When Keith Schrader was in an Arizona hospital after open heart surgery four years ago, he couldn’t help but watch the clock. It was opposite his bed, a constant reminder of how sick he was.
All the design elements in a hospital—bed placement, paint color, noise level, lighting—can have a big impact on patient healing and comfort.
Dozens of studies have examined this connection. Roger Ulrich, PhD, a well-respected healthcare architecture expert, studied patient outcomes in a unit where some rooms looked out onto a brick wall and others a natural environment. Those patients who had the natural view took fewer pain medications, had fewer complaints and left the hospital earlier than those who looked onto the wall.
“Elements of the built and natural environment do impact healing outcomes for patients, their family members and staff,” says Terri Zborowsky, PhD, of the Nursing Institute of Healthcare Design. The design of everything from nursing stations and patient rooms to bathrooms and washbasins can affect care delivery and efficiency as well as provider stress and attitude.
Beauty and Function
Minimizing stress while boosting comfort, efficiency and function were primary considerations during construction of the Ann & Robert H. Lurie Children’s Hospital of Chicago, says Maureen Mahoney, the hospital’s chief clinical excellence officer.
Patients, parents, healthcare providers and others were all involved in the design process for Lurie Children’s, which opened in 2012; they weighed in on everything from the artwork and décor to the flooring surfaces, lighting, room layouts and furniture placement. There is even a salon, added after one patient said her mother needed a place to get her hair styled during the child’s long hospital stays.
Mahoney says the hospital was designed to be “functional and comfortable, a place for exploring and discovering for all ages of kids and parents and visitors.”
Attention was given to creating a soothing atmosphere. The eleventh-floor lobby includes a blend of natural elements: Mahoney says a translucent interactive light wall weaves around a water feature and bamboo garden.
“When you are in the hospital you feel like you can never get outside,” Mahoney explains. “So we wanted to create that natural space. It is a beautiful space, but it also promotes a feeling of calm.”
Mahoney notes there are small “nooks and crannies” so that people can find a private place to unwind and relax. And the patient rooms are all single occupancy, so children can rest and parents can stay with them.
Patients need sleep-inducing spaces to recover, Zborowsky says. “Loud noise or beeps cause us to wake up suddenly,” she explains. “Healing happens when you sleep. If people cannot sleep they cannot heal. The environment can either take you to that healing place or it can destroy it.”
Schrader said he had a harder time recovering because his roommate had frequent visitors and a constantly blaring television.
Schrader, 69, of Flagstaff, Arizona, a retired Minolta sales representative, is now fully recovered. He volunteers with The Institute for Patient Centered Design, going into healthcare facilities to offer a patient-focused perspective.
Sometimes Schrader simply recommends that staff angle the beds toward the window, shift computer screens so nurses can make eye contact with patients or move the clock. Other times he suggests more extensive changes, such as putting a washbasin near the door or replacing the furniture so that nurses can reach the patient more quickly and easily.
It’s essential to talk over these details says Zborowsky, who notes that a shared vision among patients, providers and designers can promote a new design standard for healing environments—one that is good for everyone.
“To me optimal healing environments are created when people, place and process come together,” Zborowsky says. “Healing happens together in communities.”