing others to benefit from the investigation and providing the team a common document to work from.

The team conducts a focus meeting to ask: What are the major lessons of the investigation? What does it tell the team about the current project?

The Focus Report briefly summarizes the key conclusions of the visit for the visit team and for later use by the entire design team. It is an executive summary of the Visit Report which may provide a number of pages of observations and interview notes.

• Prepare and distribute a brief Focus Report.

The purpose of this document is to inform the design process.

• Write a brief newsletter about the design project that includes key findings from the visit.

SAMPLE FACILITY FACT SHEET (see PDF version)

CHAPTER 3:  CRITICAL ISSUES IN CONDUCTING FACILITY VISITS

Selecting visit sites.

One of the most important steps in conducting healthcare facility visits is the selection of appropriate sites. However, there is no single source of information on healthcare facilities, and site selection is not an easy task. It is difficult to locate sites with comparable features in terms of workload, size, budget, operational facilities and physical features. Without this information, the tendency is to choose sites based on other criteria, such as location and proximity, or the presence of a friend or former coworker at specific host facilities.

However, depending on the nature of the facility visit, there are several resources that can be consulted for site selection. Some healthcare and design professional associations periodically publish guides and reference books which are helpful in selecting sites for facility visits. The following sources can be referred to before selecting specific facilities for field visits:

NATIONAL HEALTHCARE ASSOCIATIONS

American Hospital Association (AHA) AHA Resource Center, Chicago, (312) 280-6000

AHA database for healthcare facilities in the state of Missouri. : Missouri Hospitals Profile . Listed price: $27.50.

AHA Guide to locating healthcare facilities in the US . The listed facilities are classified according to the city/county with a coded format for the number of beds, admission fee, etc. Listed price: $195 for nonmembers and $75 for members.

AHA Health Care Construction Database Survey . Contact Robert Zank at the AHA Division of Health Facilities Management, (312) 280-5910.

Association of Health Facilities Survey Agency (AHFSA) Directory of the Association of Health Facilities Survey Agency. AHFSA, Springfield, IL.

National Association of Health Data Organizations (NAHDO) Some states collect detailed hospital-level data. To obtain information on states with legislative mandates to gather hospital-level data, contact Stacey Carman at 254 B N. Washington Street, Falls Church, VA 22046-4517, Telephone: (703) 532-3282, FAX: (703) 5323593.

NATIONAL ASSOCIATIONS FOR DESIGN PROFESSIONALS

American Institute of Architects (AIA) AIA Academy on Architecture for Health 1735 New York Avenue NW Washington, DC 20006

(202) 626-7493 or (202) 626-7366, FAX (202) 626-7587 To order AIA publications: (800) 365-2724

Hospital Interior Architect .

Hospital and Health Care Facilities, 1992. Listed price: $48.50 for nonmembers; 10% discount for members off listed price.

Hospitals and Health Systems Review, July 1994. Listed price: $12.95 for nonmembers; 30 % discount for members off listed price.

Hospital Planning . Listed price: $37.50 for nonmembers; 10% discount for members off listed price.

Hospital Special Care Facility , 1993.

Organizational Change: Transforming Today’s Hospitals, January 1995: Listed price: $36.00 for nonmembers; 30% discount for members off listed price.

Health Facilities Review (biannual), 1993. Listed price: $20 for nonmembers; $14 for members.

PERIODICALS DESCRIBING SPECIFIC HEALTHCARE FACILITIES

Modern Healthcare. This national weekly business news magazine for healthcare management is published by Crain Communication, and holds annual design awards. In conjunction with AIA Academy of Architecture for Health, this periodical announces annual competition and honors architectural projects that build on changes in healthcare delivery. Contact Joan Fitzgerald or Mary Chamberlain at 740 N. Rush Street, Chicago IL 60611-2590, (312) 649-5355.

American Hospital Association Exhibition of Architecture for Health , 1993.

For further information contact Robert Zank at the Division of Health Facilities Management, (312) 280-5910.

Journal of Healthcare Design . This journal illustrates 20-40 exemplary healthcare facilities in each

annual issue. Free list of previously-toured exemplary facilities (available by calling The Center).

