Reducing Visual Overload In The ED
Cleveland Clinic has been working to standardize its design aesthetic over the years to create a unified identity for its facilities while improving patient care with an environment that helps to lessen stress and anxiety.
When the opportunity arose to expand its Brunswick Family Health Center (Brunswick, Ohio) with a full-service emergency department (ED), the provider decided to pull together its best practices in design, materials, finishes, and layout into the new setting.
“Generally speaking, medical interiors have a lot of visual overload when you think about the equipment, signals, devices, and all of the things going on,” says Ronald Reed, a principal and project designer at Westlake Reed Leskosky (Cleveland), which designed the two-story addition. “The goal in this facility was to take away a lot of the visual noise, which can overstimulate people, and get them into as tranquil an environment as possible.”
The 22,500-square-foot first floor houses 18 treatment spaces, imaging, and laboratory services. The project also included 17,000 square feet of shell space on the second floor for future expansion of family health center services and a rooftop helipad.
The key to uncluttering the ED was taking a disciplined approach to everything—from the placement of the fixtures, equipment, and outlets to the color and materials on the exterior and interior.
“Using a minimalistic and modern approach, we implemented a clean and simple design as a way of reducing the large amount of colors, lines, and clutter that comes with some designs,” says Travis Tyson, an architect and healthcare facility planner at Cleveland Clinic (Cleveland, Ohio).
For example, in the radiology room, technicians stand behind an angled wall to reduce the amount of equipment that patients can see, while the underside of cabinets is used to keep supplies nearby but out of sight. In the exam rooms, the headwall and staff desk areas are organized so that outlets and supplies are cleanly located on the wall to reduce clutter.
“We spent a lot of time eliminating and organizing things, so that when you go from exam room to exam room every room is set up the same way,” says Philip LiBassi, project principal in charge at Westlake Reed Leskosky, who led the medical planning on the project.
Cleveland Clinic’s Tyson says operational efficiencies were improved by involving ED doctors, nurses, and key staff in the design process. The layout incudes a large atrium and waiting area along the front of the building with the middle section of the ED reserved for exam rooms and open work stations, followed by staff support spaces at the back of the building.
For those seeking treatment, a nurse is located at registration to access the acuity of the patient or send them to triage. Patients can be routed to one of four split-flow bays or an exam and treatment room, including two critical care spaces.
The simple color and materials palette throughout the space includes bright white walls and linoleum flooring with pops of color coming in through the artwork, furniture, and wood accent walls. “We particularly focused on key items that patients would encounter as they moved from the waiting room to the treatment area,” Tyson says.
The Brunswick ED is also the first Cleveland Clinic project to participate in the U.S. Green Building Council’s LEED for Healthcare program. Through the focus on recycled-content materials, water-efficient plumbing fixtures, and LED lighting, the project is under review to receive LEED Silver recognition.
Since the ED is located on a busy suburban street near other commercial developments and shopping centers, Reed says it was also important to create a serene setting outside using landscaping and a monochromatic exterior palette. The addition’s glass and metal panel exterior is designed to complement the family health center’s façade but with a different modularity applied to the opaque and transparent parts of the enclosure screen to create a sense of differentiation for arriving patients and families.
The floor-to-ceiling glazing allows patients and visitors approaching the ED to have an immediate view into the waiting area and creates an ease of wayfinding. “We know that one of the most important things you can do to put people at ease is to introduce them to the activities and what’s going on beyond the façade,” Reed says.
LiBassi says one of the challenges on the project was deciding how to join the buildings, since expanding out from one side of the health center would have reduced the amount of natural light entering the buildings. Instead the design team chose to connect the building at two corners, preserving the views and natural light as well as creating a continuity of circulation with the large atrium spaces aligned along the perimeter. “As you come into the building, you’ve got the activities in the waiting areas along the front of the buildings, which is the first visual cue to the arriving patient,” he says.
The simple, uncluttered approach—both inside and out—allows the environment to become a quiet backdrop to the workings inside the ED, Reed says. “We’re not trying to challenge patients with clever architectural designs or new color schemes,” he says. “We’re trying to create an environment where they can come and feel confident that they’re being taken care of."
Anne DiNardo is senior editor of Healthcare Design. She can be reached at email@example.com.