1
tools to improve the quality of interior environments Interior design is a key aspect of design for health and wellness. In fact, understood holistically to include the organisation, shaping and elaboration of internal space, it is arguably more crucial to the experience of all users than any other aspect of physical design. Over the last 20 years interior design has moved rapidly from perfunctory and formulaic spatial decoration to sophisticated shaping of perception and mood, not unlike what can be found in some of the best contemporary hospitality designs. engaging interiors designing successful communities in healthcare buildings BASE MATERIAL PALETTE Metal Ceiling Integrated Acoustical Ceiling Wood Ceiling Solid Surface Laminate Wood Panels Porcelain Wall Tile Resilient Flooring Porcelain Slab Flooring Bonded Metal Textured Porcelain Wall Tile Antique Bronze Metal Resin Panel Wall Decorative Glass Solid Surface Wall Panels Textured Wall Covering High Performance Textured Panels Textured Textiles Back Painted Glass Printed Glass Fabric Wrapped Acoustical Panels TEXTURE design challenges in the healthcare interior One of the biggest challenges for the hospital designer is the size and scale of a project. Large hospitals share some similarities with small towns - different people with different purpose move daily, stay for diagnostic and treatment or work in the building. The challenge is to direct and streamline the flows of different users and to create successful communities for the different constituents occupying the building. Therefore, the consideration of the “town planning aspects” of the design is key for a successful interior architecture of large hospital buildings. Scale and massing Different user communities When designing healthcare facilities it is important that designers base their design decisions on credible evidence-based research to achieve the best possible results. patients & visitors general public Patients and visitors come to a facility for a period of time and then leave. This aspect of "forced tourism" is the main characteristic of the patient and visitor group. In the late 1990s the UK Department of Health implemented the concept of "the patient as a consumer" – a trend emanating from the US healthcare system. This health consumerism was an acknowledgment that a patient had the right to a good quality experience when in hospital. It resulted in the allocation of upliſted budgets for enhanced interiors and additional space - social spaces in bedrooms for example. Within the space of 15 years, the UK has seen interior design progress from the adornment of space to the shaping of experience. The design for the patient community requires the following considerations: • Positive influences on the emotional state of patients and visitors de-stress, inform, reassure, stimulate • Clear wayfinding • Integration of patient and family • Respect of cultural values when designing in different countries or for different ethnic groups Hospitals are workplaces for hundreds of staff, who either work in the building or visit it for educational purposes. As such, good interior design for hospitals should consider the trends of modern workspace design: flexibility, connectivity, ergonomics Well-designed amenities for staff are an important factor in the recruitment and retention of qualified professionals. The main design features to consider are: • Acoustic privacy • Connectivity - visual and physical • Formal / Informal meeting spaces • Ergonomics • Touch-down workstations • Elements which upliſt the spirit Designing to accommodate the local community can create a hospital which becomes a destination in itself. Increasingly, large hospitals are attracting people through their public amenities - good shops, cafés, salons, cinemas, education, landscaped gardens and art programmes give locals a reason to visit the hospital even when they are well. Clear wayfinding and the creation of security and privacy boundaries through the careful location of public amenities are important aspects of the hospital design. Evidence-based design Palette Spatial organisation Art At its core every project requires a clear vision and a strong organising design concept that is seamlessly integrated within its context and breadth of that context. By the design of large hospitals it is important to create from the beginning a clear spatial organisation through: 2. A constellation of landmarks physicians, carers administrators researchers students Bridgepoint Active Healthcare Redevelopment (Diamond Schmitt / HDR / KPMB / Stantec) A material palette has to work for each facility. A base neutral palette can be a unifying factor across the various interior spaces, from public to back-of-house areas, and from patient treatment to staff work areas. The base palette should be: Limited for easy maintenance Durable for longevity and saving cost Cleanable for patient safety Additional accent colour palettes and specialty materials and textures can provide unexpected splashes of colour and interesting elements to create a hospitality environment in a clinical setting. Further aspects to be considered by the material and finishes selection are: • Cultural sensitivity and appropriateness • Local and regional sourcing of materials • Human health / reduced toxicity in materials • Evidence-based design • Sustainability 1. The creation of hierarchies Establishing key space categories provides an organisational system for addressing the quantity and variety of spaces within a large and complex building. 3. The integration of interior design with clinical planning Simple organisational diagram of circulation and key landmark spaces at NCCCR (leſt) Hierarchy of scale Humanising clinical areas Minimising the impact of major medical equipment Calming clutter Integration of functionally-required items into the interior architecture On-stage & off-stage design Just as successful city and campus planning rely on the development of iconic centres for each zone or neighbourhood, we must create similar emotional “heart spaces” to anchor key areas both for staff and physicians as well as for patients and families. In recognition of the very human need for variety, the concept for a successful interior is the development of a variety of landmarks. Variety is the antidote to the institutional; it provides physical and emotional relief and is a key component for inherent wayfinding. Integrated art and activities in the waiting area of Hospital for Sick Kids Emergency Department (Stantec) Separation of public-patient zones from staff zones to safeguard privacy Lynn Befu Velimira Drummer Connections to nature Access to the exterior and natural environment has been proven to accelerate the healing processes. Important considerations are: • Access to filtered natural light and external views • Visual connection to sky, water and nature • Patient circulation routes with natural light L0 Entry Foyer L1 Piano Nobile Concourse L2 Meditation Path around Courtyard L3 Auditorium L3/L4 2-Storey Interactive Staff Zone Staff Collaboration Zone Hospitality Suite Personal Pockets L4/L5/L6/L7 L1 Infusion Cabins Are we basing design decisions on trustworthy sources of the most up-to-date evidence as it relates to the project? Do we have a process to prioritise design principles based upon the best available research, client goals and objectives? Do we pro-actively work with health system clients to apply EBD concepts, hypothesise expected outcomes? Does our organisation collect baseline performance metrics, evaluate the impact of design post-occupancy? Goal: Evaluate Available Research Goal: Add to the Body of Knowledge Process for Evidence-Based Design Correctness Prioritisation Implementation Assessment Teaching hub at Edmonton North Clinic (HOK / Stantec) Large-scale public atrium at Leeds Cancer Centre (Stantec) Home-like scale patient bedroom at NCCCR (Stantec) Research has shown that the arts have the capacity to produce positive health outcomes. Evidence for art as a healing modality includes not only the visual arts, but also music and performance, media and interactive art, and art therapy in which patients, family and staff benefit from the participation in creative expression. The arts are a counterbalance to the stress-creating aspects of a medical environment; they provide opportunities for respite, make spaces more personal, and add elements of discovery and delight. They are also a key component in creating a culturally relevant environment in a building driven by international standards. Art is considered on a number of levels: architecturally integrated art; commissioned art; and therapeutic art created by and for patients. Landmark entrance hall at Naufar Wellness and Recovery Centre (Stantec) Providence Cancer Centre (Stantec) Lutherwood Children's Mental Health Centre (Stantec) New Cancer Centre at Guy's Hospital (RSHP/Stantec) Creating a visual dialogue between inside spaces and nature at Meyer Children's Hospital (CSPE / Stantec) (c)2014 The Advisory Board Company Activity wall in the waiting area of The Hospital for Sick Kids Haematology Department (Stantec)