Æsclepius . Æsclepius is a newsletter discussing a range of design issues relevant to healthcare facilities.

TEAMBUILDING

Many people who conduct healthcare facility field visits use them as a way to build an ongoing design team. This is particularly true of designer-client-consultant teams who conduct visits early in a design project. According to organizational researcher and consultant J. Richard Hackman, 1 teams often spend too much time worrying about the “feelgood” aspects of interpersonal relationships and not enough time focusing on other key issues such as choosing the right people for the team, making roles and resources clear, specifying final products, and clarifying how the final product will be used.

Participants are often chosen because they are upper-level administrators or because they deserve the perk. It may not be clear what their function is on the visit or how they would contribute to any later decision making about the design project. Likewise, visit teams often don’t know what resources are available to them: Can they visit national sites? Can they call on others to help prepare and distribute a visit report?

• Some key team building steps include:
• Select visit participants with a clear idea of why they are participating and how they can contribute.
• Keep the team small; visit teams of more than seven or eight people are hard to manage.
• Provide each participant a clear role before, during and after the actual site visit, and negotiate this role to fit their interests and skills. Roles should be clearly differentiated and clear to all participants.
• Make the final product clear: simple photocopying and assembly of notes and photos taken during the visit; brief illustrated written report; videotape, etc.
• Clarify how the visit findings are to be used: what key decisions are the major focus?

ROLES IN CONDUCTING FACILITY VISITS

There are several key roles in the process. Depending on the size of the team and the nature of the visit, each role may be taken on by a different person, or they may be combined.

LEADERSHIP TASKS:

• Restate current need and parameters of the design project.
• Develop some background information on the issues or setting types being investigated, and distribute to team members.
• Conduct a brainstorming meeting to understand the expertise, interests, values, and goals of each team member.
• Identify potential visit team members, and invite them.
• Summarize the goals of the design project, clarify how the field visit might advance these goals, and communicate these to the team.
• Identify roles for each team member.
• Develop a work plan and budget.
• Clarify the criteria for choosing sites.
• Prepare and/or review major documents: site-specific protocols; checklists and lists of questions and issues; information about each site being visited; overall plan for the visit; visit report; focus report.
• Conduct wrap-up meeting at each site.
• Conduct focus meeting on returning home.

SUPPORT TASKS:

• Assemble a few key articles or other documents to help the team understand the key issues in the setting types, processes or departments being visited.
• Identify potential sites, with some information about each site candidate so the leader and team can make final choices.
• Confirm with sites, and clarify what information the team will need in advance and what will be collected during the visit.
• Prepare draft materials (Background Brief, site information package, visit information, interview protocol) for review by the leader.
• Organize any trip logistics that are not done individually by participants: car rentals, hotel reservations, air tickets, etc.
• Write thank-you letters to site participants.
• Prepare a Draft Visit Report for review by the leader and team.
• Draft a Focus Report for review by the leader and the team.

FACILITATION TASKS:

When the team is attempting to get broad input into the process, such as when the team meets initially to set direction, it is often useful to have someone run the meeting who has the role of simply looking after the process of the meeting, rather than the content. He or she is charged with making sure that everyone is heard without prejudice, and that all positions are brought out. It often works poorly to have a senior manager in this role. Even if he or she has good facilitation skills, it is intimidating for many people to speak up in a meeting led by their boss.

Specific tasks:

• Conduct the initial brainstorming session that establishes the direction, issues and roles for the visit.
• Conduct any additional sessions where balanced participation is important to increasing the pool of ideas or getting “buy-in” from all team members.

RECORDER TASKS:

During the actual site visit, one or more people are typically charged with maintaining the “official” records of the visit (individuals may keep their own notes as well). This may include written notes, audio or video records, or photographs. If the team breaks up during the visit, a recorder should accompany each group.

Specific tasks include:

• Procure any required recording devices and supplies, such as cameras, tape recorders, paper forms, etc.
• Make records during the visit.
• Edit the record and assemble into a report.

