“Quiet movement” summarizes the design intent of the unit. It is designed to meet the needs of its unique patient population. The goal was to create an environment that encourages patient mobility as part of the recovery process yet is calming and restful. Challenging the norms of healthcare environments, it was also intended to be a place where the staff could provide the best care for their patients with efficiency and the least stress.

The design was constrained by the footprint of a 1980s-era building that was used for outpatient programs. A major challenge was to develop patient rooms that addressed privacy, confidentiality, and comfort yet yielded a viable number of beds. Private rooms were mixed with oversize semiprivates. Positioning of toilet cores and headwalls encouraged visualization of the patient, privacy, and ease of access.

Mobility is a key aspect of recovery. A continuous walking path is reinforced by undulating soffits highlighted with indirect lighting, built-in benches, and colors chosen to encourage movement and recovery.

The nursing staff is decentralized at satellite workstations and nurse servers. This places the caregivers and supplies closest to the patients.

The project incorporates several features whose direct benefit to patient healing is supported by evidence-based research. These include: double-door toilet rooms to reduce patient falls, reduction of hospital noise by distributing nurses' stations and enclosing work areas, and sound absorbing materials used at critical noise-producing areas to further enhance a quiet environment that reduces patient stress and discomfort, the most common patient complaints.

Postoccupancy observations and comments have confirmed the designer's goals. Good design will provide direct benefits to the patient and the caregiver.

The finished unit is significantly quieter and less institutional, resulting in measurable improvement in Press Ganey scores and staff satisfaction.

Project category: Remodel/Renovation (completed May 2004)

Chief administrator: Michael Green, President and CEO, (603) 225-2711

Firm: Lavallee/Brensinger Architects, (603) 622-5450

Design team: Steve Clayman, Vice-President, Project Manager; Barry Brensinger, CEO (Lavallee/Brensinger Architects); Mechanical Engineers (Yeaton Associates); Electrical Engineers (C & M Engineering); Construction Manager (Gilbane Building Company)

Photography: Joe St. Pierre Photography

Total building area (sq. ft.): 13,000

Construction cost/sq. ft.: $115

Total construction cost (excluding land): $1,500,000