Fargo - Some steps along the path to healing begin on the drawing board.
Poor hospital design can make it easier for infections to spread, generate or amplify noise that irritates patients and staff, or confront patients and visitors with a confusing layout that drains time from staff barraged by distracting requests for directions.
Better design, on the other hand, can beget better results.
Studies have shown that brightly lit patient rooms appreciably shortened hospital stays for depressed patients, for instance, and designs that invoke the natural world provide positive distractions for patients that reduce stress and aid healing.
As major hospital building projects advance here, there’s ample proof that Florence Nightingale’s successors have gone to architectural school and boned up on the literature of evidence-based design.
The most significant opportunities are presented by the new $494 million Sanford Medical Center under construction – a once-in-a-lifetime opportunity to design a facility to optimize patient experiences and staff efficiencies.
But other examples can be found in the new wing under construction at Essentia Health, which will include a new acute care unit.
“We do know that environment plays a big part in a patient’s and family’s healing,” said Roberta Young, a registered nurse and a vice president at Sanford involved in the new medical center’s design. “There’s been quite a lot of research around this.”
Studies have demonstrated links between the physical environment and patient outcomes in several areas, according to research cited by the Center for Health Design:
- Reducing staff stress and fatigue and increasing effectiveness in delivering care.
- Improving patient safety.
- Reducing stress and improving outcomes.
- Improving overall health quality.
One key design component is providing connections to nature, Young said. That includes ample windows that provide views as well as natural light and use of earth tones. Another important element, she said, is to give patients as many choices as possible. That includes bedside control of lighting, deciding when to eat and controlling room temperature.
“Sometimes they seem trivial but they really are important,” Young said.
Positive distractions, including soothing music and images, can help ease pain and discomfort. Social support, including room to accommodate family and friends, also can help.
“We should welcome families all the time, but then we have to create space for them,” Young said.
Having family or friends at the bedside also can help to reduce patient falls.
Similarly, nurses’ stations with windows allow a nurse to watch two patient rooms at a time, enabling close monitoring and also helping to reduce falls.
Designers for the new Sanford Medical Center and new wing at Essentia Health incorporated color schemes evoking the prairie, with blues and earth tones, to provide serene surroundings.
“Our palette has a lot of soft blue colors,” as well as a lot of neutral colors, said Diana Ricks of HKS Architects, who led the interior design of the new Sanford Medical Center.
Brighter colors, however, are used in certain public spaces, including dining rooms.
Reducing stressors, including noise, glaring lights and clutter, can help put patients at ease.
To reduce noise, cabinets in patients’ rooms can be stocked from the hallway, so patients aren’t disturbed.
Providing single rooms helps to reduce noise and make patients and their visitors more comfortable. Private rooms also help to prevent the spread of infections.
Distributing supplies and nursing stations throughout a unit help to reduce noise. They also mean far fewer steps for nurses; fewer steps mean less fatigue for nurses and more time with patients.
To improve efficiency, designers with HKS met with Sanford staff and used mockup rooms and floor designs to chart staff and procedural flows.
“That is the best laboratory,” a way to test and adjust ideas first laid out on paper, said Tim Solohubow of HKS Architects, project manager for the new Sanford Medical Center.
A similar process unfolded at Essentia, beginning with patient registration.
Designers and administrators for Sanford and Essentia Health also surveyed patients to learn what features they wanted.
Creating a friendly atmosphere, building at a human scale, using timeless design themes – all are pieces that contribute to a hospital design that is comfortable for patients and staff alike.
“It all works together,” Solohubow said. “It’s an integrated approach to a healing environment.”
Bob Bakkum, senior director of administration at Essentia Health, has seen his share of hospital construction and expansion projects in a career that has spanned decades.
He’s also found himself a hospital patient a few times over the years, an experience that left him with strong opinions about what he wanted to see in a patient room: more space, a flat-screen television and more privacy.
In the old days, hospital administrators and designers gave little thought to patient comfort and desires, Bakkum said.
The results were sterile but also harsh environments, often noisy and confusing, that actually impeded patient outcomes, he said.
But design striving to improve patient outcomes and boost patient satisfaction has been a trend that has steadily grown over the past three decades.
“When we really get back to the basics, it’s the golden rule,” Bakkum said. “Treat others the way you’d like to be treated.”
Readers can reach Forum reporter Patrick Springer at (701) 241-5522