TEAM PARTICIPANTS TASKS:

INTERVIEWING

Interviews vary greatly in the amount of control exercised by the interviewer in choosing the topic for discussion and in structuring the response. An intermediate level of control over topic and responses, often called a “structured interview,” is usually appropriate in a facility visit. In a structured interview, the interviewer has an interview schedule which is a detailed list of questions or issues which serves as a general map of the discussion. However, the interviewer allows the respondent to answer in his or her own words and to follow his or her own order of questioning if desired. The interview is usually aided by walking through the setting or by having plans or other visual aids during seated sessions.

The use of fixed responses, in which respondents have to choose a “best” alternative among several presented, allows rapid analysis of results and may be appropriate if a large number of people are interviewed during a visit. The cost-effectiveness of interviews needs to be considered by the architect or manager when designing the process. Individual interviews are useful because people being questioned may be more forthcoming than if friends or colleagues are present.

However, individual interviews are expensive. With scheduling, waiting time, running the interview, and coding, a brief individual interview may involve several hours or more of staff time.

In summary, interviews are valuable because people can directly communicate their feelings, motives and actions. However, interviews are limited by people’s desire to be socially desirable or by their faulty memories, although these problems may not be too serious unless the questions are very sensitive.

CHAPTER 4:  CONCLUSIONS

Unfortunately, many design processes do not do a good job at controlling risks, costs, and inefficiencies. A design project may have a big influence on the future of an organization, but critical operational and design decisions often receive too little attention. And problems or new ideas are often discovered very late in a design process, when they are difficult and costly to accommodate. It is not hard to understand the source of these difficulties. The crises of everyday life go on unabated during design and distract people from design, short-term politics continue, and many people are comfortable with what they already know. Many design team participants representing healthcare organizations want to reproduce their existing operation, even if they can recognize its flaws.

A healthcare design team is too often more like a raucous international meeting than like an effective task-oriented organization. Participants speak different professional languages, have different experiences, have different short-term objectives, hold different motivations for participating, and hold different values about what constitutes a successful project. The team may be far into a project before it understands the different viewpoints represented on the team.

A facility visit is a unique opportunity to address some of these problems. It provides an extended opportunity for a design or planning team to get together outside the pressures of daily life, to critically examine the operations of an excellent facility, to rethink its own ideas, and to build the basis of a team that may function for several years. It is often the longest uninterrupted time a team ever spends together, and the best chance to think in new ways.

A visit has three goals: to establish a situation for effective critical examination of state-of-the-art operations and facilities; to think about the project in new ways; and building a team. These goals are intertwined. A well-structured facility visit may help build a team more effectively than an artificial “feel-good” exercise of mountain climbing or simulated war games. A team that looks at a facility from different perspectives, and in which participants forcefully argue their viewpoint based on evidence from a common visit, can learn each other’s strengths, preferences, and priorities quickly and in a way that builds a bond that is closely related to their own project.

Many teams, however, do not provide enough structure for either critical examination or team building. Critical examination requires an understanding of what key issues are to be examined and how they might apply to the current design problem. Team building requires that a team clearly establishes the role of each team member, makes the resources, process, and schedule clear, is explicit about the form and use of the final report, and establishes a common language.

Healthcare designers and consultants can develop better facility visits, but the responsibility for improving this practice rests with healthcare clients. For a visit to reach its potential, clients must demand an improved process, hold the organizer accountable-and be willing to pay for it. The healthcare client must see design and planning as a process open to mutual learning, and make it happen.

APPENDIX A: BIBLIOGRAPHY

See PDF version for bibliography.

APPENDIX B: EXEMPLARY MICRO-CASES

See PDF version for micro-cases.

Copyright © 1994 by The Center for Health Design, Inc. All rights reserved. No part of this work covered by the copyright herein may be reproduced by any means or used in any form without written permission of the publisher.

The views and methods expressed by the authors do not necessarily reflect the opinions of The Center for Health Design, or its Board, or staff.

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Hospital visits further extended

The Hospital Authority today announced that the special visiting arrangement will be extended to 12 acute and specialist hospitals from August 18.

The authority explained that visitors to acute and specialist hospitals are required to have completed a two-dose COVID-19 vaccination for more than 14 days, a requirement different from the special visiting arrangements to hospitals and wards with non-acute settings.

