Category Archives: hospital design

“Is This a Hospital or a Hotel?”

“Is This a Hospital or a Hotel?”

I don’t know how I missed this silly quiz the NY Times ran back in September as part of an article about patient amenities and hospitality influenced design in hospitals.

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In a highly competitive field, patients — sometimes now referred to as “guests” — appreciate amenities. The tactic works. “We found that patient demand correlates much better to amenities than quality of care,” said Dr. John Romley, a research professor at the Leonard D. Schaeffer Center for Health Policy and Economics of the University of Southern California, who has studied the trend. That means that hospitals can improve their bottom line and their reputation by focusing more on hospitality than health care — offering organic food by a celebrity chef rather than lowering medication errors, for example.

The article provides very few real insights and completely ignores years of evidence that make s strong case for patient comfort as a measurable factor in a speedier recovery…but I must admit taking the “quiz” is enjoyable. I managed to get 11/12 – and the one I got wrong is a private “medspa” within a hospital so I don’t think it should count against me!

Metropolis: A Culture of caring

The October 2012 issue of Metropolis Magazine includes an insightful article chronicling the unique considerations Western architecture firms must address when designing healthcare facilities for oversees markets. From the article:

For health-care designers working in far-flung regions, learning to patch the seams that split as  West meets East (and Middle East), is as important  as calculating volumes, systems, and energy loads.  In China, designers need to produce structures that integrate best-in-class Western technologies with time-tested traditional Chinese medicine. In India, developers want new hospitals to conform to the thousand-year-old practice of vastu shastra—the Hindu version of China’s feng shui. In the Islamic world, facility plans must include prayer and ablution rooms, along with gender-specific waiting areas.  And plans must be jiggered to ensure that not a single toilet in any facility faces Mecca.

Jean-Philippe Pargade

Private hospital outside of Lille, France by Jean-Philippe Pargade

Jean-Philippe Pargade‘s Paris based architecture studio is receiving attention for a recently inaugrated private hospital located outside of Lille, France. Pictured above, the hospitality inspired hospital includes 225 beds, 10 operating rooms, and well as radiotherapy, chemotherapy and nuclear medicine units. Color blocks of spring hues matched with large windows and swaths of white, allow for clever way-finding clues in a light and crisp environment. The windows are the most strikingly unique element of the building, featuring flower motifs by artist Gary Glaser in incorporated into glazing by Ace Glass.

This hospital is not Pargade’s first project in the field of healthcare design. In 2007 they worked with Gary Glaser to colorize the Sarthe-et-Loir Health Center, Using a similar vocabulary, the firm explains that the design “creates tension between the rural landscape and the technological elegance of the architecture. The sensitive facade of silk-screen-printed glass is animated by the musical rhythm of the windows. Colour plays a major role and reveals the vital contribution to the clinics that has been made by the use of art work.”

A similar color scheme and ideology can be seen in the beautiful 2012 facade renovation at the military teaching hospital in Saint-Mande “which creates a hyphen between the city and the Bois de Vincennes, an architecture of transitions and passages, introducing fluidity between the countryside and architectural stratifications of different ages that are present at the site.”

Royal Children’s Hospital Melbourne

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Uk Design Website Adelto has a stunning slideshow of design details at The Royal Children’s Hospital in Melbourne. 

Melbourne’s new $1 billion (Aus) Royal Children’s Hospital,  unveiled by Queen Elizabeth II was Designed in a joint venture between Billard Leece Partnership and Bates Smart Architects (BLBS), with US-based HKS as international advisors. The RCH received the ‘International Interior Design Award’ at the 2012 Emirates Glass LEAF Awards, which took place during this year’s London Design Festival.

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Bridget Duffy Experia Health

Rock Health presents an insightful talk by Bridget Duffy of Experia Health,  a leading patient experience design. Dr Duffy is an engaging speaker and I find her to be one of the most relateable, convincing advocates for humanizing the healthcare experience.

[youtube http://www.youtube.com/watch?v=FaCxTQvRuoA?rel=0&w=560&h=315%5D

Projectione at Riley Hospital for Children

Indianna Design/Fabrication Studio Projectione recently completed a large-scale installation at the still-under-construction Simon Family Tower at the Riley Hospital for Children. The video above chronicles the installation, and provides fun insight into the complexities of actually installing such an ambitious element in a project. The Sunrise installation covers 768 feet of the first floor atrium and includes over 3800 unique components making up the image and surface, each with a different color, scale, and distance from the wall. From Projectione’s press release:

The Riley Sunrise aims at representing imagery at multiple scales for all audiences. The vibrancy of the colors and symbolism of each shape or “pixel” speaks to the child, peaking their interest and lifting their spirits. The complexity and patterns generated speak to all generations and encourage discussion and interpretation. Our concept is an abstraction of an image into its main colors and uses graphic symbols as the representation of each pixel. Each symbol is independently mounted and varies its distance from the wall, creating a three dimensional graphic that is read from across the room and up close. Because of the 3D variation, the graphic will visually change as users walk by and can be experienced differently each time….Our hope is that these super-graphics can serve as a pleasant distraction for visitors of the hospital and lead to discussions that can re-focus a conversation towards something positive and uplifting.

