Contract - Designing for Health: Workspaces for Well-being

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Designing for Health: Workspaces for Well-being

16 August, 2010

-By By Courtney Johnston & Brenda Smith


"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.

Staff well-being is vital to a company’s success, and in the healthcare industry, it is vital to a patient’s success in healing. Caregivers, especially nurses, often experience high levels of stress while caring for patients. Healthcare systems are recognizing that patient outcome can be linked to the stress on the staff, and therefore it is important to provide staff opportunities for respite and escape from their busy routines.

The observations of shared work processes developed by Ikujiro Nanako and Hirotaka Takeuchi in their book, The Knowledge-Creating Company, describe work modes as four models: Focusing, Collaborating, Learning, and Socializing. Each of the four modes is critical to knowledge-based work. For example, focused “head down” work is best accomplished in one’s own mental “zone,” while socializing aids in internalizing learned information and builds team trust. By designing flexible work options for differing work modes, the environment can improve both work outcomes and the staff’s sense of well-being.

Creating spaces with visual connectivity and flexibility for interaction encourages knowledge-sharing and team collaboration. Eliminating built barriers allows staff to read visual cues for patient care and promotes teaming. Designing areas for impromptu meetings supports communication. Providing quiet, off-stage spaces for “head down” work or for focused team interface aids in processing efforts. At Halifax Medical Center in Daytona Beach, Fla., the inpatient units advance these concepts. By breaking the programmatic components into those that require walls, transparent walls, half walls, and no walls, the project team created an open design and a less institutional feel. Transparent team rooms adjacent to nurse desks encourage focused collaboration and provide a space for quiet individual work processing. Low-height partitions shield equipment and supplies. The ability to see across the unit increases team communication. The adjacency of nurse stations, low-wall alcoves, and the teaming areas further improve the flexibility of the space and shorten travel distances by placing frequent processes and supplies close at hand.

While the built environment of a caregiving professional may contribute to an improved work experience, poor ergonomics and worksurface clutter could be considered physical detriments to workplace design for nursing staff. Co-author Brenda Smith worked in the nursing field prior to her career in design. Smith states, “By nature, nursing professionals are an accommodating and adaptable population. Many times I have witnessed staff independently manipulating their work environments to make them function, rather than requesting a modification. An example that comes to mind is of a wall-mounted computer charting station. In order to face the patient while charting, the staff modified the non-functioning keyboard trays with industrial grade Velcro rather than demanding better equipment. Utilizing components that are highly adaptable and intuitive provide staff a smarter and adaptable solution.” By providing for flexibility in individual work locations, each seat can become “the best seat in the house.” Equipping each seat with adjustable computer tools and paper storage systems allows staff to adjust the space for the task at hand, reducing physical stressors.

Several studies have linked healthy, sustainable environments as having positive effects on people in those spaces. Patients have had very positive results in hospital rooms with access to views and daylight, and now research is being used to support improvements to staff environments for positive effects on staff. In “Relationships Between Exterior Views and Nurse Stress: An Exploratory Examination” by Pati, Harvey, & Barach, (HERD, Winter 2008), the authors suggest that access to nature views and natural daylight for caregiving staff have direct and indirect effects on patient outcomes. Staff is focused intensely on patient care during their shifts, and the stress they experience can lead to errors and compromises in patient safety. Increasingly more healthcare facilities are adding upgrades to staff areas as a means to attract and sustain high-quality caregivers.

University Health System is currently planning a new bed tower addition and renovations to the main hospital campus in San Antonio. The project team is focused on creating a healing environment where anxiety and stress are reduced. Positive distraction will provide psychological relief for patients, visitors, and staff. Employing active and passive design strategies—such as a quality sense of arrival, dedicated staff spaces, both indoor and outdoor, and additional support programs—help encourage staff well-being.

“The well-being of our current and future staff is extremely important to University Health System. We want employees to feel a sense of pride in their place of work, and the program space we are adding to the hospital says something about our commitment not only to patients, but also to our staff that makes the care-giving possible. We hope to have added features and spaces that will make us competitive in attracting qualified employees and retaining them,” states Mark Webb, vice president for facilities development and project management for University Health System in San Antonio.

The expansive site will allow wellness programs to take advantage of the natural landscaping and vistas planned on the campus grounds. “‘Walk Wednesdays’ is a current staff walking program that we are excited to extend in the future. Staff will get to experience the various destinations along the path and the educational opportunities the site has to offer,” explains Leni Kirkman, vice president, strategic communications & patient relations for University Health Systems.