Amid the huge volume of service and people movement in acute hospitals, the vaccination requirement aims to minimise the infection risks of patients and staff in the hospitals.

With due consideration to the usually shorter length of stay of acute hospital patients, the special visiting arrangement is only applicable to patients admitted for more than one week.

Family members are not required to contact the wards for booking as ward staff will call them to schedule the visits in the next few days.

One to two visits will be arranged for a family member in a designated time slot each week.

Visitors can scan the Hospital Visit QR code found on the authority’s webpage and the mobile app HA Go to fill in the health declaration form within 24 hours before the visit and show the QR code to the ward staff.

The authority said it hopes the community can understand that visiting arrangements can only be made with certain restrictions under the current epidemic situation, noting that its hospitals will continue to facilitate compassionate and video visiting as far as practicable.

Visiting Hours

In accordance with the Hong Kong Government’s Preparedness Plan, the hospital has implemented measures for the Alert Response Level and the following visiting arrangements:

Visiting hours:

• 11:00am to 2:00pm
• 5:00pm to 8:00pm

Updated on 31 May 2023

Kate Middleton in 'Vegetative State for Months,' Funeral Arrangements Being Made?

The princess of wales has been subject to numerous rumors regarding her health since she announced her cancer diagnosis in march 2024., nick hardinges, published may 13, 2024.

About this rating

On May 12, 2024, an X user claimed funeral arrangements were being made for Kate Middleton because she had "been in a vegetative state for months."

Citing an anonymous royal biographer, the X user also claimed eulogies and tributes were being prepared for when the Princess of Wales dies. 

Because Snopes found no examples of any reputable news outlets reporting the same claims, which appeared to originate from the X user, and no relevant announcements from the royal family, we have rated this claim "Unfounded."

The X user wrote : Breaking!! Anon Royal Biographer drops a bombshell claiming funeral arrangements are being made for #KateMiddleton !! 'She's been in a vegetative state for months. They're writing eulogies and tributes for when the time comes to announce.' WHAT?! #WhereIsKateMiddleton"

Other X users shared the post, which had amassed more than 20,000 views at the time of this writing, with one demanding Kate's family speak out , and another simply adding : "Uh oh."

Similar claims about the princess being placed in a vegetative state also appeared on YouTube , Facebook  and on X .

Searching the  royal family's website  and  Google , we found no evidence of anyone revealing Kate was in a "vegetative state." There was also  no proof  funeral plans were being arranged for the royal. No reputable news publications substantiated the claims — which, if true, would be eminently newsworthy.

Snopes contacted the X user and Buckingham Palace for comment on the rumor and will update this article if we receive responses.

On Jan. 17, 2024, Buckingham Palace announced the princess was  admitted to a hospital  the day before for planned abdominal surgery and that she was "unlikely to return to public duties until after Easter." However, on March 22, Kensington Palace  released a video  of Kate announcing she was being treated for cancer.

After releasing the footage, multiple British media outlets, including  Sky News ,  ITV  and  The Independent , reported a statement from Kensington Palace, which read:

The princess will return to official duties when she is cleared to do so by her medical team. She is in good spirits and is focused on making a full recovery.

Snopes also asked Buckingham Palace whether this was the latest update on Kate's health and will update this article if we receive a response.

It was not the first time rumors about Kate being in a coma had circulated on social media. On Feb. 1, 2024, U.K. newspaper The Times reported on Kensington Palace's anger over a Spanish journalist's claim the princess was in a coma, which was made the day before she was released from hospital after her abdominal surgery.

"It's total nonsense," a palace source reportedly told the newspaper at the time, adding:

No attempt was made by that journalist to fact-check anything that she said with anyone in the household. It's fundamentally, totally made-up, and I'll use polite English here: it's absolutely not the case.

Another unsubstantiated claim appeared on social media about the Princess of Wales and her cancer diagnosis in May 2024 . Likewise, rumors circulated about the health of King Charles III in  March  and  May , where it was claimed the British monarch had been given two years to live and, respectively, his funeral plans had been updated, as he was "very unwell."