 

(via archdaily)

“Hospitals are not Hotels”

An important opinion piece from this week’s NY Times, which reminds us that even in the best built environment, with the most earnest attempt to treat patients as people, much of the healthcare experience is going to be fundamentally difficult for those experiencing it. From the article:

“The survey evaluates behaviors that are integral to high-quality care: How good was the communication in the hospital? Were patients educated about all new medications? On discharge, were the instructions the patient received clear?

These are important questions. But implied in the proposal is a troubling misapprehension of how unpleasant a lot of actual health care is. The survey measures the “patient experience of care” to generate information important to “consumers.” Put colloquially, it evaluates hospital patients’ level of satisfaction.

The problem with this metric is that a lot of hospital care is, like pleurodesis, invasive, painful and even dehumanizing. Surgery leaves incisional pain as well as internal hurts from the removal of a gallbladder or tumor, or the repair of a broken bone. Chemotherapy weakens the immune system. We might like to say it shouldn’t be, but physical pain, and its concomitant emotional suffering, tend to be inseparable from standard care.”

WRL: Cleveland Clinic Hillcrest Expansion

Minimalists will take get great joy from this post about the Cleveland Clinic’s Hillcrest Hospital‘s expansion and renovation by architecture firm Westlake Reed Leskosky. The hospital, located in Ohio, has about 500 beds, with 72 of them located in the newly built tower, which includes two dozen NICU rooms, as well as general inpatient beds. Healthcare Building Ideas writer  Jennifer Kovacs Silvis recently took a tour of the facility and noted:

Looking more like an art museum than a traditional healthcare setting, yesterday I saw firsthand how white walls, floors, ceilings, and, yes, even furniture, create an environment that goes against what many support as the proven best methods of healthcare design. What I found on our tours were very minimalistic interiors complemented by a standout art program that showcases commissioned works right alongside prints of infamous classics… And it’s silent. From sound-absorbing ceiling panels to offset the hard surface floors to systems running without any noticeable buzz, patients and staff alike are left with a soothing environment absent of distraction, a place where they can focus and be reflective on the medical situations at hand. Reed jokingly called it “un-architecture”—the firm’s simplification of the building design. But it’s really quite the opposite.

From the looks of these images, she’s spot-on. It’s an unusually simple space, with crispy simple art and tons of white, but it’s a breath of fresh air when viewed next to bright and busy linoleum floors and pattered upholstery. As for that art, the most noteworthy commission was for Catherine Opie’s series of photographic large-format photographs of Lake Erie in four seasons. The moody and luminous series was created specifically for the 100-foot concourse of the new tower. It’s a far cry from Opie’s political, challenging gender focused work she’s best known for – but it’s an excellent example of how an artist you’d never imagine including in a healthcare environment can create the perfect piece for one. There’s a nice review of the series here at cleveland.com, and in an article from the Cleveland News-Helard, Opie says:

“For those from the area, this serves as a reminder of all that exists just outside the walls of Hillcrest Hospital — the entire world’s potential and natural beauty”

Design Bugs Out

Bedside cabinet by Kinneir Dufort

Patient chair by Pearson Lloyd

Commode by Pearson Lloyd

Overbed table by Hollington

The above images are the results of a UK hospital furniture design competition that started in August of 2008 and have recently been analyzed and finalized. The goal was to challenge the historic features of hospital furniture and show how its design can enhance effective cleaning and help to tackle Healthcare Associated Infections. The Design Bugs Out website introduces the project:

The Department of Health, the NHS Purchasing and Supply Agency and the Design Council challenged the UK’s design and manufacturing community to design and prototype new hospital furniture and equipment that will help to reduce Healthcare Associated Infections (HCAIs). If hospital equipment and furniture is designed to be easy to clean and easy to use, it will stay cleaner — and therefore help reduce the risk of infection.

Out of an initial 51 design possibilities, 11 products were developed and considered, and only 4 were tested for mass production.  After extensive user testing in 8 hospitals throughout the UK, each of the above designs are will soon be available for purchase by hospitals in the NHS Supply Chain catalogue online. Patient approval rates were impressive, as per the Daily Echo, and the following percents of caretakers, patients, and visitors gave the thumbs up to the new designs:

Bedside cabinet by Kinneir Dufort: 68% patients, 75% visitors, 70% staff

Patient chair by Pearson Lloyd: 91% patients, 88% visitors, 68% staff

Commode by Pearson Lloyd: 90% patients, 84% visitors, 78% staff

Overbed table by Hollington: 91% patients, 87% visitors, 72% staff

The entire report by the Department of Health can be downloaded in a PDF here. It’s an extremely well thought out study and well worth reading if you have the time.

