"Designing for Health" is a monthly, web-exclusive series from the healthcare interior design leaders at Perkins+Will that focuses on the issues, trends, challenges, and research involved in crafting today's healing environments.
A most satisfying result of the design process is experiencing people joyfully occupying spaces; ones that inspire and delight. In the inpatient setting, understanding and celebrating the positive impact of aesthetics and beauty can be overshadowed by functional drivers that dictate extreme durability and easily-maintained, orderly spaces.
But, what if aesthetics and beauty were held as the
highest priority in the design of healthcare? That the pragmatic needs for durability and maintenance ease would be achieved without compromise
to the visual impact?
It can be daunting to find healthcare-appropriate furnishings that achieve high aesthetic goals and meet maintenance, durability, flame spread codes, ergonomics, and healthcare-functional need. It can be equally difficult to find beautiful, healthy-content upholstery materials that stand up to the harsh cleansers used to fight infection. Often, practical facility-drivers trump visual impact.
According to Teri Lura Bennett RN, CID, IIDA, Johns Hopkins Health System Lead Interior Designer, “The industry has made great improvements in offering more fabric options which are pre-certified to provide Nanotex, Crypton , Durablock & CAL TB 133 options. It will continue to be a challenge to offer non-vinyl options, but as the fabric industry provides more viable fabric solutions we can implement these to achieve the most desirable effect.”
At the new 1.6 million square foot Johns Hopkins Hospital (JHH), Sheikh Zayed Tower and Charlotte R. Bloomberg Children’s Center, in Baltimore, Maryland, the client and donor held aspirations for a new facility that would be "uplifting, welcoming and joyful," a place where families would be able to sit together, where children could curl up next to a parent, where one would be comfortable for long periods of time. The new facility would serve as inpatient towers and the new campus front door to this renowned institution.
In response, the team focused on creating an institutional identity and civic presence in East Baltimore that was carefully crafted in tandem with a compassionate care environment. Art commissions led by Nancy Rosen, Curator, were envisioned to be the highlight of the patient and family experience throughout. Bold, sculptural and colorful furnishings were selected to complement and coexist in the modern, light and art-filled interiors.
Color design was employed to create distinct identities for departments in the large, complex facility, and a large palette of upholstery was required to achieve this vision. The Perkins+Will design team, working closely with the Johns Hopkins Facilities department, strategized that the path to success would be through testing of furniture by caregivers and patients and by accepting and working within reality of the JHH Environmental Services department’s parameters. This included bleach for patient care surfaces and hydrogen peroxide purge systems. The team sourced a wide range of appropriate products for testing.
Per Ms. Bennett; “More and more I see products where simple cleaning methods will do the job. Proprietary cleaning products are a deal breaker as the designer has limited authority to prescribe specialty products to be used on any specific item. Operationally, it needs to be a simple solution.”
Specifically, to test upholstery performance, one-yard samples were selected for fiber content and wear-ability, in a range of bold color and pattern, and if appropriate, were treated with stain or moisture barrier (Crypton, Nanotex, Durablock). These were then “stained” with the hospital’s most prevalent offenders, for example; ink, soda, coffee, then were left to “set” for a few days. The JHH Environmental Services department was then asked to clean these using typical products and protocols and products already in use at the hospital. Afterwards, samples were assessed by Teri Lura Bennett and her team. Only fabrics passing the test were considered as upholstery options for the richly-colored interior palettes.
To test furniture pieces, samples were tested in the existing hospital for ease of use and ergonomics. Items intended for use in public as well as patient rooms were analyzed. Feedback from patients, families, and nursing staff was solicited.
Some furnishings were modified to better suit the healthcare setting, for example, Allermuir “Lola” Chair samples were mocked up with fabric treated with Durablock which required additional topstitching for some items. Frames of some waiting chairs were specified to be reinforced for 350 pounds instead of industry-standard 250 lbs. for use in waiting rooms.
Some atypical healthcare solutions resulted from the process; Vladimir Kagan Couture pieces were specified in the Children’s Lobby and upholstered in Nanotex-treated Kvadrat wool upholstery in a range of blues and violet. Cappelini “And” sculptural seating designed by Fabio Novembre delights in bright red. In the Adult Lobby arc-shaped “Plus” sofa by Inno orients visitors towards the garden. These and Coalesse “Bob” chairs are adorned in Edelman custom-colored, custom-textured, Crypton-treated leather in variations of green and Brayton polyurethane.
In high-performance care areas, Willow Tex "IZIT Leather," polyurethane-faced upholstery, has been a solid performer. It’s used throughout the inpatient towers, in both blue and a light neutral, even in nurse work areas and in patient rooms.
An important factor to consider is that institutional installations must be designed with a long view. Products often become part of standards packages throughout. Savvy manufacturers partner with their customers for the long term – beyond the initial “sale” - as institutions commit tremendous resources to these products and need for them to hold up. Manufacturers who do make this commitment create enduring, positive relationships with designers and institutions.
The overall vision has been positively received; per Ms. Bennett, “Everyone seems to now appreciate the new look and colors. Comfort is achieved. Flexibility in layouts is apparent, though as a designer I have had to let go of my preferred layouts. We will work with our user groups to find a middle ground. It reminds me of when landscapers install paved paths on campuses, and then the reality of where those paths need to be asserts itself.”
Carolyn BaRoss, ASID, IIDA, LEED AP, is a Principal with the New York office of Perkins+Will. Her focus for over 20 years has been the creation of healing environments. She led the interior design for the new Johns Hopkins Hospital. Carolyn can be reached at firstname.lastname@example.org