At the recently completed HEALTHCARE DESIGN.11 Conference in Nashville, I attended a session presented by Healthcare Design Psychology Consultant Barbara Lyons Stewart, AIA, EDAC, MArch, titled "Flooring Patterns in Healthcare Facilities--Friend or Foe?" Armed with tons of examples both photographic and anecdotal, Lyons Stewart had developed a series of 18 instinct-based design principals to use in the development and selection of flooring patterns based not only on reinforcement of themes through color, shapes, and the like, but also psychology--namely our primitive brains. The basic message: add psychology to aesthetics and function and you arrive at ideal solutions.

But the most interesting part of the presentation was the evidence presented of properly (and improperly) designed floor designs, especially as they relate to instructing patients and visitors to where they want to go--and in some cases, where they don't want to go. Semi-circular stripes were painted to flow directly into walls and lead people deliberately off-center in the name of... well, I'll assume in the name of some sort of misguided design aesthetic, but really it is simply over thought design.

The key, according to Lyons Stewart, is to keep it simple and direct; people will follow stripes on the floor instinctively as long as they lead to where they are trying to go, either in straight lines or around corners. Floor patterns can also create a meandering path while defining function areas, seating areas, and the like. Complicating these patterns can also artificially define these areas, true, but they can also confuse that inner caveman inside of all of us that simply wants to follow a line from point A to point B to get where we want to go.

One of the biggest cues from nature that can and should be utilized in overall room design--and this applies to healthcare as well as any other space, including homes--is the idea that "light" is up and "earth" is down. Designing a room with a dark floor (to represent the earth), mid-color walls (to create ease at eye level), and light ceilings (representing the sky and our basic human orientation below it) has been shown to decrease instability and falls, as well as increase an overall feeling of comfort and stability. If you've ever sold or shopped for a house, chances are that your feelings (and your realtor's feelings!) reflect exactly that.

As Lyons Stewart said during the presentation, "pretend you are age 9 or age 85" when designing these spaces. And perhaps throw a little Cro-Magnon in there, too.