Old Designs Vs. New Designs

Phoenix Children’s Hospital

The new tower at the Phoenix Children’s Hospital successfully avoids the typical hospital typology in favor of…an aesthetic I’m going to call the 1990s cruise ship aesthetic! The architects explain their aim was to evoke a “blooming desert flower.” No matter the associations, it’s a magical, spirited, and unique space designed by the firm HKS, a Dallas based powerhouse for medical architecture. Each floor has an animal that ‘sponsors’ it and a unique color scheme – enhancing wayfinding and adding to the playful atmosphere. Just how do these floors stack up? The lower level =  labs, a pharmacy, information technology, and storage for equipment. First floor = imaging, patient registry, outpatient pharmacy, a kitchen/restaurant, a 24-hour café, and administrative offices. The second floor =  ambulatory clinics. The third floor =  support functions, family spaces, and a rooftop garden. The fourth floor = inpatient procedures. The fifth floor and above are patient rooms. The patient rooms are each arranged with two groups of 24 single occupancy rooms. The elevator lobbies that people encounter as they move between floors each feature exterior views, a bronze animal sculpture, and a digital photographic wallcovering of a plant or nature scene. Like this:

A wonderful virtual tour is available on the Hospital’s website here. The project was featured on the March 2011 cover of Healthcare Design Magazine. In the accompanying article,  Sandra Miller, the HKS Interior Designer overseeing the interiors explains:

One of our directives was to avoid looking childish, which is one of the major challenges in a pediatric facility. The children treated here range in age from newborns to 20 years old, so it doesn’t make sense to only target the 5-to-8 year olds.  We established the look of the tower through color and artwork, and incorporating interactive positive distractions within the building

Art plays an important role in the concept. There are magnetic marker boards and each patient has an area on the wall outside of their room to display his or her own artwork, allowing them to personalize their own space. Miller explains that “the goal was to make each patient room like their own individual ‘front door’ into their world.” The hospital’s Center for Cancer and Blood Disorders also runs a website that allows shoppers to purchase original artwork or note cards featuring art by patients, with all funds going towards the hospital. You can see the spaces for patient artwork in the background here:

The dramatic lighting scheme throughout the building was overseen by lighting designer Scott Older with Philips Color Kinetics. The lighting is truly transformative in the above images, all taken after dark and perhaps ran through a photoshop filter or two. During the day the hospital looks a bit more…like a hospital, as you can see in this video from Phoenix news chanel abc 15:

(All Images HOK via modxdesign)

 

 

 

when researcher becomes patient

Healthcare spaces can be exceptionally challenging to understand from the user’s perspective, with their emotionally nuanced and personal experience entirely outside of most people’s day to day lives. I came across two personal blog posts from designers and researchers who went from theorists, to patients.

Photo: Salma Patel

Salma Patel is a British doctoral researcher interested in digital engagement and participation in healthcare. The above photograph was taken by her on an unexpected visit last summer to Addenbrooke’s A&E department in Cambridge. In this blog post titled “Experiencing the link between environment design & patient experience” she chronicles her interactions with the built environment. She begins the narrative:

As we approached the hospital it wasn’t clear where we supposed to park. There was a sign directing people towards the main car park but there was no sign for A&E parking point or drop off. We continued through the emergency route as it was late at night. As we came in front of the A&E department we realised that the parking bays were disabled only – and though they were all empty, my husband being the ethical man he is, decided not to park there. Ahead of me, I could see some parking spots, but again as there were no signs we were unaware if we were allowed to park there. My husband decided we should just go to the main car park. He had no idea which way to turn.

Luckily, it was a quick stay and Salma is fine. I find it worthwhile to click through and read this visual narrative of the a&e experience from a patient who has an eye turned very specifically to the design of the facility.

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Crystal Richards, is a member of the healthcare team of the Pertkins+Will Seattle office with five years of healthcare experience. She is also a Lukemia survivor. Richards and Perkins + Will colleagues Missy Kutner and Susan Lee wrote an affecting post for the Contract Magazine blog. Richards begins:

I had just finished creating a walk-through animation of a new ambulatory surgery center the day before I got the call. Sure, I understood how to lay out a healthcare facility, how circulation through a hospital worked, where the “family zones” needed to be drawn on the plan, but I was about to get an unsolicited insider’s perspective that would change my life.

She then provides powerful insights surrounding her own emotional experience as a patient. Kutner and Lee relate these personal experiences to existing design elements sometimes put in place to ease the stay of long-term patients, including windows and skylights, bringing the outdoors in and extending patient areas into common spaces, providing social spaces and exercise equipment, creating “family zones” in patient rooms and and workspaces for caregivers in common spaces. The post provides a uniquely personal piece in an field that tends to be analytic and evidence based.