Reengineering the patient's environment: Establishment of a “Red Box” to improve communications with patients on isolation precautions

Prashant Malhotra, Aradhana Khameraj, Tanzila Salim, Donna Armellino, Susan Wirostek, Marcia E. Epstein, Bruce F. Farber

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Hospitalized patients on isolation precautions are reported to have less frequent health care provider (HCP) visits owing to time required to don and doff personal protective equipment (PPE). Thus, placement on isolation precautions leads to negative patient perception and affects their care. Methods: A “Red Box” that extended 3 feet beyond the door was marked in 50 patient rooms of a tertiary care hospital and used for patient communication by HCPs without PPE. HCP and patient perceptions of the Red Box were studied via a survey and personal interviews. Compliance was also observed by “secret shoppers.” Rates of health care–associated infections (HAIs) were monitored. Results: Over a 1-year period, HCPs reported improved patient communication, utilization of time, and increased interactions. HCPs used the Red Box to communicate with patients 76% of the time. In 92% of the cases, HCPs remembered not to use PPE while in the Red Box and were observed 80% of the time using PPE when venturing beyond the Red Box. Patients reported improved frequency of HCP contact and satisfaction. HAIs in these units did not show any increase compared with those in prior years. Conclusions: HCP interaction and communication with patients on isolation precautions improved with the reengineering of the patient environment in the form of the Red Box. HAI rates did not increase with this intervention.

Original languageEnglish (US)
Pages (from-to)264-267
Number of pages4
JournalAmerican Journal of Infection Control
Issue number3
StatePublished - Mar 2019
Externally publishedYes


  • Health care–associated infection
  • Infection prevention
  • Patient safety
  • Patient satisfaction
  • Personal protective equipment

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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