Good-bye to Gangs
Last week I had a curious conversation with the Director of Facilities at a community hospital. When he explained his current interior finishes renovation project he informed me that, where possible, the hospital was eliminating two and three “hole” toilet rooms in favor of singles. He related that it is seen as a significant upgrade, and has been well received. His hospital pushed the aesthetics toward a more upscale residential feel with wood dividers and pedestal fixtures.
Several conflicting thoughts immediately coursed through my head.
Good for you for taking patient survey responses to heart and seeking improvement…Wait a minute—that sounds unnecessary; there are hospitals fighting to stay alive and you are making bathrooms private?!…Hey, that’s how you differentiate yourself—by responding to the patient and visitor…Isn’t this exactly what’s raising the cost of healthcare today?…Finally, someone breaking down the institutional feel and investing in the forgotten toilet rooms for once…Your boss thought this was a smart use of precious cash—can’t this money be better spent on patient care?…And doesn’t that screw up your fixture counts for code?
I resolved that what his facility was doing was not so wrong; he was continuing an industry march away from groups and toward the individual.
When I was in high school, physical education was part of my required curriculum (clue #1 that I am not fresh out of school). On top of that, we were graded on things like “dressing for class” and “hygiene”—which meant showering. My schools were of the era that gang showers were still common, and anyone who has had to endure a facet of adolescence through the concept of gang showers (ahem, YMCA) can understand, at least on some level, why they are not acceptable design these days. Times have changed.
But it is not just group shower rooms on the outs today. Other multi’s have been eschewed in favor of singles, especially in healthcare. Obviously, hospitals are all marching as quickly as they can afford toward 100% private rooms. Patient registration is a single slot, practically a booth now due to HIPAA. Waiting rooms have been scaled to allow for smaller family groupings and private sitting areas. The cafeteria is now a cafe, with bistro-type seating instead of family-style—and rare is the occasion when two strangers sit at the same table. In some ways, bathrooms are a logical progression.
This may be a social sign-of-the-times manifest in healthcare design. Most would admit solitude is ideal in the bathroom, but still an unexpected bonus outside of our own homes. I can think of only a couple large restaurants or hotels, the Ritz-Carlton comes to mind, that have this level of privacy. We might be headed in the wrong direction if the public expects customer service on the level of the Ritz from hospitals.
And yet, this is really what the healthcare industry is focused on: retailization and finding its niche. Hospitals cannot be everything to everyone; they must focus and be really good at a few things, while referring patients outside their specialties to other hospitals and systems. If this means less volume (masses) in favor of choice environs (individual), then so be it. And the argument for dignity, found in a solo powder room, to trump efficiency via gang toilets, at least in some circumstances, may be overdue.