Designing Better Hospital Environments

One architect put people first in his quest to make safer, better designed hospital rooms

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A friend of mine once said that the patient room is the last frontier in hospital design. I now know exactly what he means. Over a two-year period starting in February 2003, I was a patient in eight different hospitals and two rehabilitation centers. During this time, I developed a personal perspective on how patient rooms in most medical facilities do very little to encourage healing. In fact, I learned from conversations with others that some patient rooms and their furnishings contribute to the spread of infection and even to injuries. This is not acceptable.  

I recently spoke about how my paralysis fueled my desire to improve healthcare design at a special event hosted by the Antimicrobial Copper program of the Copper Development Association (CDA) at the 2012 Health Forum and the American Hospital Association's Leadership Summit in San Francisco, CA. More than 80 leading hospital and healthcare executives attended his lecture.

Rare Virus
Ten years ago, I was one of the busiest architects in the world. I was traveling nearly three weeks of every month to visit building sites and meet with clients around the globe. I was also lecturing widely and designing hundreds of new products for Target stores. Life was hectic, but good. Then I contracted a sinus infection on the eve of a business trip to Europe. By the time I returned home a few days later, I was very sick. For the first time in my memory, I had to leave my office in the middle of the day to go home and rest. That was on a Monday afternoon. By Tuesday morning, I was paralyzed from the chest down. I had contracted a rare virus that made its way from my sinuses to my brain to my spinal cord. 

Poorly Designed Hospital Rooms
For the next two years, I battled to keep my upper torso, arms, hands, neck and head functioning. I was determined not to lose the very bodily functions that would allow me to continue my life's work. It was during this time that I experienced the patient room from the patient's perspective. As an architect and designer who unexpectedly became a long term patient, I can confirm what my friend said: The patient room is in fact the last frontier in healthcare design. The rooms are typically too small; they lack functionality at almost every level; and the furniture is bulky, poorly designed, uncomfortable and often unsanitary. The bathrooms are so small that a wheelchair can't turn around; the showers have curbs that keep the water in, and the wheelchair-bound patient out, as I came to learn. 

Patients First
When I returned to my office to resume my practice full time, I vowed to make it my mission to improve healthcare outcomes by improving patient room design. My business development team went to work to identify manufacturing and distribution partners who could share my vision for patient room furniture. Happily, Stryker Medical stepped up to the challenge. Our resulting collection is a stunning testament to what you can achieve when you employ research-driven, evidence-based design principles - and sheer logic - to identify the real problems. We started simply by putting the patient first. And the insights and innovations started to flow.

One of the insights that I gained as a patient, and later confirmed as we critically examined healthcare design, is that the furniture is overly complicated. Individual pieces evolved from precedents without their designers challenging underlying assumptions. For example, the bedside stand, a furniture type normally found at home, has little function in a patient room and is often relegated to the corner and under-used. On the other hand, the typical over-bed table has too many functions. Manufacturers have tended to compete with each other by adding more and more features to the point where the tables are actually harder for patients and caregivers to use, and harder for the environmental services staff to keep clean. We saw that with our own eyes as we conducted our research.

HAI Reduction
Our research also revealed that one of the greatest challenges in achieving successful patient recovery is the avoidance of hospital-acquired infections. We asked ourselves, if the patient is at risk of contracting infections in the hospital, can we design a piece of furniture to help control their spread? Thankfully, the answer is yes. Once we focused on this task, we were able to re-think the over-bed table and the bedside stand, re-allocating features between them to make them both more useful and intuitive to use. We also made them safer by making them lighter, easier to adjust and easier to clean.

Our patient room furniture was just the beginning. We've since moved into the realm of patient transport by re-designing the ubiquitous hospital wheelchair. Our new "Prime TC" for Stryker Medical hits the market this coming winter and it's going to change everything. We also have had the honor of designing houses for Wounded Warriors with various disabilities, and we are working side-by-side with a host of healthcare companies on patient-centered care facilities. I am excited by what the future will bring as we continue our quest to put the patient first - one patient room at a time. 

Michael Graves, the founder of Michael Graves & Associates and Michael Graves Design Group, is well known throughout the world for design excellence. The 2012 Richard H. Driehaus Prize Laureate, and recipient of the 2001 American Institute of Architects' Gold Medal and the 1999 National Medal of Arts, Graves is credited with broadening the role of the architect in society and raising public interest in good design as essential to the quality of everyday life.

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What a great article and I'm sorry you had to find this information out first-hand. How can we have a first rate healthcare system when we are lacking basics like practical, efficient and safe environmental design which includes furniture?

Thank you for your efforts and continued success and health to you!

Grace ,  Charge Nurse,  HospitalFebruary 26, 2013
Oakland, CA


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