With the Healthcare Reform Bill signed into law, hospital and medical-center administrators are scrutinizing design and construction budgets with renewed attention to the bottom line. For healthcare architects and their clients, however, this doesn't mean a return to cold ceramic walls and stark fluorescent lighting, or inexpensive yet toxic asbestos in flooring and ceiling tiles. Nor do such changes mean assigning patients two or three to a room, eliminating the privacy individuals have come to expect during their recovery.

In the last two decades, evidence-based design-features that improve patient healing, mood, and well-being, as well as staff efficiency and safety, through thoughtful and research-based design initiatives-has fundamentally changed how we design hospital interiors. Similarly, sustainable design has provided us with strategies to maximize natural light, incorporate nontoxic materials and increase energy efficiency to reduce costs and create cleaner indoor environments.

As we advance into the second decade of the 21st century, healthcare interior designers will continue to incorporate innovations introduced by sustainable or green design. More specifically, we will maximize daylighting strategies, and select from an array of high-quality artificial lighting to improve task efficiency, increase patient health, and enhance visitor comfort. Healthcare centers will also increasingly share resources and space with nearby cultural and educational organizations, thus becoming even more integral and valued members of their communities.

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In addition, at HGA Architects and Engineers, (HGA), we see three innovations in healthcare design evolving in the next decade. We will be designing to facilitate instant access to such technologies as 24/7 connectivity that enables patients and their families to surf the Internet; friend and family social-media platforms like Skype, Facebook and Twitter; and databases for individuals to research medical conditions, procedures, medications, and healthcare options. We're building on our recent experiences designing educational centers within hospitals and healthcare complexes, to provide clients with state-of-the art facilities for in-house use and for sharing with their larger communities. And we're driving the evolution of family lounges in healthcare facilities to enhance comfort and accommodate diverse and changing needs.

Interior design innovations: Three that are here to stay

Daylighting and quality artificial light. Since the 1980s, numerous studies have shown that employee productivity and client health improve when designers strategically place windows to bring optimal natural light into family areas, patient rooms, and staff work areas. In two-story entry atriums with floor-to-ceiling windows of low-e glass, we've clustered family sitting areas and installed fountains and plantings to enhance the visitor and patient experience. Strips of clerestory windows can focus daylight into labs or other work areas without creating glare. Windows placed at bed height can bring in sun to warm a patient's hands and face, promoting a sense of well-being.

At the same time, advances in artificial lighting technologies continue to give healthcare interior designers cost-effective, energy-efficient options for highlighting interior work areas and tasks. As medical centers expand to include education facilities, ceramic metal halide lighting installed in high ceilings provides long-lasting and high-quality ambience. In family lounges, we've installed homelike floor and table lamps for reading. Above nurse workstations, we've used pendant lamps as focused task lighting and to create a less institutional feel.

Owatonna Hospital: Steve Henke, Henke Studio
Owatonna Hospital: Steve Henke, Henke Studio

In patient rooms flexible lighting is essential, as are separate controls for different types of fixtures. We incorporate low-level lighting for family visits and for staff to use when checking on patients. Exam light and task lighting direct illumination where staff need it, without glaring into patients' eyes. We also specify nightlights to allow staff and patients to navigate the room.

Outside of patient rooms, wherever gurney-bound patients might be waiting or transported, we specify shielded or dimmable fixtures so patients needn't look directly at bright light.

Sustainable (green) design. For at least a decade, healthcare interior designers have been specifying green products to ensure healthier indoor environments. Such products include low-VOC paint, recycled paint, less toxic adhesives that generate less off-gassing, and carpets and ceiling tiles that include post-consumer waste and/or can be recycled. The U.S. Green Building Council's LEED program for healthcare facilities, as well as the Green Guide for Healthcare, provides incentives for architects and healthcare administrators to institute sustainable design strategies and install green products that ensure high performance and energy efficiency, as well as healthier indoor environments. These programs reduce the environmental demands buildings place on natural resources, but don't eliminate those demands.

The 2030 Challenge has upped the ante in the sustainable design of healthcare facilities. This directive asks that all new buildings and major renovations be designed “to meet a fossil fuel, GHG-emitting, energy consumption performance standard of 50% of the regional (or country) average for that building type.” The Cascadia Region Green Building Council has also issued the Living Building Challenge, which asks that all new buildings be carbon neutral and water balanced, and produce zero-net energy and zero waste. As healthcare architects and their clients work toward such goals, the sustainable design of hospitals and medical centers will continue to evolve.

