-By Katie Weeks

No one enjoys getting sick, and the thought of an extended stay at a hospital isn’t exactly topping anyone’s must-do list. However, the patient room, and how the design of this space can affect the patient experience and the delivery of care, provides a number of opportunities for designers. “Interiors are such an important factor in a hospital because people go in and could be there for months at a time,” says Timothy Powers, AIA, senior vice president at Astorino in Pittsburgh. “I think of all the built environments, the hospital interior is the most critical of any building type.”

During the first half of the decade, the biggest driver in patient room design was the switch from double patient rooms to like-handed single-bed rooms. As evidence increasingly shows how single-patient rooms impact care, this layout is increasingly being adopted into building codes for new construction. Playing with this configuration on a floor, designers also began experimenting with zones within the room itself. Could you, for instance, reduce a patient’s fall risk by placing the toilet near the bed and installing a handrail to help guide the patient from bed to bathroom? What amenities could be added for visiting family members? How could the caregiver’s zone be improved to reduce infections and improve efficiency? “Space is a big deal,” notes Christine Guzzo Vickery, CID, associate vice president and interior designer at HGA Architects and Engineers. “There’s a lot going on in the room, so how do you make it functional and aesthetically pleasing?”

Today, the key factor informing patient room design is, of course, budget. “The biggest thing influencing patient room design right now is the economy, and this will be the thing we will be confronting for several years moving forward,” says Mark Banholzer, AIA, LEED AP, vice president and national practice leader for healthcare interior architecture at RTKL in Chicago. It creates a conflicting scenario. On one hand, the push for more hospitality-like rooms may pay the price, literally, as facilities lean back toward more budget-friendly options. On the other hand, these same facilities increasingly find themselves competing for patients, who may connect a room’s visual appeal with the perceived quality of care received at the institution. For example, both Banholzer and Vickery mention the headwall and how it treats gases. While in the past designers may have pushed to hide gases, functional concerns are increasingly demanding that these functions be more visual. The task now becomes making them visually appealing.

Technology also continues to play a dominant role in patient room design, providing both opportunities and challenges. Given the time frame for a project (years in development, years in construction, years in operation) in contrast to hyper-evolution of technology, designing flexibility into a room is key. For now, many rooms are equipped for in-room charting, but how, exactly, will caregivers be charting? On a tablet PC or a laptop? Is the room wired to support new developments or can these systems be upgraded as needed? Technology also factors into the patient and visitor experience. Beds now can take a patient’s vitals, and lighting systems are being designed to mimic circadian rhythms. Flat-screen TVs are doing double duty as art displays or feature interactive gaming like a Wii where, for instance, a child at a children’s hospital can play against other patients down the hall.

The idea of community and interaction taps into another design driver, with teams crafting interiors that address the more emotional aspects of a hospital stay. At HKS in Dallas, Becky Hass, IIDA, LEED AP, designer, healthcare interiors, notes that many families and patients are requesting a more subdued palette, especially in children’s facilities. “They’re asking us to tone down the positive distractions and step down the color range to make the patient room more peaceful,” she says. “They want it to be more sophisticated and calming, with the more brilliant colors in the corridors so that the patient room experience is relaxing, not over-stimulating.”

Family dynamics also are being addressed. In designing the patient rooms for Pittsburgh Children’s Hospital, Astorino equipped each room to sleep two parents or family members, outfitting each room with a custom-designed sofa that has a trundle bed that can be moved elsewhere in the room should the two caregivers want separation. Many rooms across the board are now being designed with amenities like refrigerators, safes, and wireless Internet access.

Infection control remains a large concern. Patient room designs often now include sinks near the doorway so caregivers can wash their hands before attending to a patient, and going one step further, patients are being educated to ask their clinician whether they have washed their hands. One newer development is looking at whether it’s best to move patients as needed or to keep them stationary in a flexible room that can adapt to the level of care needed. “There’s a movement to bring all the services to the patient,” notes Rosalyn Cama, FASID, EDAC, president of Cama, Inc., in New Haven, Conn. “If a patient’s acuity level changes and they need more intensive services, rather than transferring them, which costs money and changes caregivers, can we build a room with a 13-ft. headwall that offers all the equipment needed for variable acuity?” However, Cama notes, this hasn’t yet caught on in a widespread movement, and there is not yet in-depth research into this approach.

What these approaches do, however, is raise the discussion on the effects of design not only on the patient room, but also on a facility as a whole. For additional reading on patient-room issues as well as past articles on healthcare facilities design in general, click below.

Designing for Health: Making Hospitals More Hospitable for Children

Designing for Health: The Importance of Family in Patient Rehabilitation

Essay: Greening the Patient Room

Focus: Patient Room Furniture