Design to address patient depression and anxiety

At the former dialysis center for Logan Regional Hospital in Logan, Utah, I saw patients attached to blood cleansing machines for hours, something they had to do two to three times a week for the rest of their lives, or until they received an organ transplant.

Everyone seemed exhausted. Family members and friends would usher the patients to and from treatments, all relegated to a waiting space consisting of two cramped rooms, white walls, humming machines, and cold, fluorescent lighting.

Years of dialysis treatment resulted in strong feelings of depression and anxiety for patients, their family and friends, and department staff.

(For other design solutions to help address patient anxiety, see “Using Artwork to Alleviate Patient Anxiety.”)

Dialysis center design problems

Located on the third floor of the hospital, the department had become inconvenient for dialysis patients with declining mobility and for their families. It was cramped. It had no color, no pattern, no visual rhythm. Just large blue chairs, several machines, and two nurses’ desks piled with stacks of papers.

The staff was concerned about the lack of privacy during one-on-one consultations when patients requested to remain seated in the treatment bay.

Medical codes restricted any accessories to prevent blood contamination. A 7-foot-minimum radial clearance around each patient to allow staff total access to the patient and equipment also prevented decorative furnishings or accessories.

Due to a high prevalence of physical limitations at the center, it was imperative that all rooms and furnishings meet ADA guidelines and bariatric requirements.

Quite simply, the department needed a new building that would allow adequate space to function efficiently, as well as aesthetics proven to elevate symptoms of depression and anxiety.

Designing a new dialysis center

A previous doctor suite was selected as the site for the new facility. This one-story clinic has a private parking lot and bus stop, as well as a spacious layout to meet medical and design codes, and ADA requirements.

The floor plan includes a radial nurses’ station in the center of the largest treatment bay, which allows for direct eye contact with every patient.

The individual treatment stations include new, adjustable dialysis chairs that are impervious to blood/chemicals; a private TV; Wi-Fi; a nurses’ counter; and room for guest seating. A second treatment bay has similar amenities in a gallery layout for overflow. An isolated patient room (for patients with contagious blood diseases) offers the same amenities in a sun-filled, spacious area.

All patients are provided small lockers to stow personal items for the duration of their treatments.

The staff has separate bathrooms with showers, separate lockers, and a break room away from patient traffic with a kitchen, reclining seating (to soothe swollen feet), and a wall-length window off the central yard.

The social support of the center was enhanced through a family lobby, private counseling rooms, and display stands for networking, classes, and bulletins.

All rooms are designed to subtly allow ADA and bariatric access. Minimalist chairs are easily mountable from a wheelchair, and their tabular arms provide greater comfort for bariatric patients. ADA guidelines were strategically implemented in the family lobby, as well, to create natural conversation groups with space for wheelchairs among stationary seating.

Using color theory to reduce patient anxiety

Interviews, patient observations, and surveys showed that bright and vibrant colors can be jarring and anxiety-inducing for many patients. Color theory was therefore imperative to ensure that the planned color palette would have the best impact on patient health.

The design also called for indirect lighting fixtures, open and diffused natural light, and a quiet HVAC system.

And because Wi-Fi affords the majority of people direct access to what media they want—quietly—there’s no television in the waiting area. The goal was a gentle design: no irritations.

The color theories of the late Tony Torrice, an interior designer who specialized in therapeutic designs for children and the disabled, suggest a strong correlation between subconscious healing and the colors associated with Indian chakras (defined as energy centers in the body that power different major organs and systems).

The chakras that represent areas of the body affected by organ failure and blood disease are associated with the colors orange, yellow, and green. To avoid the look of a bag of frozen mixed vegetables, these colors were refined to mimic the high-mountain desert of the Utah landscape.

Not only are they timeless and familiar, but studies have shown these colors don’t cause emotional triggers because of our constant exposure to them.

Layers of texture and light add sophistication. Rich, earthen tones and raw materials create warmth; textural elements include a variety of living plants and potted branches, locally made pottery, wooden accessories, tweed-woven treatment chairs, wooden drum tables, and luscious plant troughs—all symbols associated with the chakra elements.

Examples of holistic healthcare design

The neutral envelope of the walls, ceiling, and flooring offsets the dynamic ceiling heights, sky-lit entry, and floor-to-ceiling windows throughout the center. It was also the start for composing elements of design that would mentally reinforce vitality and soothe anxiety.

Vivid artworks of treescapes are showcased for their cyclical change and connotation of growth and stability, as well as being void of emotional connotations (such as human forms or religious tokens). The reason is patients who are burdened by depression may subjugate a depiction of human form as a projection of their loss or anxiety, or use it to create an emotional trigger.

The gallery-wrapped giclée artwork is bold, modern, and resilient to sun and harsh hospital cleaners.

To further aid in the response and awareness of depression/loss/trauma in patients, many “small moments” or pleasant distractions were incorporated throughout the center.

For example, an impromptu art gallery along a small hallway connects the counseling/medical offices to patient treatment bays for some positive distraction. Against the adobe walls, the cobalt and jade colors appear to fluoresce.

In the bathroom finishes, the design features a spa-like scheme of three-quarter-tiled walls in large, sandstone ceramic tile and accented slate and glass mosaic banding. Potted reeds amplify the sophisticated colors and add organic texture to soften the space.

Place of healing

The attention to color and detail is meant to assure patients and staff that this is a place of healing, designed specifically for them. Every design element was thoughtfully considered for accessibility, maintenance, and aesthetic appeal.

Jess Bear is owner of Jess Bear Interior Design LLC in Logan, Utah. She can be reached at jess.bear.design@gmail.com. For more information on Logan Regional Hospital, please visit http://intermountainhealthcare.org/hospitals/logan/.