Relationship of hospital room design to pain medication usage and pain perception

Objectives: To determine if architectural improvements in hospital room design affect opiate usage after orthopedic surgery. Methods: IRB approval was obtained. Patients aged 18-65 years receiving a total hip arthroplasty or total knee arthroplasty were randomly assigned to a standard private hospital room (standard room) or a private hospital room with architectural improvements (redesigned room); for the purposes of this analysis, patients who were not opiate naïve were excluded from the data set. Patients in the standard room were compared to patients in the redesigned room based on mean opiate usage during hospital stay and mean percent reduction in pain scale, both stratified by use of adjunctive analgesia; standard statistical tests were used. Results: At the end of the preliminary review period, 49 patients were enrolled, 25 patients in the standard room and 24 patients in the redesigned room; 35 patients received a peripheral nerve block; the average length of stay was 70.8 hours (SD=18.44 hours). During hospital stay, patients in the standard and redesigned room used a mean (SD) of 0.92 (0.90) morphine equivalents per hour and 0.74 (0.40) morphine equivalents per hour, respectively (p=0.36). Patients in the standard room experienced a mean (standard deviation) reduction in pain scale of 65.8% (18.5) and patients in the redesigned room experienced a 73.4% (21.8) reduction in pain scale (p=0.19). All results were not significant when stratified by use of peripheral nerve block. Conclusion: Architectural improvements in hospital room design did not significantly impact pain medication usage or patient perception of pain in our preliminary data set.