"Designing for Health" is a monthly, web-exclusive series from healthcare interior  design leaders at Perkins+Will that focuses on the issues, trends, challenges, and research involved in crafting today's healing environments. This month's topic:

The Importance of Family in Patient Rehabilitation

By Lynnette McCurdy Tedder  AAHID, IIDA, CID, LEED AP

As a representative for Construction Specialties, Leslie Beatty provides healthcare interior wall protection, handrails, doors and the like to Arizona-based hospitals. Over the years, she has become familiar with a number of facilities, included St. Joseph’s Hospital and Medical Center in Phoenix. In December 2008, however, a turn of events gave Beatty a new perspective on the facility and, more specifically, The Barrow Neuro Rehabilitation unit.

That winter, Beatty’s husband Mike was paralyzed from a traumatic injury. He was treated in the ICU of a local hospital for seven days. At the end of the week, however, the hospital needed to transfer him to a long-term rehab center for further treatment. At first, Mike was transferred to an interim facility that Beatty describes as "grey, sterile, and depressing."

What is it about design that can impact a patient and their family so strongly? We often talk of the elements of a successful healing environment: natural light, private space, warm and comforting colors, supportive staff, and individual control of lighting and temperature, among other elements. In designing Barrow, which Perkins+Will completed in 2007 as an additional scope to the Barrow Neurological Institute’s new patient tower, the design team had to ask how these elements should be translated to a rehabilitation facility, how they might affect the healing and hope of a patient with a spinal cord injury, and also what the design’s impact would be on the patient’s families.

Consider this: The trend for acute healthcare is a private patient room, but in rehab, it is critical to have the support of other patients and one’s family. In shared rooms, peer support and socialization is promoted and this sharing of experiences may be critical to gaining hope and making progress in recovery. For Leslie Beatty, getting her husband into a shared patient room was critical. "Family inclusion and participation in therapy, education sessions, social outings, and patient-family conferences were part of Mike’s rehab," she says. At Barrow, Mike was in a semi-private room with another paralyzed patient of a similar age. The families supported each other.  "We had great times in the recreation/rehab rooms," Beatty recalls. "The tables dropped from the ceiling to allow the room to be a multi-purpose environment. I remember late evenings where a bunch of the families would get together and play Scrabble, eat late night pizza, talk, and play Wii. We bonded together. At other times during the day, the room would transform for rehab classes."

This multi-functional aspect was carried through in the pediatric rehab unit, which provides a therapy playroom and counseling areas that can be utilized by pediatric patients, as well as younger members of the patients’ families. "It is not easy for a three year old and five year old to visit their dad and see him confined to a wheelchair or bed," explains Beatty. In this multi-purpose room, she says, "there was a place they could interact with their father and quickly find out that he could still play ball, color a picture, and build buildings out of blocks."

In addition, small rooms are available for patients or visitors to decompress, talk intimately with staff or take a few minutes out to breathe.  There are also small family areas just outside of the patient rooms so visitors can take a break without being too far away. "The area’s design invoked a positive spirit and neighborhood feel," says Beatty.

Facilitating patient comfort was a key design goal. The main patient tower provided a close proximity for imaging or other medical tests as well as prayer/meditation rooms and family support areas eliminating the need for expensive and taxing ambulance transfers.



And when it comes to the interiors, "The Barrow rehab is far from an institution," says Beatty. "Its calming colors, clear lighting, wood tones and comfortable surroundings make the facility more relaxing and therapeutic." Support areas like family kitchens and family use showers support long or frequent visits by family.  The Barrow patient showers are designed to be easily accessible for a wheelchair patient as well as an assistant or caregiver, and as a result showers are roomy and sink units are very accommodating.

The Perkins+Will design team chose a palette that followed the new Barrow Tower.  The concept was the healing colors of nature with soft neutral tones of the desert and accents of a vibrant  plum and sage green on upholstery and cubicle curtains to add punch. The tonal taupes, tans, and creams worked well with the rift cut white oak woodwork and stainless accents. Back painted glass and speckled solid surface tops completed the practical approach of a neutral background that could remain timeless. Beatty also found out that the products she represented were very appropriate to the facility. The designer at Perkins + Will chose a wood and stainless handrail for the corridors to keep away from the "bumper car" approach of the plastic ones. It turns out that the one specified was comfortable, easy for all patient types to grip, and gave a non-institutional feel to the facility.

Of the staff and community at Barrow Leslie comments "they are the ones that give patients hope. Life has changed for our family,…but it is not over, just a new beginning…one with new possibilities. Thanks to Barrow, Mike has a renewed self-esteem and self-independence." Speaking as the designer, it is so rewarding to be part of the design of a facility that fosters these kind of results.

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Lynnette is a senior associate in the Los Angeles office of Perkins+Will. She is a founding member of the American Academy of Healthcare Interior Designers and participates in the national leadership of the healthcare interiors practice at P+W. Projects she has been involved in include the Ronald Reagan UCLA Medical Center Replacement Hospital, City of Hope, and Johns Hopkins Hospital, and is currently working on the clinical skills scope of the Princess Nora University for Women in Riyadh, Saudi Arabia and the King Saud University Health Science Campus in Jeddah, Saudi Arabia.

Past installments of "Designing for Health" include (click on title to access the full article):
• Maximizing the Impact of Art in Architecture
• The Benefits of Healthcare Learning Environments
• Making Hospitals More Hospitable for Children and Their Families
• A Seat at the Table
• Healthcare Facilities Want You to Take Notice
• A Prescription to Go Paperless
• Peace and Quiet
• Research Informing Design
• Shifting Culture, Shifting Service Lines