Be sure to check out our feature in Healthcare Snapshots if you haven’t seen our recent work on the Women and Newborn Center at Davis Hospital. We are very proud of how everything turned out – the perfect place to welcome a new little one into the world.
In today’s world we spend approximately 90% of our time indoors. This time is spent in
the spaces we live, play, work and learn in, which takes or makes up the majority of our life
experiences. These experiences are impacted by the space we are in and the tone or mood that
it portrays. How each space is carefully crafted can impact our outlook on our current situation.
Interior designers craft spaces that shape a concept, mood or experience. Through colors,
materials and lighting, interior spaces take form and purpose for all users. The spaces that are
designed with high detail and awareness to the tone that the space is portraying allows users to
continually want to go back or spend more time within that space.
Colors of high saturation and vibrance can make the users within feel empowered and
hopeful. Whereas, neutral paint colors can feel clean, refreshing and calming in comparison. It’s
not to say that you can’t use both types of colors together to create a perfect blend, allowing the
eye to bounce within the space and create more visual interest and sensations. When an accent
color is brought into a neutral space and added with several cohesive patterns and materials
this allows for the space to feel more welcoming to a broader clientele.
Layering materials and patterns most importantly creates visual depth and interest.
Interior spaces need that level of softness brought in through fabrics and carpets to break up the
hard surfaces like walls, windows and tables. This balance allows the mind to relax within the
space and not feel overwhelmed because there is too much of one type of material.
To take then materials a step beyond, lighting is added to create drama and significance.
Lighting, both natural and artificial are needed in most spaces. Natural lighting provides
health benefits as well as assistance with sight. While artificial lighting can be added in different
layers to serve as general, task or accent lighting. With each of these layers the space is
properly lit so that the spaces can be adequately used. Interior spaces, if designed with the
intent of the end user, can successful impact the user and improve their production, experience
and mood.
The sense of familiarity, cohesiveness and welcoming is what interior spaces must have
in order to bring people back time and time again. And with ease the user can use the space to
its full intent. Emotions drive people, so when interior spaces are designed without thorough
thought, the end users perception can be of a space with little interest. Interior design is the
creation of a space which impacts the emotions of everyone who steps foot inside.
Article contributed by Sara Cooper, Interior Designer
As humans, stories are one of our most powerful methods of communication. Our love of stories begins in childhood. Storytelling began in the ancient period—before the written language. Early people told stories by oral tradition or cave painting. And today, narratives are an essential part of our society and culture and can come from anywhere. People on social media love to tell stories—whether it is through words, image, audio, video, or a combination of them all. Everyone uses different narrative tools to tell great tales. Architects and designers are also great storytellers – even though our work does not come in the form of literature or the spoken word, it does not mean our creations do not communicate. What makes our tales different is that they play out experientially through architectural design, layout, material, furnishings, and decorations.
When we start a new project—whether it is a new building, remodel or repurposing a space—we begin with a storyboard. We must establish: who are the users? What is the purpose for the space? How can we achieve the client’s mission and goals? Once the project criteria is determined, we start brainstorming to decide what narrative we plan to tell. Recently for example when we were developing the story for a new Cancer Center, we asked ourselves the question “where do people go to find peace during the healing process?” We looked to nature and found inspiration in Asian-Zen centered elements which determined the design elements and color palette.
Shaping a project storyboard can also be a strategic tool for your team. The design story will help to build cohesiveness throughout the project and within your team. It ensures that the entire team understands the vision of what they are trying to accomplish and more importantly, why.
Visual design creates a powerful impact when telling the story of a building or a space and helps clients understand, engage and remember. Nothing will engage your clients and drive them to action more than a compelling tale. A good narrative will tap into the emotions of your clients and allow them to relate and empathize with the design concept you are telling. Rather than focusing on the layout or function of your design, try walking your clients through the concept behind the design. This will allow clients to feel more connected to the concept, help them to catch the vision, and increase their desire to make it real. Remember, you are not only selling your clients your skills and designs, you are selling them a story, an idea, and a dream.