Upon arrival at the site, staff is afforded direct access to the hospital from the parking garage via a climate controlled pedestrian bridge. Circulation within staff corridors allows vistas to a dedicated staff roof garden that includes choices of seating, shade, and water features. The corridor includes dedicated coffee and vending stations. An additional roof garden planned for the top floor of the new bed tower will provide respite and calm for caregivers and visitors on the nursing floor.

Finally, additional staff amenities related to well-being are provided within each nursing unit. Staff lounges are strategically placed on the building perimeter to maximize daylight and provide expansive views to nature. Private spaces such as lactation rooms for nursing mothers and quiet rooms support the staff's individual needs.

The complexity and pace at which nurses must care for patients continue to increase as the number of nursing professionals decreases. These factors demand that healthcare designers continue to work for quality solutions for the best environments, escalating the importance of creating pleasant and functional spaces that help recruit and retain skilled caregiving professionals.

Courtney Johnston, RID, IIDA, LEED AP BD+C, is the Director of Design for the Interiors Studio of Perkins+Will, Dallas. She is responsible for managing the design process for projects and collaborating with other design disciplines for the best possible project solutions. Courtney’s experience includes healthcare, corporate and education projects.

Brenda Smith, RID, IIDA, LEED AP, is a Senior Associate at Perkins + Will, Atlanta. She leads the Interior Design Healthcare team for the Atlanta office.


References
"A Healthy Work Environment: It Begins With You" by Kupperschmidt, B., Kientz, E., Ward, J., Reinholz, B., OJIN: The Online Journal of Issues in Nursing, 2010

The Knowledge-Creating Company: How Japanese Companies Create the Dynamic of Innovation, by Ikujior Nanako and Horotaka Takeuchi, Copyright 1995, Oxford University Press

Steelcase 360 White Paper, “How the Workplace can Improve Collaboration”, June 2010, 360Steelcase.com

“Relationships Between Exterior Views and Nurse Stress: An Exploratory Examination” by Pati, Harvey, & Barach, HERD, Winter 2008

Past installments of "Designing for Health" include (click on title to access the full article):
The Cultural Differences of Latin American Countries and Their Desire for American Influence
Light and Its Role in Patient Safety
Research-Based Client Communication
An Urban Clinic—Connecting with the Community
Patient and Staff Safety in Behavioral Health Facilities
A Harmonious Companionship—Rejuvenating State-of-the-Art
Leading by Design – A Place to Flourish 




Designing for Health: Workspaces for Well-being

16 August, 2010


perkins+will

"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.

Staff well-being is vital to a company’s success, and in the healthcare industry, it is vital to a patient’s success in healing. Caregivers, especially nurses, often experience high levels of stress while caring for patients. Healthcare systems are recognizing that patient outcome can be linked to the stress on the staff, and therefore it is important to provide staff opportunities for respite and escape from their busy routines.

The observations of shared work processes developed by Ikujiro Nanako and Hirotaka Takeuchi in their book, The Knowledge-Creating Company, describe work modes as four models: Focusing, Collaborating, Learning, and Socializing. Each of the four modes is critical to knowledge-based work. For example, focused “head down” work is best accomplished in one’s own mental “zone,” while socializing aids in internalizing learned information and builds team trust. By designing flexible work options for differing work modes, the environment can improve both work outcomes and the staff’s sense of well-being.

Creating spaces with visual connectivity and flexibility for interaction encourages knowledge-sharing and team collaboration. Eliminating built barriers allows staff to read visual cues for patient care and promotes teaming. Designing areas for impromptu meetings supports communication. Providing quiet, off-stage spaces for “head down” work or for focused team interface aids in processing efforts. At Halifax Medical Center in Daytona Beach, Fla., the inpatient units advance these concepts. By breaking the programmatic components into those that require walls, transparent walls, half walls, and no walls, the project team created an open design and a less institutional feel. Transparent team rooms adjacent to nurse desks encourage focused collaboration and provide a space for quiet individual work processing. Low-height partitions shield equipment and supplies. The ability to see across the unit increases team communication. The adjacency of nurse stations, low-wall alcoves, and the teaming areas further improve the flexibility of the space and shorten travel distances by placing frequent processes and supplies close at hand.

While the built environment of a caregiving professional may contribute to an improved work experience, poor ergonomics and worksurface clutter could be considered physical detriments to workplace design for nursing staff. Co-author Brenda Smith worked in the nursing field prior to her career in design. Smith states, “By nature, nursing professionals are an accommodating and adaptable population. Many times I have witnessed staff independently manipulating their work environments to make them function, rather than requesting a modification. An example that comes to mind is of a wall-mounted computer charting station. In order to face the patient while charting, the staff modified the non-functioning keyboard trays with industrial grade Velcro rather than demanding better equipment. Utilizing components that are highly adaptable and intuitive provide staff a smarter and adaptable solution.” By providing for flexibility in individual work locations, each seat can become “the best seat in the house.” Equipping each seat with adjustable computer tools and paper storage systems allows staff to adjust the space for the task at hand, reducing physical stressors.