Hardinges, Nick. 'Kate Middleton Won't Return to Royal Duties for "Many Years," Friends "Lost Contact" with Her?' Snopes , 8 May 2024, https://www.snopes.com//fact-check/kate-middleton-royal-family/.

---. 'King Charles III Was Diagnosed with Pancreatic Cancer, Given 2 Years To Live?' Snopes , 1 Apr. 2024, https://www.snopes.com//fact-check/king-charles-pancreatic-cancer/.

---. 'King Charles III's Funeral Plans Reportedly Updated, Saying He's "Very Unwell" With Cancer'. Snopes , 3 May 2024, https://www.snopes.com//news/2024/05/03/king-charles-iii-funeral-royal/.

Instagram . https://www.instagram.com/p/C402JKPtLVB/?hl=en. Accessed 13 May 2024.

Kate Middleton Funeral Arrangements - Google Search . https://www.google.com/search?q=kate+middleton+funeral+arrangements&sca_esv=4771c1dce5b9df5f&biw=1280&bih=593&tbm=nws&ei=JUFCZoDKHuPaxc8PsJ61iAc&ved=0ahUKEwjA8Lm0h4uGAxVjbfEDHTBPDXEQ4dUDCA0&uact=5&oq=kate+middleton+funeral+arrangements&gs_lp=Egxnd3Mtd2l6LW5ld3MiI2thdGUgbWlkZGxldG9uIGZ1bmVyYWwgYXJyYW5nZW1lbnRzMgUQIRigATIFECEYnwUyBRAhGJ8FSNQSUABYzBFwAHgAkAEAmAG4AaAB5xGqAQQ4LjEyuAEDyAEA-AEBmAIUoAKkE8ICCxAAGIAEGJECGIoFwgIFEAAYgATCAgYQABgWGB7CAgsQABiABBiGAxiKBcICCBAAGIAEGKIEwgIHECEYoAEYCpgDAJIHBDMuMTegB9dd&sclient=gws-wiz-news&gws_rd=ssl. Accessed 13 May 2024.

Kate Middleton Vegetative State - Google Search . https://www.google.com/search?q=kate+middleton+vegetative+state&sca_esv=4771c1dce5b9df5f&source=lnms&sa=X&ved=2ahUKEwjA8Lm0h4uGAxVjbfEDHTBPDXEQ0pQJegQIBhAC&biw=1280&bih=593&dpr=1.5&gws_rd=ssl. Accessed 13 May 2024.

--- . https://www.google.com/search?sca_esv=4771c1dce5b9df5f&q=kate+middleton+vegetative+state&tbm=nws&source=lnms&prmd=invmbtz&sa=X&ved=2ahUKEwjrl5GYiIuGAxXCBNsEHVlmDXcQ0pQJegQIChAB&biw=1280&bih=593&dpr=1.5&gws_rd=ssl. Accessed 13 May 2024.

Madrid, Kate Mansey and Simon Hunter. Palace Angered by 'Made-up' Reports That Princess of Wales Was in Coma . 13 May 2024. www.thetimes.co.uk , https://www.thetimes.co.uk/article/kate-princess-wales-health-hospital-royal-family-news-kensington-palace-5fjjpbxls.

'Princess of Wales Cancer Treatment: When Will Kate Return to the Public Eye?' Sky News , https://news.sky.com/story/princess-of-wales-cancer-treatment-when-will-kate-return-to-the-public-eye-13100363. Accessed 13 May 2024.

Royal.UK . https://www.royal.uk/news. Accessed 13 May 2024.

'When will we see the Princess of Wales in public again?'  ITV.com , 23 Mar. 2024. https://www.itv.com/news/2024-03-23/when-will-we-see-the-princess-of-wales-in-public-again. Accessed 13 May 2024.

William, Helen. 'When Will We See Kate in Public Again?' The Independent , 22 Mar. 2024. www.independent.co.uk , https://www.independent.co.uk/news/uk/prince-of-wales-kensington-palace-prince-wales-princess-of-wales-b2517284.html.

By Nick Hardinges

Nick Hardinges is a London-based reporter who previously worked as a fact-checker at Reuters.