How do the users experience storytelling in our built environments? Let us picture the architecture itself as a book. Imagine the exterior of the building as the cover of the book. The users might be intrigued by the cover and want to open it, but they only get a small sense of what the book is about. Then they open the cover, turn the page and walk toward the entrance. This is the first chapter, the start of their adventure. Now the users no longer see the building from a distance—they are starting to interact with it. They walk into it, seeing the finishes and materials, listening to the sounds in the space, feeling the textures, and experiencing the openness of space. As they journey through, they discover more of the character and details, and they build a relationship with the story. As designers, we focus on creating a narrative that pulls the user in and will deliver them elegantly to a meaningful, cohesive and endearing story, instead of just constructing a logical arrangement of space.
Telling a compelling story is an essential part of developing a design. It is like hearing the great tales from our childhood that were told by our loving parents over and over again and we never get tired of it.
— Contributed by Stephanie Kwok, Interior Designer
Studies show that most humans spend about 93% of their life indoors. Nearly 87% of that is inside buildings and the rest of the 6-7% is spent in automobiles for commuting. People design and decorate their houses as a place of refuge from their daily routines, stresses and sadness same as their offices or work desks in a way that helps them to feel at home. Employers encourage their employees to do that same thing and in many cases, help provide such an atmosphere because they know the benefit of employees who are comfortable in their workspace: higher productivity and efficiency. In general, owners utilize elements such as design and materials for exterior; and furniture, colors, lighting on so on as interior elements to achieve this goal.
For instance, the combination of warm and active colors like red or yellow with uncomfortable furniture and more energetic background music in fast foods would make consumers feel happy and vibrant, encouraging them to move from one space to another. While in a more traditional restaurant, dimmer light paired with very comfortable furniture, lighter colors and soft background music encourages consumers to stay and enjoy their time. Everyone has experienced these environments throughout their life, but it seems when it comes to healthcare not everyone has a similar perception. This provokes the questions, “why is that?”, “why are they different?” and “how can we change this?”.
For so long, the feeling has been that hospitals and other places that provide patient care are depressing. Many patients didn’t want to stay overnight, and likewise many family members or relatives felt the same due to the harsh atmosphere. Hospitals, clinics, senior living and many other health-related places have a similar atmosphere translating to unwelcoming, unhealthy or unhappy places for their users which takes us back to the earlier question of “why is like that?”.
The perception of owners, staff, doctors and many other stakeholders previously was in essence that places like hospitals were, in a word: “cold”. Hence, this would explain why there was almost zero effort towards such places to make them beautiful or comfortable. The thing that mattered most was to have a functional building. Later, through experiences and studies, people understood that besides treatment and technology there are other factors such as hope and happiness that enable patients to recover faster or even overcome a disease and enjoy a longer and happier life. As a result, other sectors started to understand the importance of design in these environments.
However, there were/are designers or architects without experience in hospitals, surgical suites, emergency rooms who began designing these environments. Similarly, there were many that haven’t walked in any senior assisted living and have done the same. There is no doubt that they put a lot of effort in their design to build a wonderful and comfortable building and environment for users, but ultimately weren’t successful and failed due to lack of perspective and experience.
The result?
After a few years, owners had to invest more money to fix and improve a very recently updated or new building. Learning from past mistakes and other experiences helps prevent such situations. A very common, useful tool and practice that helps designers, owners or even developers to benefit from previous projects is called the “Post Occupancy Evaluation (POE)”. Through POE, we can test our theory and design, we can evaluate the building’s performance and its relationship with its users. We can examine our building to understand the flaws to improve them for future projects. POE not only works for healthcare environments and buildings but also for any other types.
One method of POE study is self-observation. Walking around a building, sometimes we see there are windows with their shades is always closed. For instance, most patient rooms have windows as they are a source of natural light and view to outside bringing happiness, color and hope to the room. However, you may find those windows closed. Imagine if the window is located such that the sun glares in, or glare from other rooms becomes bothersome for their users. As a result, the shades are kept down during the day to prevent glare and remain closed at night for privacy. This simple example demonstrates that although there is window in the room, it doesn’t work in the way that it was designed to. Consequently, it essentially seems as though there is no window in the first place and the hospital has been charged extra.
