Tyson cited Florence Nightingale's book “Notes on Nursing” published in 1860, which recommended that sick people should be able to look out of a window without raising themselves out of bed.
In a variation of the old joke where the patient says “Doc, it hurts when I do this” and the doctor replies “Well, then don't do that,” Tyson said Nightingale wrote about how patients will complain about feeling pain while lying on their side. So why are they lying on their sides then? They don't know, she wrote, but the reason is—like a flower—they will turn to face the sun even if it causes them pain to do so.
Going through my notes of the programs and presentations I attended, here are few other items that stood out for me:
“Adjacenies” may be becoming the new buzzword, as designers seek to maximize space while minimizing patient movement by putting facilities that are often used by the same sets of staff and patients together.
David Chambers, Sutter Health's director of planning, architecture and design, said that idea is being used in his organization's $6 billion capital projects plan with fewer patient handoffs being a goal.
“We're not looking at business as usual,” Chambers said, as he encouraged architects to “think beyond the bed” when designing new hospitals.
Robert Porter, president and chief strategy officer for SSM Health Care-St. Louis, echoed a similar theme while discussing the design process for his organization's new St. Clare Health Center in suburban St. Louis, which was a winner in this year's Modern Healthcare Design Awards.
“You constantly feel the tug back to what's familiar,” Porter said.
Porter's co-presenter Kurt Spiering, vice president and leader of the national healthcare practice group of Milwaukee-based HGA Architects and Engineers—the firm that designed St. Clare—noted how the idea was not to build larger waiting rooms with “positive distractions,” but to design a facility where patients don't have to wait in the first place.
Porter also touched upon the new spirit of collegial collaboration fostered by integrated design teams where everyone works together from day one instead of in separate silos that try to cram their ideas together later. “The historical culture of big construction projects is one of mutual distrust,” he said.
This was touched upon earlier by David Kievet, group president of California operations for the Boldt Co., an Appleton, Wis.-based construction and design firm. Kievet mentioned a culture where companies spend more time documenting what they've done instead of doing what they are supposed to do as different project participants prepare for how they will eventually sue each other once the building is finished.
Several trends combine to form interesting consequences. In describing how adjacencies and intradepartmental functions are affected by the desire to give patients rooms with windows, Susan Black, a principal and director with the Toronto studio of Perkins Eastman Black Architects, said “back of the house” support facilities are moving from the back to the middle of hospital floors.
And while speaker after speaker repeated the need to give patients a sense of control, Deborah D'Agostino of New York-based architect and planning company P4H noted that often the first things to be removed when organizations are looking to “value engineer” costs out of their project are individual thermostats from patient rooms.
Other random points heard at the symposium and jotted down include:
Annette Valenta, professor and associate dean for health informatics and technology at the University of Illinois Chicago, said how exam rooms have to be designed to accommodate the third party joining the physician and patient: the doctor's computer.
Wider use of computer modeling of designs is leading to more opportunities to prefabricate project elements—such as piping connections and even bathrooms—and then perform “plug and play” installations at the construction site.
“Targeted growth” is a phrase that will be heard more often in the coming years (as opposed to “growth for growth's sake,” apparently).
More attention is going to be given to ceilings as a source of positive distraction as there is a growing realization that this where patients are often staring while undergoing unnerving procedures.
Orest Burdiak, principal interior designer with the Veterans Affairs Department, noted that—as a throwback to when everyone smoked—the VA liked to keep its ceilings dark because it was easier to paint them then clean them.
Burdiak also announced that the VA will soon be releasing its new mental health facility design guide. The significance of this, he said, is that it will bring to an end the era of the “plexi-glass tomb” design.
Remember, you heard it here first.
Andis Robeznieks reports on physician issues, healthcare construction/design and healthcare marketing. He covers healthcare business news in Colorado, Montana, Nebraska, North Dakota and South Dakota.
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