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HEALING SPACES TO PROMOTE WELL-BEING
HEALING SPACES TO SUPPORT WELL-BEING
Presented by:Karen Wendt, MA, RN, PHN, Program Director, Child/Adolescent Mental HealthUniversity of Minnesota Health, University of Minnesota Health, University of Minnesota Health, University of Minnesota Health, Children’s HospitalChildren’s HospitalChildren’s HospitalChildren’s Hospital
Rick Dahl, AIA, PrincipalBWBRBWBRBWBRBWBR HEALING SPACES TO PROMOTE WELL-BEING
� Unique Issues of Mental Health Design
� Concepts for Inspiration
� Strategies for Mental Health Design
� Does it Make a Difference?
– Case Study: University of Minnesota Children’s Hospital
� Takeaways: 8 Action Items for Tomorrow
� Q&A
PRESENTATION OUTLINE
HEALING SPACES TO PROMOTE WELL-BEING
DESIGNING FOR BEHAVIORAL/MENTAL HEALTHUnique Issues of Mental Health Design Unique Issues of Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
physical
emotional
Unique Issues of Mental Health Design Unique Issues of Mental Health Design
Emotional: Agitated, angry, isolated, frightened, depressed, lonely, denial, confused, anxious
Physical: Frozen, violent, destructive, unsafe, cold, tired, fatigued, hyper-sensitive, dehydrated
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HEALING SPACES TO PROMOTE WELL-BEING
nature
calm, quiet
Concepts for InspirationConcepts for Inspiration
HEALING SPACES TO PROMOTE WELL-BEING
transitions
places of negotiation
Concepts for InspirationConcepts for Inspiration
HEALING SPACES TO PROMOTE WELL-BEING
prayer, meditation
inner journey, discovery
Concepts for InspirationConcepts for Inspiration
HEALING SPACES TO PROMOTE WELL-BEING
foster communication
inviting
Concepts for InspirationConcepts for Inspiration
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HEALING SPACES TO PROMOTE WELL-BEING
safe, planned
Concepts for InspirationConcepts for Inspiration
sense of scale
HEALING SPACES TO PROMOTE WELL-BEING
Create transformative environments that encourage health and wellness… and patients will respond.
DESIGN
PLANNING
OPERATIONS/CARE MODEL
CULTURAL/CARE TEAM
Strategies for Mental Health DesignStrategies for Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
Additional Patient Room Features
CHALKBOARDS
SENTINEL EVENT BATHROOM DOORS
INTEGRAL PATIENT ROOM DOOR BLINDS
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HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
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HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
Strategies for Mental Health DesignStrategies for Mental Health Design
HEALING SPACES TO PROMOTE WELL-BEING
“does space matter?”
� Literature Review
� Staff Surveys
� Staff Interviews
� Patient Exit Interviews
Case StudyCase Study
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HEALING SPACES TO PROMOTE WELL-BEING
research questions
� Among patients hospitalized on a child-
adolescent mental health unit, which
environmental characteristics contribute most
to patients feeling calm?
� How does the design influence staff
perceptions of the environment and its
influence on patient behavior?
� In addition, this exploratory case study will
begin the process of validation for new
measurement tools.
Case StudyCase Study
HEALING SPACES TO PROMOTE WELL-BEING
literature review
� 142 articles reviewed
� Between 1984 and 2013
� 57 were specific to child-adolescent mental health� Over half were 10 or more years old
� This population is underrepresentedin the literature
Case StudyCase Study
HEALING SPACES TO PROMOTE WELL-BEING
staff surveys
� Email invitation (75 staff)
� 52 responses
� 70.6% response rate
� Likert-scale questions with open-ended questions
Case StudyCase Study
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
Job RolePsychiatric Associate 44%Physician 4%RN 38%CTC 8%Clinical Rehab 6%
Unit7A 45%7ITC 28%Both 21%N/A 6%
Primary ShiftDays 55%Evenings 34%Nights 11%
9%
26%
38%
15%
6%6%
5 months or less5 months – 1 year1 year – 5 years5 – 10 years10 – 20 yearsOver 20 years
DEMOGRAPHICS
How long have you been working on this unit?
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HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
78%
STAFFSTAFFSTAFFSTAFFATTITUDESATTITUDESATTITUDESATTITUDES
responses for very positive or somewhat positive for the environment’s impact on
“It’s a brighter place to work – makes me happy to be here…”
“…appreciate the brightness and calm therapeutic environment…”
2%
14%
6%
61%
17%
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
86%
STAFFSTAFFSTAFFSTAFF INTERACTIONSINTERACTIONSINTERACTIONSINTERACTIONSWITHWITHWITHWITH PATIENTSPATIENTSPATIENTSPATIENTS
responses for very positive or somewhat positive for the environment’s impact on
“The environment contributes to calming the patients.”
