Facilitate Friendly Design for Your ASC

By Jennifer Schraag

Patients can only be as comfortable as they feel in their surroundings. With impending medical procedures and the accompanying anxiety they bring, a friendly design can be an ASC’s advocate to a peaceful, positive experience for its patients.

Patients perceive sustainable healthcare environments to be supportive of their health and recovery.¹ Richard Barnett, president of Newton, Mass.-based MCMUSA Inc., points out that patients are in various stages of mental and physical condition when they enter an ASC. They may be in pain, they may feel ill, and they often feel some level of anxiety of what is to come during their time at the center. The ability to walk into an ASC and feel “at home” can make all the difference in both the patient’s anxiety level as well as their ultimate outcome.

“Healthcare design should not look clinical, but rather comfortable,” asserts Barnett. “Often not given proper consideration in design, is the perspective of the patient. For example, what does the patient see when they are being transported on a stretcher or when they are in a recovery station? Consider the ceiling and lighting. In addition, more thought should be given to patient privacy from extraneous noise and conversation.”

Bill Witherspoon, founder and president of Fairfield, Iowa-based The Sky Factory, LLC, agrees, adding, “Consider how much time your patients spend as captive observers of ceilings. The ceiling is where their attention is directed during the most crucial periods of their healthcare experience. A patient-friendly design establishes environments that create an experience conducive to healing. In general, consider every aspect of the environment that is touched by the patient’s senses. How can every element be designed to make a positive contribution to the healing process,” he asks.

Witherspoon says the answer is simple: nature. “Results from thousands of patient satisfaction surveys tell us: I want nature. I want the beauty and truth of the natural world and I want the care and compassion that is part of human nature. This is truly the core of the environmental message – stay in tune with the deep structures and processes of nature,” he says.

Barnett advises the correct usage of light as one remedy to good design that includes nature. “Windows in spaces that are immediately adjacent to exterior walls provide daylight to those spaces only,” he points out. “There are numerous methods of seeing daylight from within a building such as skylights, borrower light where a person sees daylight from an internal space through a space on the exterior wall, and having long corridors end at an exterior wall with a window.

Additional aspects to consider in designing an ASC include artificial lighting, HVAC systems, and of course interior design. Design should be flexible, according to Barnett. He points out additional aspects to be considered. “They include, but are not limited to, easily maintained finishes, way finding, plants, etc.,” he says. “Waiting room seating should be designed for conversation in lieu of the ‘bus terminal’ arrangement. Both natural and artificial light will have a significant effect on patients. More consideration should also be given to the selection of interior colors and materials. Way finding should be simplified and be consistent both for interior and exterior. Lastly, as much as the square footage of an area is important, the height should be designed in proportion to the length and width.”

Additional suggestions to consider in healthcare design include:² 

• Accessibility and mobility 
• Ground and landscape designs 
• Social and public spaces 
• Homeliness and assurance 
• Cultural diversity 
• Safety and security 
• Personal space and access to outside 
• Quality of the ward design 
• State and quality of personal space 
• Facilities for recreation and leisure 

Limitation of private space around the bed area, privacy and dignity support, and noise and other disturbances are among the top concerns voiced by patients. Overall, home-like environments that support normal lifestyle and family functioning, as well as designs that are supportive of accessibility and travel movements through transitional spaces, are imperative considerations when planning the design of a healthcare facility.

Incorporating features meant to mitigate the stressful nature of serious illness have proven successful in the comfort and well being of patients. Ambient features such as soft lighting, water features, or healing gardens all are helpful and research has shown that such features can in fact have positive effects on patients by reducing stress and speeding physical healing.² Design also impacts staff satisfaction.

Building a business case for better, friendlier, more efficient buildings can be achieved by simply doing a little homework. Efficient, patient- and environmentally-friendly design is a key component to better, safer, and less wasteful healthcare.³ According to a Texas A&M University study, evidence indicates that the one-time incremental costs of designing and building optimal facilities can be quickly repaid through operational savings and increased revenue. The Texas researchers went on to conclude that such friendly designs result in “substantial, measurable, and sustainable financial benefits.”

Furthermore, “green building” can be incorporated into a healthcare facility design relatively easily. Witherspoon says green building implies two things: a building that is built according to principals of sustainability and a building that respects and elicits respect from its occupants for a dynamic balance between human and planetary life.

Barnett says some of the more fundamental aspects of green building design include:

• For the site and landscape: consider water retention and reuse, a planted roof, permeable site materials such as dry brick paving instead of bituminous paving.
• For the building: consider high performance and operable windows, water efficient fixtures, efficient and flexible mechanical and electrical systems.

Bringing nature into the healthcare environment is vital. Witherspoon says he strongly advises the integration of the balancing, refreshing, and healing qualities of nature – whether real or illusory – into new ASC designs. “Consider the amount of time spent looking at the ceiling or a portion of wall,” he contends. “Remember what your patients see and feel and the impact of the ‘last’ image and experience before conscious awareness is lost to anesthesia.” 

References:

1. Douglas CH, Douglas MR. Patient-centred improvements in health-care built environments: perspectives and design indicators. Health Expect. 2005 Sep;8(3):264-76.

2. Mroczek J, et al. Hospital design and staff perceptions: an exploratory analysis. Health Care Manag (Frederick). 2005 Jul-Sep;24(3):233-44.

3. Berry LL,et al. The business case for better buildings. Front Health Serv Manage. 2004 Fall;21(1):3-24. “Consider how much time your patients spend as captive observers of ceilings.” — Bill Witherspoon, The Sky Factory, LLC

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