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Geographic coordinates of Elektrostal, Moscow Oblast, Russia

City coordinates

Coordinates of Elektrostal in decimal degrees

Coordinates of elektrostal in degrees and decimal minutes, utm coordinates of elektrostal, geographic coordinate systems.

WGS 84 coordinate reference system is the latest revision of the World Geodetic System, which is used in mapping and navigation, including GPS satellite navigation system (the Global Positioning System).

Geographic coordinates (latitude and longitude) define a position on the Earth’s surface. Coordinates are angular units. The canonical form of latitude and longitude representation uses degrees (°), minutes (′), and seconds (″). GPS systems widely use coordinates in degrees and decimal minutes, or in decimal degrees.

Latitude varies from −90° to 90°. The latitude of the Equator is 0°; the latitude of the South Pole is −90°; the latitude of the North Pole is 90°. Positive latitude values correspond to the geographic locations north of the Equator (abbrev. N). Negative latitude values correspond to the geographic locations south of the Equator (abbrev. S).

Longitude is counted from the prime meridian ( IERS Reference Meridian for WGS 84) and varies from −180° to 180°. Positive longitude values correspond to the geographic locations east of the prime meridian (abbrev. E). Negative longitude values correspond to the geographic locations west of the prime meridian (abbrev. W).

UTM or Universal Transverse Mercator coordinate system divides the Earth’s surface into 60 longitudinal zones. The coordinates of a location within each zone are defined as a planar coordinate pair related to the intersection of the equator and the zone’s central meridian, and measured in meters.

Elevation above sea level is a measure of a geographic location’s height. We are using the global digital elevation model GTOPO30 .

Elektrostal , Moscow Oblast, Russia

40 Facts About Elektrostal

Written by Lanette Mayes

Modified & Updated: 21 May 2024

Reviewed by Jessica Corbett

Elektrostal is a vibrant city located in the Moscow Oblast region of Russia. With a rich history, stunning architecture, and a thriving community, Elektrostal is a city that has much to offer. Whether you are a history buff, nature enthusiast, or simply curious about different cultures, Elektrostal is sure to captivate you.

This article will provide you with 40 fascinating facts about Elektrostal, giving you a better understanding of why this city is worth exploring. From its origins as an industrial hub to its modern-day charm, we will delve into the various aspects that make Elektrostal a unique and must-visit destination.

So, join us as we uncover the hidden treasures of Elektrostal and discover what makes this city a true gem in the heart of Russia.

Key Takeaways:

• Elektrostal, known as the “Motor City of Russia,” is a vibrant and growing city with a rich industrial history, offering diverse cultural experiences and a strong commitment to environmental sustainability.
• With its convenient location near Moscow, Elektrostal provides a picturesque landscape, vibrant nightlife, and a range of recreational activities, making it an ideal destination for residents and visitors alike.

Known as the “Motor City of Russia.”

Elektrostal, a city located in the Moscow Oblast region of Russia, earned the nickname “Motor City” due to its significant involvement in the automotive industry.

Home to the Elektrostal Metallurgical Plant.

Elektrostal is renowned for its metallurgical plant, which has been producing high-quality steel and alloys since its establishment in 1916.

Boasts a rich industrial heritage.

Elektrostal has a long history of industrial development, contributing to the growth and progress of the region.

Founded in 1916.

The city of Elektrostal was founded in 1916 as a result of the construction of the Elektrostal Metallurgical Plant.

Located approximately 50 kilometers east of Moscow.

Elektrostal is situated in close proximity to the Russian capital, making it easily accessible for both residents and visitors.

Known for its vibrant cultural scene.

Elektrostal is home to several cultural institutions, including museums, theaters, and art galleries that showcase the city’s rich artistic heritage.

A popular destination for nature lovers.

Surrounded by picturesque landscapes and forests, Elektrostal offers ample opportunities for outdoor activities such as hiking, camping, and birdwatching.

Hosts the annual Elektrostal City Day celebrations.

Every year, Elektrostal organizes festive events and activities to celebrate its founding, bringing together residents and visitors in a spirit of unity and joy.

Has a population of approximately 160,000 people.

Elektrostal is home to a diverse and vibrant community of around 160,000 residents, contributing to its dynamic atmosphere.