Other examples include when a surveyor interviews staff or even patients and realizes how much patients are dependent on others. With this information, designers and architects with help of doctors and nurses start looking for solutions to help patients gain more independence. A simple approach is to help them to gain more confidence. This creates a snowball effect – even the smallest bit of progress encourages more independence and progress. The easy solution to encourage patients to get out of bed and ambulate on their own is to make their room and department completely accessible and equipped with necessary items such as grab bars to help patients to walk around their room independently.
Engaging with others and having group activities, spending time outside, having a fresh air and looking at greenery are all invaluable sources of hope and happiness. Encouraging people to spend time outside mitigates depression and sickness and enhances their process of getting better both mentally and physically. However, many healthcare buildings have limited gathering areas and are restricted for activities. They even have limited outdoor access for different activities. There are times they don’t have enough man power to look after patients or vise versa, the patient’s condition prevents them from getting outside. It is on the designer to study all probable conditions and with that information provide the best and most efficient space for both owner and users. Sometimes providing a conditioned space such as a green house is a viable solution to bring the outside, while another option is elevating a gathering space above street level to have a more relaxing and quiet view to both blue sky and greenery.
In the end, POE is not just for healthcare and it is not only after the building is occupied. This is a tool that can be used in all building sectors including educational, commercial and so on and helps design times before designing a building and prior to occupancy as well. The surveyor looks at buildings through a different lens, taking advantage of information to influence future projects. Regardless of building typology, the goal is always the same: designing a high-performance building with higher levels of user satisfaction.
— Contributed by Ardavan Tookaloo
A stay in the hospital, even if just for a few hours or a short visit, is never an experience to look forward to. It was hard for anyone to imagine hospitals or medical facilities as friendly, sophisticated, attractive, and beautiful spaces until the past few years. There is an industry-wide movement that is pushing architects, designers and related decision makers to plan and design medical facilities with a patient- centric approach. The boring interiors, old-fashioned furnishings, and typical color combinations had never succeeded in creating a friendly impression for the patients or visitors. One trend that has been getting more traction into the healthcare design evolution is making the facilities feel more residential and hospitable. This design is more focused on patient customization and personal preference. Healthcare interior design needs to aim toward a healing approach and relaxation, which helps reduce stress levels for patients and visitors.
Color influences. Colors are a major contributor to a space and can influence mood and behavior. Many healthcare facilities have moved from monotonous color palettes to more vibrant, refreshing and warm palettes. Using neutral and refreshing hues brings a feeling of comfort to patient rooms. Including some pops of color and contemporary patterns adds energy to the environment. A brighter color can also act as branding for the facility.
Lighting & Technology. Lighting design can play a very important role in human health. Research shows that the human body and brain respond to natural light in a positive way, and the use of natural light has gained incomparable attention recently. Modern lighting technologies have been introduced to help negate the unhealthy effects of artificial lighting and focus on high performance, energy efficiency, longer bulb life and low maintenance. A well-designed system can lead to reductions in medical errors, stress, depression, pain and length of stay, as well as aid in a good night’s sleep.
Nature’s Cue. Many studies show improved health and well-being when connecting with nature. It makes sense for the interior design to include and emulate aspects of nature. The trend is to create connections to nature by using natural light, pleasant exterior views, natural element finishes, natural or organic shades, patterns, and graphics, and beautiful works of art. “It is not about the color of one lake or a single stone outcropping, but a general representation of regional elements. The goal is to capture a range of colors, tones, textures and shapes—in the variety of natural elements that represent the community. When done properly, the human mind, body and spirit instinctively respond in a positive way.” – Sheila Semrou AAHID, ASID
The healthcare design industry and TSA Architects are making extra efforts to be more innovative and create environments that encourage healing in the most positive way possible. With the knowledge we are equipped with, we believe we can make space for the human spirit in the healthcare industry.
— Contributed by Stephanie Kwok, Interior Designer
“[Bellevue Hospital Psychiatric Ward] is a place of challenges, redemption, and surprising joy where tough hardworking doctors and staff fight to care for and keep safe a population that many would like to forget.” Memoir Summary; Sometimes Amazing Things Happen; Elizabeth Ford, MD.
