Trend 1 Shifting to Patient-Centric Design

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2 Introduction Healthcare design has evolved dramatically over the past 20 years. Research is showing that fresh and innovative designs as well as facility layout, design and structure can improve both patient and employee outcomes. Research shows that design can facilitate healing, enhance visitor comfort, increase employee productivity, reduce hospital-acquired infections and provide a more effective hospital environment. This has become so paramount to health care facilities; The Pebble Project is an example of the importance of design. The project is a collaboration of healthcare organizations, architects, designers and industry partners that work together to identify and measure designs and solutions that improve safety, outcomes, environmental performance and operating efficiency. You can learn more by visiting healthdesign.org/pebble. This guide will provide you with an overview of the 5 trends we think are having the highest impact on healthcare design. Whether you are an architect, designer, facility manager or supplier, these are trends you should be aware of. 1

3 Trend 1 Shifting to Patient-Centric Design Healthcare facilities are shifting design to focus on the patient s needs first. Objectives are on reducing stress, making it easier for patients to sleep, increasing privacy and incorporating family visits. Increasingly, this shift has been focused on two main areas; private spaces and family-centered care rooms. Private Spaces and Single Patient Rooms Private rooms have been shown to reduce stress, improve sleep, speed recovery times, increase privacy, and may even reduce the incidence of medical errors. A literature review by the Coalition for Health Environments Research (CHER) found that private rooms impacted outcomes in the following ways: 1 Increased privacy Increased patient satisfaction Decreased sleep disturbances Decreased operating costs Decreased length of stay Decreased medication errors and costs Decreased HCV transmission between patients Family-Centered Care Room The presence of family members can help improve patient outcomes as well. Primarily, it has been shown to prevent patient falls. A hospital in Indianapolis redesigned a unit to have larger single patient rooms. The number of patient falls was reduced by two-thirds. 2 Furthermore, if falls do occur, the presence of family members can reduce the time to alert nurses to a fall. Trend 2 Creating Residential Warmth Hospital settings are now being designed to reduce environmental stresses and have begun to reflect the approach that hotels are taking to make patients feel more comfortable. From cabinets to headwalls to linens, healthcare facilities are creating a consistent look that creates familiarity for patients. Greenery and gardens that evoke nature have been used with great success to reduce patient stress. In 1995, Cooper Marcus and landscape architect Marni Barnes studied the physical layout and daily use of several hospital gardens in California. 3 They found that patients visited the garden areas to seek relaxation and restoration from emotional fatigue. Even more surprising was the impact it had on hospital employees. Results showed that stressed out employees visited the greenery areas just as many times as patients themselves. 2

4 Trend 3 Reducing Hospital Acquired Infections Hospital design is increasingly focused on minimizing hosptital-acquired infections. In the U.S. it is estimated that 10% or 2 million patients a year become infected, with the annual cost ranging from $4.5 billion to $11 billion. 4 Healthcare furniture can have a large impact on reducing infection rates. Furniture that is easy to clean and disinfect while looking stylish, is vital. Healthcare furniture manufacturers are challenged to create pieces that minimize risk for healthcare facilities. Here are a few characteristics of furniture that help reduce hospital-acquired infections: Furniture that is easy to clean Incorporating furniture that is easy to clean and disinfect is important. Furniture that utilizes clean lines and also rounded corners helps to minimize spaces that can hide dirt and dust. Utilizing removable components makes furniture easier to clean. Overall, furniture should be easy to clean, provide visual cues for unclean areas and should be designed to eliminate catch spots that can easily hide germs and bacteria. Durable furniture that can stand up to thousands of rounds of cleaning/disinfection Because of the need to extensively clean furniture, it is vital that furniture can stand up thousands of rounds of cleaning. Furniture that cracks or degrades while being cleaned can carry bacteria and increase infection rates. Furniture that is mobile to make hospital room cleaning easier Mobile furniture allows staff to move pieces and more easily clean all areas of the hospital room. The Oasis Sleeper by Stance Healthcare is mobile, easy to clean and extremely durable. The proprietary central locking system allows caregivers and housekeeping staff to operate and move the sleeper with ease. 3 3