Boasts excellent education facilities.

The city is known for its well-established educational institutions, providing quality education to students of all ages.

A center for scientific research and innovation.

Elektrostal serves as an important hub for scientific research, particularly in the fields of metallurgy , materials science, and engineering.

Surrounded by picturesque lakes.

The city is blessed with numerous beautiful lakes , offering scenic views and recreational opportunities for locals and visitors alike.

Well-connected transportation system.

Elektrostal benefits from an efficient transportation network, including highways, railways, and public transportation options, ensuring convenient travel within and beyond the city.

Famous for its traditional Russian cuisine.

Food enthusiasts can indulge in authentic Russian dishes at numerous restaurants and cafes scattered throughout Elektrostal.

Home to notable architectural landmarks.

Elektrostal boasts impressive architecture, including the Church of the Transfiguration of the Lord and the Elektrostal Palace of Culture.

Offers a wide range of recreational facilities.

Residents and visitors can enjoy various recreational activities, such as sports complexes, swimming pools, and fitness centers, enhancing the overall quality of life.

Provides a high standard of healthcare.

Elektrostal is equipped with modern medical facilities, ensuring residents have access to quality healthcare services.

Home to the Elektrostal History Museum.

The Elektrostal History Museum showcases the city’s fascinating past through exhibitions and displays.

A hub for sports enthusiasts.

Elektrostal is passionate about sports, with numerous stadiums, arenas, and sports clubs offering opportunities for athletes and spectators.

Celebrates diverse cultural festivals.

Throughout the year, Elektrostal hosts a variety of cultural festivals, celebrating different ethnicities, traditions, and art forms.

Electric power played a significant role in its early development.

Elektrostal owes its name and initial growth to the establishment of electric power stations and the utilization of electricity in the industrial sector.

Boasts a thriving economy.

The city’s strong industrial base, coupled with its strategic location near Moscow, has contributed to Elektrostal’s prosperous economic status.

Houses the Elektrostal Drama Theater.

The Elektrostal Drama Theater is a cultural centerpiece, attracting theater enthusiasts from far and wide.

Popular destination for winter sports.

Elektrostal’s proximity to ski resorts and winter sport facilities makes it a favorite destination for skiing, snowboarding, and other winter activities.

Promotes environmental sustainability.

Elektrostal prioritizes environmental protection and sustainability, implementing initiatives to reduce pollution and preserve natural resources.

Home to renowned educational institutions.

Elektrostal is known for its prestigious schools and universities, offering a wide range of academic programs to students.

Committed to cultural preservation.

The city values its cultural heritage and takes active steps to preserve and promote traditional customs, crafts, and arts.

Hosts an annual International Film Festival.

The Elektrostal International Film Festival attracts filmmakers and cinema enthusiasts from around the world, showcasing a diverse range of films.

Encourages entrepreneurship and innovation.

Elektrostal supports aspiring entrepreneurs and fosters a culture of innovation, providing opportunities for startups and business development.

Offers a range of housing options.

Elektrostal provides diverse housing options, including apartments, houses, and residential complexes, catering to different lifestyles and budgets.

Home to notable sports teams.

Elektrostal is proud of its sports legacy, with several successful sports teams competing at regional and national levels.

Boasts a vibrant nightlife scene.

Residents and visitors can enjoy a lively nightlife in Elektrostal, with numerous bars, clubs, and entertainment venues.

Promotes cultural exchange and international relations.

Elektrostal actively engages in international partnerships, cultural exchanges, and diplomatic collaborations to foster global connections.

Surrounded by beautiful nature reserves.

Nearby nature reserves, such as the Barybino Forest and Luchinskoye Lake, offer opportunities for nature enthusiasts to explore and appreciate the region’s biodiversity.

Commemorates historical events.

The city pays tribute to significant historical events through memorials, monuments, and exhibitions, ensuring the preservation of collective memory.

Promotes sports and youth development.

Elektrostal invests in sports infrastructure and programs to encourage youth participation, health, and physical fitness.

Hosts annual cultural and artistic festivals.

Throughout the year, Elektrostal celebrates its cultural diversity through festivals dedicated to music, dance, art, and theater.