Local cultural and educational influences. Healthcare facilities are fast becoming not only places of care and healing, and business and employment within a community; hospitals are increasingly collaborating with educational and cultural organizations to become a more integral part of their communities. HGA completed an expansion of the Owatonna Hospital, in Owatonna, Minnesota, which celebrates such collaborations and their influences. The first and second-floor galleries showcase artwork by local artists and is managed by the Owatonna Art Center. The local art gives the facility a greater sense of place, and the artists showcased find new audiences in the staff, healthcare providers, patients, and visitors who see their work.

The local art gives the facility a greater sense of place, and the artists showcased find new audiences in the staff, healthcare providers, patients, and visitors who see their work.

The hospital expansion includes a new simulation center, which is an innovative teaching environment that uses electronically programmed manikins. Healthcare educators at nearby Riverland College are using the simulation center to train medical students in highly technical procedures. Additionally, the hospital's new circulation corridor, adjacent to large windows that bring in natural light and provide views to outdoor gardens, doubles as a Wellness Walk. Employees, patients, and visitors from the community make daily use of the space by exercizing on the terrazzo-clad path, which begins at the main entrance, winds through the hospital's retail and dining corridor, and loops back to the front entry.

Butler Health: HGA Architects and Engineers
Butler Health: HGA Architects and Engineers

Interior design innovations: Three to watch

Supporting high-tech connectivity. The hospitals and medical centers we're currently designing are outfitted with distributed antenna systems, which provide wireless accessibility throughout the facilities, including in patient rooms. Thus, every member of a hospital's staff-from caregivers to administrators-is able to do their work with greater ease, efficiency, and attention to patients and families. In addition, we've eliminated the need for designated areas on each floor with data hubs for family members to access the Internet. Instead, we've incorporated docking stations and charging outlets throughout facilities-in OB wards for cameras, in education centers for laptops, in patient rooms, family lounges and cafes for cell phones, iPods and netbooks-to ensure instant connectivity isn't disrupted by low batteries.

In patient rooms, large flat-panel monitors with programming systems allow hospitals to broadcast cable television, show healthcare DVDs on medical issues and processes, provide Internet access, and screen movies. Wireless keyboards, hand-held interfaces and touch-screen controls allow patients to easily choose from viewing and listening options. These devices also allow room occupants to control room temperature, lighting, curtains, and the sound system.

Education or knowledge centers. More hospitals and medical centers are augmenting their community outreach efforts by incorporating education centers into healthcare facilities. HGA designed a Knowledge Center for Butler Health System, in Butler, Pennsylvania, which is currently under construction. This space includes a 150-seat auditorium and lecture hall, large meeting rooms with flexible walls for smaller room configurations, consultation rooms, conference rooms, and a resource center. This center is open to the community for research and knowledge gathering.

With such education centers, hospitals will be better equipped to provide community outreach and education in the form of training programs and specialty clinics on topics ranging from cardiology and hospice, to breastfeeding and bereavement. Hospitals will be able to collaborate with local fitness centers on wellness programs. Designed with corporate-style furnishings, docking stations for laptops and cell phones, these knowledge centers will become sought-after and well-used community resources. The interior design and architectural detailing of the Butler Health System Knowledge Center space was designed to look like a business center with corporate finishes and design features. The designers developed a “similar yet different” design for this area to indicate it is part of the hospital yet has a very different function than the intimate patient and treatment areas.

Family lounges. The uncomfortable, sterile waiting areas of the past are quickly evolving into homelike lounges in which family members and visitors of all ages can find comfort and privacy during their stays. In our interior design of Butler Hospital, we've clustered waiting areas into a spacious, light-filled, two-story atrium for privacy. High-back chairs give waiting family members a place to lean back and rest their heads. Two-seat sofas allow children or couples to lean on each other. Table lamps provide warm task lighting.

Teenagers with iPods, business people on laptops and smartphones, mothers reading from Kindles and children watching movies on netbooks all enjoy wireless access and accessible electrical outlets. The homelike furnishings, local artwork, color palette of rich earth tones, and natural light all convey the compassionate care loved ones are receiving as visitors and family members wait. Such innovations will continue to evolve to ensure families remain up-to-date, connected and comfortable during their stay. HD

Christine Guzzo Vickery, CID, is an associate VP and interior designer at HGA Architects and Engineers in Minneapolis. She also blogs for

HEALTHCARE DESIGN Magazine. Healthcare Design 2010 May;10(5):80-86