Designing health facilities with DEI in mind

As health systems seek new ways to improve the patient experience and promote inclusivity, the environment within their facilities has become a major consideration. White walls, fluorescent lighting and complicated floor plans are signs of the past.

Heeding a call for change is a group of interior designers and architects exploring how to incorporate diversity, equity and inclusion into their work. Past efforts have focused on concerns such as privacy, noise and lighting. But recent projects take a more personalized approach that incorporates patient and community input to tailor spaces to their specific needs.

There’s a financial incentive too. Personalization helps providers score higher on patient surveys that affect how much Medicare and Medicaid pay them.

Oregon Health and Science University’s Elks Children’s Eye Clinic in Portland was built with different eye conditions in mind to ensure the space is easy to navigate. In New York, a women’s health center is filled with fixtures and artwork designed almost exclusively by women.

“It changes the way you start,” said Greg Swinton, senior associate at architecture firm NBBJ. “You want to start with a relationship with the people you are actually designing for.”

At Elks Children’s Eye Clinic, planners centered their thinking around visual impairments and identifying flaws in current designs. The NBBJ team walked through OHSU’s Casey Eye Institute while simulating various eye conditions to better understand how patients experience the facility’s environment. They also sought patients’ opinions.

“We came to learn that this isn’t really what the space is going to look like for all of the patients coming through,” said Alex Almerico, senior associate interior designer at NBBJ. “Each patient is going to see it differently, so we developed visuals to illustrate what each of their patients will experience walking into the space to help us better understand what a day in their shoes is like.”

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In internal surveys, patients with visual impairments described difficulty accessing the entryway, irritating glare from the sun on all-white surfaces and an inability to distinguish doors from walls because of a lack of color contrast.

To mitigate these shortcomings, NBBJ placed varying paint swatches and textures on the floors and ceilings to intuitively guide patients through the space without the need for excess signage, Almerico said. Rather than have patients navigate the halls by touching the walls, they incorporated guardrails to lead them directly to elevators and exam rooms.

Outside, the landscape architect laid sand-finished concrete that reduced glare in the parking lot, created a sensory garden and removed unintended barriers to entering the building.

“We always have designed with empathy and a desire to understand the community that we’re designing for, what their experiences are like and what their struggles are on a day-to-day basis,” Almerico said.

A team made up entirely of women at NYU Langone Health designed a 195,000-square-foot multispecialty clinic offering gynecological, obstetric and women’s wellness care. They filled the space with furniture and art created mostly by women.

The five-story facility is anchored by a glass mural by artist Anne Lindberg and uses mosaic tiling on the floors. Artwork is displayed throughout, including the “Healing Shawl” by Marela Zacarías. Patient surveys show positive results, said Elsie St. Léger, assistant project manager of interiors at NYU Langone Health.

“It lets patients and their families and visitors know that we actually thought about them,” St. Léger said. “Men and women design differently. They approach a problem differently and they problem-solve differently. We have very different perspectives and so the products, for instance, may look different and feel different simply because of the designs, and that’s a form of equity.”

St. Léger is also a co-founder of the Equity Council, part of the International Interior Design Association’s New York Chapter. The council is a consortium of interior designers founded in 2020 following George Floyd’s murder by a Minneapolis police officer to establish a framework for equitable design practices. The first step in designing a specific project or space is to recruit a diverse group of stakeholders into the planning process, she said. The next is to consider how to curate an individualized experience for the people to be served.

“There’s no one-size-fits-all. There’s no one formula,” St. Léger said. “Equity can mean anything. We could be talking about racial equity, we could be talking about equity for the disabled, for the mentally ill. Those questions and the answers that come from those questions are different with every project and at every location. It’s important to take those differences into consideration.”