Rethinking Details: How to Stretch Your Hospital Design Budget

 
By Doug Bazuin, senior healthcare researcher for Herman Miller Healthcare

When we design hospital patient rooms, we know that fast-paced medical advances and unpredictable shifts in government policy mean the facilities we design today must survive many changes.  But we need to keep smaller changes in mind too. Over time, these small details can add up to either big savings or big costs for the facility, depending upon the level of consideration we give them in the design process. 

Discussions with more than 550 healthcare professionals reveal that a positive patient experience and good infection prevention are two of the most important patient room design goals and the areas where details most matter. 

Preparing for changes

In designing a comforting patient room, a detail often overlooked is soiled linen. Oftentimes, a beautiful patient room design must utilize a less-than-attractive solution for dirty laundry disposal. One option for such situations is to hide the receptacle behind a door in a cabinet, but this requires extra steps for the caregiver.

The same can happen with exposed gloves and sharps receptacles. For gloves, organizing them by size and or type can help and concealing them in a cabinet also can be a good option. A solution for the institutional sharps container may be to mount it to a tool rail so its location can be changed with minimal disruption to the room.

Hand sanitizer brands and vendors can change frequently, which means new dispensers also tend to be frequently replaced. The cost of repairing the drywall and touching up the paint every time a dispenser is changed typically is not considered in the initial purchasing decision. Similarly, research uncovers that many automatic/touchless paper towel dispensers in patient rooms needed to be removed, due to the surplus noise they generated. Any initial cost savings were eliminated by the cost of needing to change dispensers. 

Asking these questions early on can solve some of these problems before they occur:
• What is the preferred process for handling soiled linen?
• Who empties the hamper and how often?
• Are there any good options for disguising the hamper?
• Can paper towel dispensers be hidden?
• How frequently will towel and soap dispensers be changed?
• How often do the locations or sizes of glove boxes and sharps receptacles have to be changed?
• Would the initial cost of a tool rail mounted on the wall to make changes nondestructive be less than ongoing wall repairs?

Small solutions for greater infection prevention

Despite the uncertainty and frustration associated with infection prevention issues, hospitals demand infection control measures. How a hospital applies infection prevention measures to its patient rooms can have a big impact on design choices.

In our research on hand washing, we focused on the sink and faucet design of the caregiver hand-washing station.

If the primary purpose of the hand-washing station is just that, then temperature control might not be required.  A touchless faucet that automatically mixes hot and cold water to achieve a selected temperature may be a good choice. But surprisingly, concerns about overly sensitive sensors have trumped the infection control advantages of not having dirty hands touch the handle. New technologies to improve sensor performance continue to deliver better results.

If the care process requires hot water drawn from this faucet for giving bed baths rather than the bathroom sink, the water temperature needs to be controlled with foot pedals or wrist blade handles. Foot pedals allow for independent operation of hot and cold water and are touchless, but they can be difficult to clean.

Here are some infection control questions to be asked when designing a patient room:
• Have you sufficiently engaged your infection prevention professional in the design of details?
• Does your infection prevention professional require the soiled linen hamper to have a lid?
• Which works best for how you need the faucet to operate—wrist blade handles, foot pedals, or sensors?
• Will the automatic sensing faucet operate on batteries, power, or emergency power? And if you choose a battery-operated faucet, has a preventive maintenance plan been put in place?
• Do the size, shape, location, and operation of the sink and faucet help prevent the spread of infection?

In the end, it always pays to sweat the small stuff. What other small details in healthcare design do you feel can help hospitals and other medical facilities keep up with changes?

Doug Bazuin is a senior healthcare researcher for Herman Miller Healthcare. He possesses 10 years of new product development experience and has been involved with several new product launches.