Using Personal Healthcare Challenges To Inspire Better Design
By nature, we as healthcare architects design to incorporate trends in delivery of care, facility requests, and code requirements. But do we really understand how design affects staff, patients, and families?
Over the past two years, I've had my share of personal medical tragedies. It started when my father passed away after surgery. He died in the surgical intensive care unit, as I watched. The ordeal made me question how we design ICUs.
Staff needs went unmet in the patient room; one computer was in the room and another in the hallway, and medical supplies were limited to one cart that wasn't stocked. Nurses ran to other units to find incision kits and needed supplies. Not all staff could fit inside the rooms, spilling into the corridor. The family was relegated to the hallway as bystanders looking into the room, while workers tended to patients in the rest of the unit.
I understood this to be the norm, but did it need to be?
And then last year, my daughter was admitted to the hospital for an autoimmune response to an infection. As I looked for the answer, a night turned into days. I listened as she asked me if she was going to die, and cried because I did not know the answer.
My daughter recovered, but I was still searching for closure. Some suggested therapy, but I realized my cure would come from working to improve the way we design healthcare facilities.
The pediatric emergency room was the start of our journey. A child is typically admitted to a 120-square-foot space that's possibly shared by another family. There's a duplication of most services in the room, except alcohol sanitation and the garbage can, due to lack of space.
What did I take away from this experience? In general, privacy is essential for children beginning at age 9, and shared space raises the level of fear of each child in the room, as they hear and see what's happening to one another.
Lowering anxiety for children and family can start with eliminating shared access to alcohol gel and garbage receptacles. Footwall televisions need to be placed at a lower height for children, with the addition of sidewall arms for sound and viewing. While doubling the standard patient room size, access to the bathroom has not doubled. Overall, the unit has to have access to more bathrooms that are double the typical code requirement.
Next, patient rooms and med/surg rooms can become a home away from home for patients and their families. Simple changes can bring security and reduce family stress, such as adding charging stations for phones and computers to help bridge the connection to home. An outlet could be added to the wardrobe, where space could be provided for a computer to be hidden. Similarly, a lockable safe in the patient/family wardrobe is desireable. A second television for the family would support an extended stay while not disturbing the patient.
My recent experiences with the healthcare system reinforce my belief in the ability of thoughtful design to impact patient care. We must offer healthcare design that meets code and enhances care. But it's also our duty as architects to provide for the patient, the staff, and the family.