5 Trend 4 Design With Bariatric Patients in Mind Obesity is becoming a design dilemma for hospitals in the United States. In 1990, ten states had a prevalence of obesity less than 10% and no states had equal or greater than 15%. In 2010, no state had a prevalence of obesity of less than 20%. Thirty-six states had a prevalence equal to or greater than 25%, and 12 of these states had a prevalence equal to or greater than 30%. 5 It is estimated by 2030 that all 50 states will have an obesity rate above 44%. 6 In order to provide proper treatment for bariatric patients, it is important to consider their needs in relation to space, equipment and furniture. The following are recommendations on design that better accommodates bariatric patients. Recommendations are based on research by a variety of organizations. Door Widths The minimum door width should be 4 feet to accommodate bariatric wheelchairs and beds. 7 Waiting Areas & Seating Provide seating that can support and accommodate larger individuals. This seating should be integrated with regular seating to minimize stigmatization. Bariatric seating generally varies from 30 to 44 wide with reinforced structure to support at least 500-lbs % of general seating should be bariatric. 8 Bathroom Sizes Bathroom size is another important consideration. According to Healthcare Design magazine, the shower needs to be larger than normal to accommodate all patient sizes, and railings need to be structurally supported to handle extra weight. Toilets need to be higher off the ground than standard toilets. 9 Patient Rooms In addition to specialized bariatric beds, patients rooms should include bedside amenities such as refrigerators and freezers for patients bariatric-program specific dietary supplements. Additional bedside amenities that improve the experience include easy access to lighting, bedside computers, and phone, television, and thermostat controls. All bariatric patient room chairs should provide adequate seating, not only for the bariatric patient but also for family members. 10 4

6 Trend 5 Better Design for Mental Health Mental illness affects approximately one in five Americans every year. 11 Recently there has been a renewed interest in treating mental illness more effectively while reducing stigma. In Canada, the first national mental health strategy has been launched. In the U.S., The Broad Institute, affiliated with Harvard University and the Massachusetts Institute of Technology, received a $650 million gift for psychiatric research. 12 With this renewed interest, understanding how facility design can aid mental health outcomes is important. Here are three key design implications for mental health facilities: Single Room Care Providing a single room for care provides a better quality of life for patients. It also provides a private outlet for patients and can help de-escalate issues. Natural Views & Access To Nature Access to natural daylight, views of the outdoors and private courtyards can significantly improve patient outcomes. Natural light has been shown to improve human health and it can have a dramatic impact in healthcare facilities. Treatment Mall Care Model Mental health facilities are shifting towards a treatment mall care model. In this model, the facility is designed to have elements like a house, neighborhood and downtown area. This better mimics a community environment. The house is where the patient lives and the neighborhood is next to the living areas where patients receive treatment. Studies indicate that more patients are motivated to participate in treatment when it takes place apart from the living units. The downtown is where patients can visit the gym, barber shop, convenience store and other amenities. 5

7 about Stance Healthcare Stance Healthcare is a manufacturer of healthcare-specific furniture and our mission is to create effective healthcare spaces through innovative furniture designs. We have become known for our innovative and highly functional furniture products that improve the experience of those who use them. In addition to comfort and functionality, our products also address the vital considerations of cleanliness, through innovative features that make our products (and the space around them) easier to clean. We arrive at these design features through consultation with both caregivers and hospital cleaning personnel. Stance Healthcare is also distinguished in the industry by our willingness and ability to customize our products to meet the challenges of specific projects. It is that consultation that fuels our ongoing commitment to innovation. Increasing caregiver efficiency by enhancing product functionality, Stance Healthcare endeavors to improve the efficiency of healthcare staff by increasing the mobility, functionality and cleanability of our furniture products. We welcome opportunities to customize our designs to meet the needs of specific projects. Meeting the challenges of specific projects keeps us close to the needs of the market we serve and drives us to pursue the innovations that enhance the utility of the furniture we build. Stance Healthcare Inc. 275 Shoemaker Street Kitchener, Ontario, Canada, N2E 3B3 Phone: Fax: sales@stancehealthcare.com 6

8 Endnotes 1 Use Of Single Patient Rooms Versus Multiple Occupancy Rooms In Acute Care Environments. Center for Health Design. 2 Gardens and Health. 3 Rising Threat of Infections Unfazed by Antibiotics. New York Times. 4 Obesity Trends Among U.S. Adults Between 1985 and San Jose Functional Medicine. 5 American Obesity In 2030: Most U.S. Residents Will Be Obese Within Next 2 Decades. Huffington Post. 6 Universal Design: Meeting the needs of the Bariatric Population. Cornell University. 7 Universal Design: Meeting the needs of the Bariatric Population. Cornell University. 8 Accommodating the bariatric patient. Healthcare Design. 9 Accommodating the bariatric patient. Healthcare Design percent of US adults experienced mental illness in the past year, report says. Substance Abuse and Mental Health Services Administration Broad Institute receives $650 million mental research gift. The Boston Globe The Impact of Light on Outcomes in Healthcare Settings. The Center for Health Design. 7