Designing from the Hospital Bed

As David M. Schwarz Architects embarks on the master planning and design of yet another significant phase of Cook Children’s Medical Center in Fort Worth, Tex. – a project we’ve been allied with since 1985 –DMSAS principal Craig Williams shares with his colleagues the musings accumulated during a collection of summertime hospital visits.  While this patient is hardly a child, some of these considerations are nonetheless applicable.

Celebrate connections.  As an architecture firm grounded as designers of community, it’s important to understand that hospitals are communities in and of themselves.  Yet few medical centers are designed to highlight that fact, or build on the healing benefits of creative communities.  In most medical institutions, the mental good-will achieved by relating to and finding comfort in your neighbors isn’t always a priority.

Contributing to this is the semi-private room, which not only robs you of privacy, but stifles communication in the attempt to offer some semblance of privacy to a roommate.  It also separates the inboard patient from the documented healing properties of natural light.

While not always financially viable, hospitals should be designed around right-sized private rooms with public spaces thoughtfully planned for gathering people together as a community, rather than an afterthought tucked into an unutilized corner, where visitors talk in hushed tones instead of interacting freely with one another.

Circulate.  For patients in recovery, the best advice is to get up and take your I-V drip pole dance partner for a walk.  Hospital planners should avoid dead-end corridors, and create circles for perambulating around rather than pacing back and forth.

And while you’re circulating, there must be a better solution to the hospital HVAC dilemma.  While operating suites must necessarily be kept very cold, the warm blanket thrown over the patient eventually grows cool.  Even in patient rooms, individual controls for heating and cooling are a must.  And can’t we do something about that disinfectant smell?

Design matters.  To a design professional, nothing is more frustrating than the haphazard placement of everything that comes after the architect and contractor have left.  Those responsible for plopping down everything from hand sanitizer dispensers to hazardous waste buckets seem constitutionally incapable of aligning things horizontally or vertically.  (Shouldn’t there be an in-house director of design to defeat such atrocities against mankind?)  When staring at the walls, even the patient without design sensibility deserves thoughtful attention to such elements as order and color

Graphics and wayfinding are more important for visitors than patients, but the fact that much of the hospital interior is off-limits to the public shouldn’t mean an absence of design awareness.  If you’re being pushed on your back on a gurney, your surroundings shouldn’t look more like a jail than a place of care and healing.

And in operating rooms and surgical units, wouldn’t it be wonderful to play up the geekdom of all those way cool robots and mysterious high-tech machines? The techno geek in this patient would find a state-of-the-art playground infinitely helpful in offsetting anxiety.  At the same time, whether in patient rooms or corridors, the necessities of technology from gas tanks to oxygen tubes should be hidden from view.

What about food?  Granted this may not be within the design professionals’ purview, but the medical community still hasn’t figured out food service.  The business of food and communal eating – another basic tenet of civilization — ought to be given more thought as a support to healing and a slightly more pleasant moment out of an otherwise unpleasant experience.

To compete effectively, many hospitals, rather than presenting TV dinner-style tray, now offer a “room service” a la carte menu. With the increase in the labor burden, the quality of food suffers in respect for the bottom line. And in some cases, the meals are downright unhealthy – with ingredient labels that would read like a toxic waste dump.

Design for health.  In a place where people generally are not at their best, even small details count.  The location of windows, the design and control of air flow, the overall environmental design – every factor is important to those who matter most inside a medical center’s walls. So thanks for taking note of one architect’s thoughts on placemaking where, in this one rare case, we’re hoping you never get to experience the design excellence.

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