Designs on High Touch Healthcare
Today's human-centered care environment incorporates noise control, air quality, thermal comfort, privacy, light, views of nature, color, texture, and accommodations for families. It involves the five senses of sight, touch, sound, taste, and smell.
It also provides a connection with nature via gardens, water, ponds, plant materials, daylight, and fresh air. Patients are made to feel in control of their environment. Positive distractions include music, fountains, art, and entertainment.
Putting Theory into Practice
Many healthcare providers are incorporating one or all of these concepts in their new facilities. Health Park Hospital, completed in 1992 in Fort Myers, Florida, was one of the first hospitals designed to incorporate a human-centered design environment.
A central atrium is the focal point of the building. Restaurants and retail shops such as a florist, a gift shop, and a newsstand surround it. A lavish landscaped garden is part of the design, complete with glass-enclosed elevators and a cascading waterfall.
During the day, light pours in from glass walls and skylights. At night, soothing rainbow-colored ambient lighting illuminates the space. The atrium hosts a variety of events from art shows and children's concerts to health fairs and screenings.
The hospital's registration area resembles a hotel check-in desk. Most outpatient testing procedures are just a few steps from the registration area, thus easing stress for patients and family.
Other facilities have followed in this approach to design. The Baptist Medical Center at Springhill in Little Rock, Arkansas is designed as a low-scale, mixed-use medical "village." At the core of the campus is the "village green," with a park-like setting.
The new Intermountain Health Care, McKay-Dee Hospital Center in Ogden, Utah represents a fully integrated health campus incorporating the newest technology, the highest planning efficiencies, operational flexibility, and a human-centered design approach to the interior and exterior environments. All the patient rooms have a view to the mountains, valley, lake, or garden.
Making Room for Family
According to A Pattern Language, Christopher Alexander's in-depth study of human relationships with built environments, when people are healing, they need to have their own things around them.
They need to have as much physical control over their environment as possible including temperature, lighting, privacy, and social interaction. The research also noted that patients with strong social support had more favorable long-term survival rates.
At the Utah Valley Regional Medical Center, one of the few such hospitals in the U.S., parents are permitted to sleep next to their sick infants within the neonatal intensive care unit (NICU) in a medically and environmentally supportive environment.
This is known in the industry as "kangaroo care." Two NICU nurseries accommodate 49 babies. Large windows promote healing in a daylit environment when appropriate. Or window shades can provide darkness at any time of day.
Public gathering spaces, daylit waiting areas, and overnight accommodations within all patient care areas enable families to be active partners in treatment.
Following birth and recovery, mother and baby can enjoy their time in one of 36 private mother/baby rooms, each with a private bathroom. These rooms are designed to provide a comfortable setting where the whole family can spend time together during the postpartum stay. One nurse cares for both mother and baby in the inpatient setting.
Human-centered care environment concepts also apply to outpatient care. The Sugarland, Texas location of the statewide Methodist Hospital System serves as a prototype facility.
This center is composed of two buildings: the physician's offices and the ambulatory care center. Uniting them is a two-story, skylit atrium bringing daylight into the public areas.
A series of gardens surrounding the waiting areas and a reflecting pool are the facility's highlights. This provides patients with a private getaway and landscaped dining areas.
According to James Burnett, a Houston-based landscape architect, gardens can be key in healing. "In a 1995 study," he says, "scholars at the University of California, Berkeley, found overwhelming evidence of the therapeutic effects of gardens."
He continues: "They looked at 24 hospitals. More than 95 percent of the people interviewed reported a therapeutic benefit. After even a short break outdoors, patients, families, and employees reported feeling calmer and more relaxed and productive."
The M.D. Anderson Cancer Center's 950,000-square-foot (88,000-square-meter) patient care tower includes many human-centered care concepts. The Houston, Texas facility allows cancer patients to accomplish daily activities in an environment that is comfortable and familiar.
An enclosed park area resembles a mall with retail shops, restaurants, a newspaper stand, and a gourmet coffee shop. It also provides an extensive library for patients, families, and staff.
Many of today's hospitals assist patients in becoming more knowledgeable about their illness and its treatment options. This empowers the patient to become a more active participant in healing.
Reducing noise is part of providing a comfortable environment. Many hospitals have reduced overhead paging systems, provided carpeted hallways, and chosen sound-absorbing construction materials to moderate noise and reduce stress.
Color is also important in healthcare design. Research shows that warm and somewhat muted colors reduce stress. Natural wood and sunlight are used to depict warmth.
Another way to reduce stress for patients and visitors is to improve "wayfinding." People like to know where they are going and how to get there.
The site of the Valley Children's Hospital, serving ten California counties, covers more than 52 acres (21 hectares). The hospital's wayfinding program operates both outside and in. A different color and shape (blue diamonds, green squares, purple circles) identify each of the entries and continue inside the building.
A Matter of Taste
Hospital patients surveyed by the Journal of the American Dietetic Association felt that the smell, taste, and appearance of their food had a profound effect on their wellness.
Some hospitals have a kitchen near the patient rooms, where fresh-baked cookies and breads are served to patients and visitors. This provides a homelike aroma and eliminates the antiseptic odor.
Zale Lipshy University Hospital in Dallas, has taken this theory to heart. The hospital's food won an "Ivy Award" from Restaurants and Institutions magazine and the "Silver Plate Award" from the International Foodservice Manufacturers Association.
Bayfront Medical Center in St. Petersburg, Florida hosts Joffery's, a gourmet coffee and pastry shop. A pizza oven is the focal point of the restaurant-style dining accommodations at Mercy Health Center in Laredo, Texas.
Staff, Heal Thyself!
The human-centered care environment isn't just about patients and their families. The concept also extends to their care providers.
As an example, a 1,500-square-foot (140-square-meter) fitness area was transformed into a 6,500-square-foot (600-square-meter) state-of-the-art wellness center for staff at Bayfront Medical Center.
Today, Bayfront offers wellness counseling and education, fitness evaluations, personalized exercise prescriptions, aerobics and other guided exercise programs and weight management, and workman's compensation programs.
At Memorial Hospital West in Pembroke Pines, Florida, care teams for the staff are part of the employee benefits. If a staff member experiences extreme stress, they can call upon volunteers trained in massage, music therapy, and aroma therapy for relief.
At McKay-Dee Hospital Center, patients and visitors as well as staff will be provided with pagers. This allows mobility anywhere within the healthcare setting.
For example, a visitor waiting for a family member in treatment can get gourmet coffee or fresh-squeezed juice from a roving vendor. They can take their beverage to a cozy fireplace setting overlooking the mountains.
"For years, as clinicians and hospital administrators, we thought we knew what was best for the patient," says Patty Harrington, administrator and chief operating officer of McKay-Dee Hospital.
"But, you need to ask the right people — our customers — what they want. Patients tells us they would like to be in a homelike environment. A human-centered care environment provides that for those we serve. It isn't just a healthcare trend. It is the direction of progressive hospital design."
Jeff Stouffer, AIA, is senior vice president of HKS Inc., an architecture firm with offices in Dallas, Texas; Los Angeles; Orlando, Florida; Atlanta; Richmond, Virginia; Salt Lake City; and Tampa, Florida.