Staff Support: Designing Optimal Healthcare Work Environments
The days of healthcare staff locker rooms decked out with mismatched chairs and rickety tables are long gone. Rather, providing a comfortable setting for workers has become a priority that’s made its way to the top of ownership’s priority lists, all in an effort to punch up staff productivity as well as recruitment and retention.
The trend has translated to a number of design demands, from break rooms that look more like business-class lounges to nurses’ stations designed to support an optimal work environment.
“Reducing stress and fatigue, and providing ergonomically supportive spaces, are now top-level goals,” confirms Carolyn BaRoss, design principal and firmwide healthcare interior design director for Perkins+Will (New York). “It’s in healthcare organizations’ best interest to have happy and healthy staff who enjoy their workplace and are as effective as possible in it.”
Historically, the design of staff spaces came as an afterthought, with dedicated areas often carved out of windowless corners. “Staff was left to steal or borrow from other program spaces to accommodate needs for respite, breaks, and education,” says Bob Schilling, senior principal at Champlin Architecture (Cincinnati).
Today, though, staff real estate is often considered during the programmatic phase of development. While the Facility Guidelines Institute’s Guidelines for Design and Construction of Hospital and Outpatient Facilities recommends allocating a minimum of 100 square feet for staff lounges and areas of respite. Haley Driscoll, director of healthcare interior design at Francis Cauffman (Philadelphia), says that comfortable staff space can be created with as a little as 80 square feet.
“It’s less about allocated square footage per person and more about the way in which spaces are organized, and where and how they can be strategically located within the facility to maximize flexibility and add value,” BaRoss agrees.
As for location of break rooms, convenient access from work areas is important. However, available space in proximity to patients is generally limited, so optimally siting these rooms can be a challenge, Schilling says. Additionally, balancing location with the creation of on-stage and off-stage areas is critical, too. This allows a necessary separation from patient care and treatment areas, especially to provide staff with the distance required to refresh and recharge.
And while strides are being made to better accommodate staff, hospitals’ primary focus remains on the patient experience. As such, staff “extras” are often considered to the extent of providing convenience and support, as opposed to rolling out luxury accommodations. “Every feature must provide benefit to the bottom line, for example, enhancing efficiency, saving time, relieving stress, and/or improving communications,” Schilling says.
Because patient families may not always appreciate seeing staff relaxing instead of working, the ideal is to locate break rooms at the ends of units, says Jennifer Aliber, a principal at Shepley Bulfinch (Boston). At the same time, if these spaces are more than a few minutes away from working areas, it can be difficult for staff to access the break room during a 30-minute lunch. As such, David Derr, a principal at Shepley Bulfinch (Phoenix), recommends locating the room within the unit, even long units, as opposed to clustering these support spaces elsewhere.
In terms of furnishing rest areas, designers say they generally seek a more residential feel and strive to make a connection to the outdoors. “Depending on the space available, we place a variety of furniture options in the room for the staff to choose from, including café tables, coffee bars with high stools, computer carrels, lounge seating, and even recliners or ottomans,” Driscoll says.
For example, at Cleveland Clinic Abu Dhabi, currently under construction, HDR Architecture designed break rooms inspired by business-class airport lounges as well as single-occupant staff meditation rooms with plush seating, warm color tones, dimmable lighting, and softer surfaces for better acoustics, reports Jim Atkinson, healthcare planning principal at HDR (Charlotte, N.C.).
On another recent HDR project, Dallas’ new Parkland Hospital, staff can take advantage of areas of respite along private courtyards, and nursing mothers have access to lactation rooms. And at both St. Joseph’s Regional Medical Center in Paterson, N.J., and St. Joseph’s Wayne Hospital in Wayne, N.J., Watson Rooms—inspired by Jean Watson’s theory of caring—feature lounge chairs with a massage feature, dimmable lighting, and soft background music. The concept is that by better caring for themselves, nurses are then better empowered to care for their patients in a more personable way.
Beyond break rooms, some hospitals are incorporating outdoor dining terraces, gardens, and walking paths, while others offer facilities to support employees’ interests, such as bike racks and showers for those who prefer to bicycle to work. In some cases, hospitals offer concierge services such as dry cleaning or retail pharmacies.
Overall, designers also take steps to distinguish staff areas from patient-facing zones to allow a mental separation for workers, too. “To provide diversion and visual interest, materials, furnishings, colors, and style may be different,” BaRoss says. “In addition, logos or brand images are typically not displayed in these spaces to allow caregivers some respite from the reminders of work.”
Back to work
For time spent on the job, there’s a growing interest in designing workspaces to optimally support ergonomics, efficiency, access, comfort, and productivity. For example, many firms are exploring approaches like bedside charting, decentralized charting outside patient rooms, team touchdown stations for small group collaboration, and team rooms for larger staff gatherings.
Another solution is the creation of collaborative multiuse areas that serve as swing space for individual work areas, staff meeting spaces, and break stations, says Andrew Quirk, senior vice president and account manager at Skanska USA Building (Nashville). This then provides flexibility and variety, based upon a staff member’s particular need at a given time. In a similar vein, Erin Cusker, staff architect at Shepley Bulfinch, is seeing the integration of “hoteling” areas within care stations to accommodate social workers and other professionals outside of the direct care team. These outside team members are then provided with a comfortable place to work, without infringing on their colleagues’ space.
And while these spaces must balance the need for a collaborative environment as well as private nooks for focused work, visibility to patients must be considered in designs, as well.
For example, when renovating Hartford Hospital’s emergency department, where space was at a premium, Perkins+Will worke
d closely with the clinicians to locate workstations in key areas throughout open team spaces, BaRoss says. Partially glazed partitions provided a visual line to patients while preserving a level of privacy for concentrated work. For Einstein Medical Center in Montgomery, Pa., the Perkins+Will team specified demountable partitions for the nursing units to provide a separation between workstations facing the patient rooms and collaborative meeting space.
Keeping staff content
Even in light of tight capital budgets, concern for staff is expected to remain high on agendas. It’s a key theme in healthcare today, Atkinson says, pointing to the idea by treating the staff as valued members of an organizations and expending capital and resources to support them will attract workers while also preventing burnout and high turnover rates.
At the same time, that effort pays it forward to providers’ keen focus on the patient experience, too. “Research seems to point at the idea that if staff members are happy, calm, and valued, the quality of care increases,” Derr says.
Barbara Horwitz-Bennett is a contributing editor for Healthcare Design. She can be reached at firstname.lastname@example.org.