“The new unit is something to be proud of and that can ‘rub off’ on the patients.”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
10% 4%
48%
38%
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
60%
STAFFSTAFFSTAFFSTAFF INTERACTIONSINTERACTIONSINTERACTIONSINTERACTIONSWITHWITHWITHWITH COWORKERSCOWORKERSCOWORKERSCOWORKERS
responses for very positive or somewhat positive for the environment’s impact on
“Better for coordination and collaborative team work. Better places to share confidential information.”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
2%
17%
21%
36%
24%
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
81%
STAFFSTAFFSTAFFSTAFF FEELINGFEELINGFEELINGFEELING CALMCALMCALMCALM
responses for very positive or somewhat positive for the artwork and colors impact on
“Very, very lovely, calming, and healthy emotionally.”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
2% 0%
17%
44%
37%
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HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
75%
SENSESENSESENSESENSE OFOFOFOF FEELINGFEELINGFEELINGFEELINGSAFESAFESAFESAFE ATATATAT WORKWORKWORKWORK
responses for very positive or somewhat positive for the safety features impact on
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
2% 4%
19%
44%
31%
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
75%
ABILITYABILITYABILITYABILITY TOTOTOTO KEEPKEEPKEEPKEEPPATIENTSPATIENTSPATIENTSPATIENTS SAFESAFESAFESAFE
responses for very positive or somewhat positive for the sentinel event prevention bathrooms impact on
“Not having to check for locked bathrooms allows staff to be more present in the milieu.”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
2%
23%
28%
47%
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
4%
2%
26%
68%
94%
WELCOMINGWELCOMINGWELCOMINGWELCOMINGFAMILIESFAMILIESFAMILIESFAMILIES
responses for very positive or somewhat positive for the environment’s impact on
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
“Parents and patients are impressed”
“Parents love it and feel very comfortable leaving their child on the unit once they have had a tour.”
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
6%
13%
35%
46%
81%
STAFF INTERACTIONS STAFF INTERACTIONS STAFF INTERACTIONS STAFF INTERACTIONS WITH FAMILIESWITH FAMILIESWITH FAMILIESWITH FAMILIES
responses for very positive or somewhat positive for environment’s impact on
STAFF SURVEY RESULTS
“Families share their feelings of safety and comfort.”
“7A is better set up for interacting with patients”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
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HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
2% 2%
44%52%
96%
FAMILY ROOMS FAMILY ROOMS FAMILY ROOMS FAMILY ROOMS ACCOMMODATING ACCOMMODATING ACCOMMODATING ACCOMMODATING OVERNIGHT STAYSOVERNIGHT STAYSOVERNIGHT STAYSOVERNIGHT STAYS
responses for very positive or somewhat positive for
“It makes it a more private affair for the family…”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
87%
PATIENTS’ PATIENTS’ PATIENTS’ PATIENTS’ BEHAVIORSBEHAVIORSBEHAVIORSBEHAVIORS
responses for very positive or somewhat positive for environment’s impact on
STAFF SURVEY RESULTS
“Sensory and game rooms are fantastic.”
“More options of calming, soothing places…”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
4%9%
59%
28%
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
79%
PROMOTING PROMOTING PROMOTING PROMOTING PHYSICAL ACTIVITY PHYSICAL ACTIVITY PHYSICAL ACTIVITY PHYSICAL ACTIVITY FOR PATIENTSFOR PATIENTSFOR PATIENTSFOR PATIENTS
responses for very positive or somewhat positive for environment’s impact on
STAFF SURVEY RESULTS
“We are able to encourage patients to explore and apply a wider variety of coping skills for in and out of the hospital.”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
10%
11%
47%
32%
HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
79%
CALMING PATIENTSCALMING PATIENTSCALMING PATIENTSCALMING PATIENTS
responses for very positive or somewhat positive for artwork and colors impact on
STAFF SURVEY RESULTS
“Light dimmers and music are great.”
“Quiet room and play room are great for individual time.”
