For the past 25 years, healthcare facilities have been evolving away from the harsh, cold, nondescript institutions of the 1950s, ’60s, and ’70s, where patients were treated as widgets on an assembly line rather than as individuals. The focus was on sterility, process, and efficiency, with little thought given as to how the patient perceived the experience. In contrast, today’s “best of class” surgery centers realize the importance of enhancing the patient experience and creating an environment of care without compromising the efficiency of the design.

The key feature and consideration in designing a surgery center that evokes an atmosphere of care is to create an environment that helps to empower the patient and give them a sense of control over their surroundings. Every factor discussed in this article ties back into this primary concept.

Historically, patients were numbers waiting to be processed. They didn’t understand the surgical processes, had no idea of what to expect, and felt that their fate was completely out of their hands. Such a sense of powerlessness greatly increases the level of anxiety and frustration for a patient. To put it in perspective, consider the fate of a passenger on a commercial flight that has been delayed on the tarmac. We’ve all been there. You’re expected to wait for long periods of time without being informed of the reason for the delay, the possible time frame for repairing the problem, or whether there is a need to reschedule connecting flights. Aggravating, isn’t it? The situation is the same for patients who aren’t receiving adequate information during their time in your surgery center. By thoroughly explaining the steps that the patient will encounter during a procedure and notifying them of any delays or schedule changes, the patient understands the process, knows what to expect, and feels more calm and in control.

To stick with the same analogy, let’s consider something that the airlines did right: provide individual reading lights and cool air jets at each chair. Such seemingly minor considerations and attention to detail can also have a huge impact in surgery centers. Take lighting, for example. The typical lighting design for a surgery center consists of light fixtures that fit into the ceiling and shine directly down on the patient, creating an environment similar to a police interrogation room. Instead, use wall sconces or light fixtures that shine up onto the ceiling and reflect down to provide a softer, diffuse light that eliminates glare and harsh shadows. Maintain a low level of ambient light in the pre-op stations, post-op stations, and reception rooms. Supplement this with task lighting that can be controlled by the patient (and, of course, by the nurses as necessary). The benefit is twofold. The overall low level of light helps to create a calming atmosphere, while the individual task lighting empowers patients by giving them a sense of control over their immediate environment.

Further patient environmental control can be achieved by incorporating individual thermostat controls in private patient rooms, or small wall-mounted fans in open cubicles where individual thermostat controls are not an option.

Use of natural materials on both the exterior and interior of the building also provide a psychological boost that enhances the patient experience. Research has shown that exposure to elements such as stone, wood, fire, water and foliage immediately lowers stress levels.

Hospitals of the past were the atmospheric equivalent of the polyester leisure suit, composed of few materials that any visitor could describe as remotely natural. Today’s “best of class” surgery centers recognize the benefit of utilizing wood, stone, slate, ceramic tile, water features, and live plants. In spaces where function has to trump form and use of natural materials is not an option (such as operating rooms, pre-op, and post-op areas), it is best to utilize warm colors and natural or color-corrected lighting to help create a comforting environment.

Additionally, windows and skylights are proven to have a calming effect on patients, providing high-quality natural light and decreasing feelings of isolation by giving patients a view to the outdoors and a sense of connection to the world beyond the surgery center. Large glass walls or prominent skylights also function as orientation landmarks that patients subconsciously use to maintain their sense of direction in an unfamiliar environment.

Many of today’s surgery centers are located in one-story buildings measuring less than 30,000 square feet. This smaller, less intimidating scale plays a role in decreasing patient anxiety, especially when compared to the overwhelming scale of many urban hospitals.

However, the closer quarters can lead to acoustical and visual privacy issues that are sometimes overlooked when designing a surgery center. From a functional standpoint, the ideal layout for a pre-op and post-op room is a donut shape with the nurse station in the center, surrounded by pre-op and post-op cubicles. The arrangement allows one nurse to have a clear line of sight and quick access to each cubicle, but this efficiency compromises patient privacy.

From a patient’s point of view, the ideal layout would be private rooms. This, in turn, conflicts with the functional needs of the nursing staff. Full-height walls between each cubicle are also impractical because design guidelines require a full four feet of clearance between the recovery bed and a solid wall (as opposed to two-and-a-half feet between a bed and a cubicle curtain).

The ideal compromise is to maintain the donut layout with the nurse station in the middle; however, rather than surrounding the central hub with open cubicles, group every three to four cubicles into alcoves that are separated from the other cubicle alcoves with a full-height wall. Cubicles within each alcove are still separated only by cubicle curtains. However, the shared full-height wall helps to provide a greater measure of acoustic and visual privacy without compromising access for the staff. The privacy afforded by the full-height wall can be complemented by white-noise generators to help mask background noise.

With the choices available to today’s patients, it’s more important now than ever to separate your surgery center from the competition. By taking the time to embrace design features that are sensitive to patient needs and psychology, you will enhance your patient’s experience and establish your center as a true "best of class" facility. 

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