Provides a picturesque landscape for photography enthusiasts.

The city’s scenic beauty, architectural landmarks, and natural surroundings make it a paradise for photographers.

Connects to Moscow via a direct train line.

The convenient train connection between Elektrostal and Moscow makes commuting between the two cities effortless.

A city with a bright future.

Elektrostal continues to grow and develop, aiming to become a model city in terms of infrastructure, sustainability, and quality of life for its residents.

In conclusion, Elektrostal is a fascinating city with a rich history and a vibrant present. From its origins as a center of steel production to its modern-day status as a hub for education and industry, Elektrostal has plenty to offer both residents and visitors. With its beautiful parks, cultural attractions, and proximity to Moscow, there is no shortage of things to see and do in this dynamic city. Whether you’re interested in exploring its historical landmarks, enjoying outdoor activities, or immersing yourself in the local culture, Elektrostal has something for everyone. So, next time you find yourself in the Moscow region, don’t miss the opportunity to discover the hidden gems of Elektrostal.

Q: What is the population of Elektrostal?

A: As of the latest data, the population of Elektrostal is approximately XXXX.

Q: How far is Elektrostal from Moscow?

A: Elektrostal is located approximately XX kilometers away from Moscow.

Q: Are there any famous landmarks in Elektrostal?

A: Yes, Elektrostal is home to several notable landmarks, including XXXX and XXXX.

Q: What industries are prominent in Elektrostal?

A: Elektrostal is known for its steel production industry and is also a center for engineering and manufacturing.

Q: Are there any universities or educational institutions in Elektrostal?

A: Yes, Elektrostal is home to XXXX University and several other educational institutions.

Q: What are some popular outdoor activities in Elektrostal?

A: Elektrostal offers several outdoor activities, such as hiking, cycling, and picnicking in its beautiful parks.

Q: Is Elektrostal well-connected in terms of transportation?

A: Yes, Elektrostal has good transportation links, including trains and buses, making it easily accessible from nearby cities.

Q: Are there any annual events or festivals in Elektrostal?

A: Yes, Elektrostal hosts various events and festivals throughout the year, including XXXX and XXXX.

Elektrostal's fascinating history, vibrant culture, and promising future make it a city worth exploring. For more captivating facts about cities around the world, discover the unique characteristics that define each city . Uncover the hidden gems of Moscow Oblast through our in-depth look at Kolomna. Lastly, dive into the rich industrial heritage of Teesside, a thriving industrial center with its own story to tell.

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Elektrostal Localisation : Country Russia , Oblast Moscow Oblast . Available Information : Geographical coordinates , Population, Area, Altitude, Weather and Hotel . Nearby cities and villages : Noginsk , Pavlovsky Posad and Staraya Kupavna .

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Weekend rundown: Here's the biggest news you missed this weekend

Dozens remain hospitalized after deadly turbulence hit Singapore Airlines flight

Forty-three people who were on board a Singapore Airlines flight that hit severe turbulence remain hospitalized in Bangkok four days after the emergency, a hospital in Thailand's capital said on Saturday.

The patients are in three different hospitals in Bangkok, Samitivej Srinakarin hospital said in a statement.

At Samitivej Srinakarin hospital, where 34 of the patients are, seven are in intensive care — three Australians, two Malaysians, one British and one New Zealander, the statement said.

The other 27 patients from the flight at the hospital include eight British, six Australian, five Malaysian and two Philippine citizens, the statement said.

Two people were discharged from Samitivej Srinakarin, while two from Samitivej Sukhumvit hospital were transferred to Samitivej Srinakarin to join hospitalized relatives, the statement said.

On Thursday, the Samitivej Srinakarin hospital director told reporters 22 patients had spinal cord injuries and six had brain and skull injuries, but none were life-threatening.

One passenger died of a suspected heart attack and dozens were injured on Tuesday after Singapore Airlines Flight SQ321, flying from London to Singapore, encountered what the airline described as sudden, extreme turbulence while flying over Myanmar.

The deceased was widely identified in the British media as Geoff Kitchen, 73.

The flight carrying 211 passengers and 18 crew diverted to Bangkok for an emergency landing.