In-Room Workstations: An Affordable Step Toward Home-Like Long-Term Care

Long-term care encompasses more than traditional nursing homes. It includes home care, assisted living and other residential environments designed to support older adults with different levels of need. As consumers become more informed and more involved in planning their care, providers must balance quality, operating efficiency, affordability and the desire for a setting that feels like home.

For facilities that cannot complete an immediate, building-wide transformation, meaningful environmental changes can still improve daily life. Installing a staff workstation in each resident’s room is one practical step. An in-room workstation can bring documentation tools, medication storage and supplies closer to the resident while reducing the visual and physical presence of institutional equipment in shared spaces.

From an institution to a household environment

The household model of long-term care aims to organize the physical environment and daily experience around the resident rather than the institution. Common characteristics include:

• Residential-scale architecture and décor.
• Small groups of residents.
• Private bedrooms and bathrooms.
• An open, functioning kitchen.
• Shared dining and living spaces that support ordinary social interaction.
• Access to an outdoor patio, balcony or similar space.

Moving toward this model can involve construction, culture change, staff training and new workflows. The capital cost may be higher than a traditional institutional layout, although household designs may also support occupancy, resident satisfaction and private-pay demand. Facilities need a phased plan that respects both operational realities and the dignity of residents.

Small environmental changes can support culture change

A complete physical transformation is not always feasible. Existing facilities may need to remain occupied during renovation, and teams may not have the budget or capacity to rebuild every area at once. Carefully chosen improvements can still move the organization toward a more residential experience.

The placement of staff tools is one example. Traditional medication carts can become a visible gathering point in hallways and common areas. They may reinforce an institutional atmosphere, occupy floor space and require staff to move repeatedly between the cart and the resident. An in-room workstation shifts appropriate work into the resident’s private space.

Meadowbrook Medical Care Facility: an in-room workstation example

Meadowbrook Medical Care Facility in Michigan pursued a transition from a traditional skilled-nursing environment toward a household model. Because the facility could not temporarily reduce its resident population enough to demolish and rebuild the entire property, administrators combined new construction with renovation of existing buildings.

The plan included seven household areas, each with its own living space and kitchen. More than 100 Proximity Systems workstations were planned for newly constructed and renovated resident rooms.

The selected workstation configuration was designed around staff and resident needs. It included:

• A customized medication cabinet.
• A built-in organizer with labeled areas for external and internal medications.
• A lower door that folded down to create a wireless computing surface.
• Support for computerized medication administration and electronic medical records.

Narcotics continued to be stored separately under the facility’s double-lock procedure. Other medications and related items could be kept in the resident’s room according to the facility’s workflow and policies.

Privacy and dignity during medication administration

One of the most important potential benefits of an in-room medication workstation is privacy. Instead of distributing medications in a shared dining room or another common area, staff can complete appropriate medication tasks in the resident’s room. This more closely resembles the privacy a person would expect in a private home.

The change can also redirect the facility’s social focus. Rather than having personnel congregate around a medication cart, household common areas can center on the kitchen, living room, fireplace and resident interaction.

Supporting staff workflow

Changing from a traditional medication cart to an in-room process requires staff adjustment and training. At Meadowbrook, staff initially expressed concern about the new medication-pass workflow. According to the interviewed nursing director, the team began recognizing the benefits after approximately three days, particularly the reduced need to push and maneuver a medication cart through hallways.

Placing tools in the resident’s room can address common workflow problems:

• Staff spend less time moving between centralized supplies and residents.
• Documentation tools are available where care occurs.
• Interruptions associated with searching for shared equipment may be reduced.
• Staff may have more time and attention available for resident interaction.
• Removing carts from circulation routes can create more usable floor space.

Space, aesthetics and resident experience

The Meadowbrook workstations were customized to coordinate with resident-room furnishings. When closed, a wall-mounted unit can look more like cabinetry than clinical equipment. Mounting or recessing the workstation in the wall can also free floor space and support mobility within the room.

This combination of function and appearance matters in a home-like environment. The workstation must provide staff with secure, organized access while remaining visually compatible with the resident’s room.

Relevant design considerations include:

• Cabinet finish and coordination with existing furniture.
• Surface height and reach range.
• Clearance for residents, visitors and mobility devices.
• Lighting and visibility.
• Computer, monitor and cable management.
• Medication and supply organization.
• Lock type and access-control policy.
• Cleaning and infection-control requirements.

Organizational and market benefits

Environmental improvements can affect more than daily operations. A well-designed resident room can address questions raised by residents, families and prospective customers. A facility that demonstrates respect for privacy, dignity and personal space may differentiate itself in a competitive senior-living market.

The original Meadowbrook account also anticipated studying whether the new workflow contributed to fewer medication errors.

A practical step toward a home-like destination

Creating a household-oriented care environment is a large undertaking, but facilities can approach it through coordinated steps. In-room workstations can support that transition by moving appropriate technology, medication storage and staff tools closer to the resident. When thoughtfully designed and implemented, they can contribute to privacy, floor-space efficiency, staff workflow and a more residential appearance.

The workstation is not a complete culture-change strategy by itself. Its value depends on staff participation, clinical policy, training, room design and the broader commitment to resident-centered care.

Sources cited in the original white paper

• The Characteristics of Long-Term Care Users, U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, publication 00-0049.
• Coe and Wu, Cost and Concerns among Residents in Seniors Housing and Care Communities: Evidence from the Residents Financial Survey, Center for Retirement Research at Boston College, April 2012.
• National Investment Center for the Seniors Housing & Care Industry newsletter, July-August 2013.
• Action Pact, Household Model resources.
• Jenkins et al., Financial Implications of The Green House Model, Seniors Housing & Care Journal, 2011, volume 19, issue 1.
• The United States of Aging Survey 2013, National Council on Aging.