Very negativeSomewhat negativeNo impactSomewhat positiveVery positive
21%
51%
28%
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HEALING SPACES TO PROMOTE WELL-BEING
STAFF SURVEY RESULTS
0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50 5.00
Desks at Hall Ends (7A Only)
Seclusion Room
Porches Outside Patient Rooms
TV in Patient Rooms (7ITC Only)
Physician's Interviewing Rooms
Circle Seat by 7A workstation
Bench in Patient Rooms (non-ADA/Family rooms)
Semi-Private Phone Areas
Game Room (7ITC Only)
Blinds on Patient's Windows to the Outside
Blinds on Patient's Hall Doors
Quiet Room (7A Only)
Rainbow Room
Music Room (7A Only)
Light Dimmer in Patient Rooms and Group Rooms
Music in Other Group Spaces (e.g. Rainbow Room, Game Room, Playroom)
Color (LED) Light Panels (in Sensory Room, Game Room, and Rainbow Room)
Pool
Sensory Room
Rating Average
n= 52
TOP 5 FEATURES
HEALING SPACES TO PROMOTE WELL-BEING
TOP 5 FEATURES/SPACES
MUSIC
PANEL
COLORED
LIGHTS
POOL LIGHT
DIMMERS
SENSORY
ROOM
STAFF SURVEY RESULTS
OTHER HIGH RANKING FEATURES/SPACES
QUIET
ROOM
MUSIC ROOM(INTEGRAL)
BLINDS ON
EXTERIOR
WINDOWS
RAINBOW
ROOM
(INTEGRAL)
BLINDS ON
PATIENT ROOM
HALL DOORS
HEALING SPACES TO PROMOTE WELL-BEING
patient exit surveys
� Staff administered
� 197 collected surveys
� 3 versions (to test measurement tool)
� Consistent results
HEALING SPACES TO PROMOTE WELL-BEING
PATIENT EXIT SURVEY RESULTS
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HEALING SPACES TO PROMOTE WELL-BEING
PATIENT EXIT SURVEY RESULTS
n= 197
TOP 5 FEATURES
0% 10% 20% 30% 40% 50% 60% 70%
Windows in Pool Area
Art
Front Porch
Sensory Room
Playground
Rainbow Room
My Desk
Bench in My Room
Light Dimmers
Pool
My Room
Colored Lights
Music Panel 60%
54%
54%
52%
46%
HEALING SPACES TO PROMOTE WELL-BEING
PATIENT EXIT SURVEY RESULTS
TOP 5 FEATURES/SPACES
OTHER HIGH RANKING FEATURES/SPACES
MUSIC
PANEL
COLORED
LIGHTS
MY ROOM POOL LIGHT DIMMERS
BENCH
IN
ROOM
MY DESK RAINBOW
ROOM
PLAYGROUND SENSORY ROOM
HEALING SPACES TO PROMOTE WELL-BEING
staff interviews
� 15-minute individual interviews
� 27 staff members� Psych Associates, RNs, Clinical Treatment
Coordinator, Occupational Therapists, Child
Psychologist
� 6 questions (semi-structured)
HEALING SPACES TO PROMOTE WELL-BEING
There are more options for interventions with patient behaviors.
“ “
STAFF INTERVIEW RESULTS
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HEALING SPACES TO PROMOTE WELL-BEING
STAFF INTERVIEW RESULTS
This unit decreases the disparity saying mental health care is as valued as medical care.
“
“
HEALING SPACES TO PROMOTE WELL-BEING
ANALYSIS
Does Space Matter?
HEALING SPACES TO PROMOTE WELL-BEING
STAFF
MUSIC
PANEL
COLORED
LIGHTS
POOL LIGHT
DIMMERS
SENSORY
ROOM
ANALYSIS/FINDINGS
MUSIC
PANEL
COLORED
LIGHTS
POOL LIGHT
DIMMERS
MY ROOM
HOW DO THEY COMPARE?
PATIENTS
HEALING SPACES TO PROMOTE WELL-BEING
STAFFimpact areas
� Calming Environment
� Sense of Pride
� Interactions with Patients
� Safety
� Attitudes
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HEALING SPACES TO PROMOTE WELL-BEING
PATIENTSimpact areas
� Calming Environment
� Interactions with Staff
� Safety
� Opportunities for Physical Activity
HEALING SPACES TO PROMOTE WELL-BEING
FAMILIESimpact areas
� Welcoming Environment
� Sense of Confidence in Care and Decision to Leave Child
� Opportunity for Overnight Stays
HEALING SPACES TO PROMOTE WELL-BEING
Take Action Today� De-clutter
� Reduce Noise
� Lighting
� Art
� Paint
� Clean/Maintain
� Incorporate Exercise
� Culture
8 Actions Items for Tomorrow8 Actions Items for Tomorrow
HEALING SPACES TO PROMOTE WELL-BEING
Thank YouQUESTIONS?
Karen Wendt, Karen Wendt, Karen Wendt, Karen Wendt, MA, RN, PHN, Program Director, Child/Adolescent Mental HealthUniversity of Minnesota University of Minnesota University of Minnesota University of Minnesota Health, Children’s HospitalHealth, Children’s HospitalHealth, Children’s HospitalHealth, Children’s [email protected]
Rick Dahl, Rick Dahl, Rick Dahl, Rick Dahl, AIA, [email protected]