We have all heard about the obesity epidemic in the United States, and now it has come around to impact us in healthcare construction. Our clients and the design teams recognize that all patient care spaces and public areas (waiting rooms, toilets, etc.) in healthcare facilities need to be suitable for obese or "bariatric" patients. The first major impact was the introduction of patient lift systems into inpatient rooms and exam rooms. These devices require some above-ceiling coordination for the support system and must be installed in the correct location in order to work properly, so the staff can use them to lift the patient from the bed. Some facilities are extending the lift track into the patient toilets; others feel that they only need to go to the doorway. I have talked to a dozen people installing these in hospitals and most say the users that initially chose the 600 or 700 pound capacity lift now wish they had chosen a 1000 or 1200 pound capacity lift. This tells us that there is still a long way to go in understanding this patient population.

That is a perfect segue into the other big impact on us: We now have to rethink how we block for and support fixtures and devices that are wall- or ceiling-hung, and that need to bear the weight of the patient. I think the best question the construction team can ask of the users and designers is, "Tell me how heavy a patient we are all trying to accommodate—what is the model?" If the model is a 500 pound patient, then we know that everything we install has to be supported to hold that weight. It's not good enough to just send the carpenters out to put some steel plate or wood blocking in like they always have. We need to make every trade aware of the potential patient weight. This issue deserves its own coordination meeting, where a group of user representatives can talk the design and construction team through the pathways that these patients follow, so that we can look at everything along the way and make sure it’s all securely installed.