At the beginning of my career, I was an intern at a large Architecture and Engineering firm in New York City. There, I began learning about the role design plays in caring for the complex needs of behavioral health patients. While patients in behavioral health centers arrive with differing afflictions, they share a common need to be treated well. From an architect’s perspective, this means that good design in a behavioral health center should generate an environment of dignity, respect, social support and independence. Most importantly, the space should be safe and aesthetically pleasing in a way that allows patient to feel that the success of their treatment is important to the team that cares for them.
In the early 2000s, I joined a team of Architects to design a Behavioral Health Adult Center in the Bronx, New York City. Our conversations, internally and with our client, focused on abandoning institutional conventions and creating a healing environment that humanized patients.
The facility we designed provided both dignity and respect by employing strategies to: reduce the stress of patients, make the facility a place where family and friends would feel comfortable, increase patient independence, and promote patient participation.
Reducing the Stress of Patients
A behavioral health center can reduce the stress of patients by providing environmental accommodations for various needs. A successful behavioral health center provides a variety of options for social interaction or quiet individual reflection. Single patient rooms supply the patient with dignity through privacy and by providing a place for individual reflection. Individual seating, grouped seating, activity tables and other program spaces located in a widened corridor are features that offer differing levels of social interaction depending on a patient’s preferences or needs. Good acoustical design is paramount to reducing stress in such open social spaces. Varied ceiling heights and materials help to keep sound from traveling too easily through open areas.
Another stress-reducing benefit to programs located in a widened corridor is visibility for patients and providers. This means easy wayfinding as open spaces help to keep the patient oriented. It would be increasingly helpful if the patient could personalize the doors of their bedrooms or activity rooms they frequent with drawings they made or pictures they like.
Smart lighting strategies can reduce the stress of the patient. A patient should have lighting choices for various activities. Dimmable lights and task lighting are safe and efficient ways to provide choice and reduce stress. Abundant daylight, views to nature and physical access to outdoor areas can also create calm.
A Place Where Family and Friends Feel Comfortable
It would be easy to feel uneasy while visiting a friend or family member in a behavioral health center. Warm and residential-like finishes can make a facility comfortable and inviting for guests. Options and choices can also set visitors at ease; architects could provide private visiting rooms and correctly-sized group rooms for shared activities.
Promoting Patient Participation
A behavioral health center can promote patient participation by providing various programs and activities for the patient to choose from. A model apartment is a place where a patient could practice skills of daily living. A salon, where a patient could have their hair cut or learn grooming techniques, promotes dignity and independence. A classroom, library, computer room, music room and art room provide creative outlets and learning opportunities. A gymnasium with a weight room and yoga room offer places to exercise or have larger social gatherings. A spiritual center is a place for patients to meditate or worship as they wish. A consignment shop run by the patients in the facility could have a reward system built into it where patients earn means of trade for healthy behavior. Finally, a central dining space and commissary could provide options for eating and socializing.
Offering a wide variety of programs that appeal to a patient’s preferences can increase patient participation. All the suggestions I listed above will reduce stress, promote healthy behavior, teach skills for independent living and give patients opportunities to choose how to spend their unscheduled time. These effects promote independence and dignity by preparing patients for life outside of the behavioral health center.
Designing for Behavioral Health is Inspiring
“The barriers to relieving suffering can be overwhelming and the rewards can seem few and far between. I have come to see my success as a doctor not by how well I treat mental illness but by how well I respect and honor my patients’ humanity, no matter where they are or what they have done.” Author’s Note; Sometimes Amazing Things Happen; Elizabeth Ford, MD.
I do not have the incredible and challenging opportunity to interact with patients of this population as a doctor or provider. I have tremendous respect for those who do. My experiences in working with these compassionate, talented women and men have helped me to understand and develop compassion for the complex needs of their patients. As an architect it is my task to use thoughtful design strategies and to provide the right environment for the treatment of their patients. It is humbling and inspiring to design a healing environment where patients can begin to find relief for their suffering and success in their journey toward mental health.
-Written by Rebecca Weidler, AIA, NCARB