Several studies have linked healthy, sustainable environments as having positive effects on people in those spaces. Patients have had very positive results in hospital rooms with access to views and daylight, and now research is being used to support improvements to staff environments for positive effects on staff. In “Relationships Between Exterior Views and Nurse Stress: An Exploratory Examination” by Pati, Harvey, & Barach, (HERD, Winter 2008), the authors suggest that access to nature views and natural daylight for caregiving staff have direct and indirect effects on patient outcomes. Staff is focused intensely on patient care during their shifts, and the stress they experience can lead to errors and compromises in patient safety. Increasingly more healthcare facilities are adding upgrades to staff areas as a means to attract and sustain high-quality caregivers.

University Health System is currently planning a new bed tower addition and renovations to the main hospital campus in San Antonio. The project team is focused on creating a healing environment where anxiety and stress are reduced. Positive distraction will provide psychological relief for patients, visitors, and staff. Employing active and passive design strategies—such as a quality sense of arrival, dedicated staff spaces, both indoor and outdoor, and additional support programs—help encourage staff well-being.

“The well-being of our current and future staff is extremely important to University Health System. We want employees to feel a sense of pride in their place of work, and the program space we are adding to the hospital says something about our commitment not only to patients, but also to our staff that makes the care-giving possible. We hope to have added features and spaces that will make us competitive in attracting qualified employees and retaining them,” states Mark Webb, vice president for facilities development and project management for University Health System in San Antonio.

The expansive site will allow wellness programs to take advantage of the natural landscaping and vistas planned on the campus grounds. “‘Walk Wednesdays’ is a current staff walking program that we are excited to extend in the future. Staff will get to experience the various destinations along the path and the educational opportunities the site has to offer,” explains Leni Kirkman, vice president, strategic communications & patient relations for University Health Systems.

Upon arrival at the site, staff is afforded direct access to the hospital from the parking garage via a climate controlled pedestrian bridge. Circulation within staff corridors allows vistas to a dedicated staff roof garden that includes choices of seating, shade, and water features. The corridor includes dedicated coffee and vending stations. An additional roof garden planned for the top floor of the new bed tower will provide respite and calm for caregivers and visitors on the nursing floor.

Finally, additional staff amenities related to well-being are provided within each nursing unit. Staff lounges are strategically placed on the building perimeter to maximize daylight and provide expansive views to nature. Private spaces such as lactation rooms for nursing mothers and quiet rooms support the staff's individual needs.

The complexity and pace at which nurses must care for patients continue to increase as the number of nursing professionals decreases. These factors demand that healthcare designers continue to work for quality solutions for the best environments, escalating the importance of creating pleasant and functional spaces that help recruit and retain skilled caregiving professionals.

Courtney Johnston, RID, IIDA, LEED AP BD+C, is the Director of Design for the Interiors Studio of Perkins+Will, Dallas. She is responsible for managing the design process for projects and collaborating with other design disciplines for the best possible project solutions. Courtney’s experience includes healthcare, corporate and education projects.

Brenda Smith, RID, IIDA, LEED AP, is a Senior Associate at Perkins + Will, Atlanta. She leads the Interior Design Healthcare team for the Atlanta office.


References
"A Healthy Work Environment: It Begins With You" by Kupperschmidt, B., Kientz, E., Ward, J., Reinholz, B., OJIN: The Online Journal of Issues in Nursing, 2010

The Knowledge-Creating Company: How Japanese Companies Create the Dynamic of Innovation, by Ikujior Nanako and Horotaka Takeuchi, Copyright 1995, Oxford University Press

Steelcase 360 White Paper, “How the Workplace can Improve Collaboration”, June 2010, 360Steelcase.com

“Relationships Between Exterior Views and Nurse Stress: An Exploratory Examination” by Pati, Harvey, & Barach, HERD, Winter 2008

Past installments of "Designing for Health" include (click on title to access the full article):
The Cultural Differences of Latin American Countries and Their Desire for American Influence
Light and Its Role in Patient Safety
Research-Based Client Communication
An Urban Clinic—Connecting with the Community
Patient and Staff Safety in Behavioral Health Facilities
A Harmonious Companionship—Rejuvenating State-of-the-Art
Leading by Design – A Place to Flourish 

 


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