January 5, 2015
By Patrick Schultz, AIA, EDAC, LEED AP, Vice President/Healthcare Practice Leader Mid-Atlantic Region; Ana Pinto-Alexander, RID, IIDA, EDAC, Principal/Global Director of Healthcare Interiors; and Debra Klimenko, Interior Designer/Healthcare Furniture Specialist, HKS, Inc.

As healthcare continues its shift to a payment for value reimbursement model (versus traditional fee for transaction) and to outpatient ambulatory care environments (versus traditional inpatient care), the need for hospitals to control costs, improve environmental quality and increase patient satisfaction has never been more important.    

Integrating these diverse needs into both inpatient and outpatient healthcare settings, accommodating new work processes, technologies and evoking comfort for all patients are among hospitals’ top priorities. 

Recent projects illustrate how furniture plays a key role in providing flexible facility solutions by meeting key patient, visitor and staff needs, while avoiding potential built-in obsolescence. 

Waiting Areas
Environments that provide comfort not only make the patient feel better by reducing stress, but also help them feel nurtured, promoting positive changes in perception and satisfaction. In all settings, the waiting experience forms first impressions, as patients and families must often wait for extended periods. 

Waiting areas are being right-sized as more common procedures shift to ambulatory care and more complex procedures remain inpatient. As a result, ambulatory waiting rooms are increasing, while inpatient waiting rooms are reducing in size. Does the waiting room design, furniture and technology integration add value to the patient and family by supporting their differing needs? Some individuals may seek a quiet place. A family may sit together waiting for a relative to come out of surgery. Clear seating arrangements allow guests to choose areas that best suit their needs. Visitors will feel the hospital has taken care of their requirements by providing seating options and control over their waiting experience. 

Technology is transforming waiting rooms into places that connect people and information. Mobile devices for communication necessitate readily accessible power outlets integrated into lounge chairs, furniture arms, end tables and work surfaces. Kiosks promote self-directed check-in. As a supplement to central registration, kiosks can streamline the patient registration process, and reduce overall wait times for first patient contact with staff. 

Plus-Size Seating
Universal seating can support the heavier weight limits; by not differentiating seats for larger guests, hospitals can help to promote patient dignity, beginning with the waiting room experience. In both inpatient and outpatient waiting areas, specifying seating to support weight ranges from 500 to 750 pounds (and up to 1,000 pounds) per seat can address concerns if sufficient “plus-size” seats have been provided. 

Good plus-size seating has a substantial chair substructure metal framework, providing strength and durability, with arms, legs, seat, back cushions attached to the metal frame as modular components. If any component is damaged or needs replacement, new parts can be ordered and switched onsite, thus reducing maintenance and increasing furniture longevity. 

Patient Rooms
In the patient room, furniture’s multi-functionality is essential in creating zones to accommodate family members and friends, patient advocates and care partners. Adaptable seating allows families to personalize their space. Sleep sofas with tablet arms, storage or built-in, adjustable-height tables with power outlets can provide useful surfaces for working while with the patient. Wall-mounted and folding chairs can provide extra seating, when needed, without taking up valuable floor space when stored. Modular cabinetry that appears to be built-in millwork, provides storage and display space for patients that can be easily removed if the room’s function changes in the future. 

Incorporating technology functions to meet individual and staff needs, with monitors accessible to patients while in bed, allows email communication, movie watching and ordering meals for the day. Patient room connectivity gives the physician the ability to display X-ray images or provide patient educational materials from tablet, bedside monitor or flat-screen TV on footwall across from patient bed for easy viewing. Wall-mounted glass patient care information (white) boards are highly cleanable and long lasting. 

Infection prevention of surface materials and furniture must be considered before specifying. New faux leather graffiti-proof upholstery materials feel less clinical, providing a warm textured feeling, and are highly cleanable for better infection control and furniture longevity. Wood-look finishes, available for use on furniture, arm caps, table tops, wall trim and headwall panels in 3-D laminates, provide the warmth of real wood with superior infection control and durability. 

Staff Work Environments
Implementation of health information technology has changed work environments areas to support new caregiver models and processes. New furniture systems enhance staff ability to access vital health information, improve communications and overall efficiency of patient care. Clinical spaces with more collaborative furniture settings encourage information sharing with team members in an open-area environment. For both inpatient and ambulatory settings, optimizing the caregiver work environment provides return on investment by saving time and relieving stress.  Furniture and casework solutions required to support mobile healthcare provider technology in the patient room require flexibility and mobility to accommodate different caregivers and types of devices. 

Furniture and casework that provide flexible solutions to enhance communications and facilitate work in the unit, allow caregivers more time with the patient. Systems furniture clusters are easily reconfigurable to adjust to changes in the team’s workflow with minimal transition time from space to space or task to task. Adjustable-height surfaces at each station allow for individuals on different shifts to make the workspace fit their personal comfort needs. 

Task chairs or stools are available for those working at one location for longer time periods. Standing- height touchdown surfaces work well for fast-paced clinical spaces where staff must quickly access information, meet regarding a patient, document vital statistics and then move on to the next task. Larger wall-mounted monitors in an open clinical environment allow frequent opportunities for teaching, telehealth, diagnosis discussion and promoting staff collaboration. 

Sustainability has greatly influenced selection of finish materials for furniture and casework to eliminate any toxic materials, phthalates and off-gassing during production. Manufacturing is being modified to remove chemically harmful materials, fabrics are adding protective coatings and casework laminates and MDF are being made without toxic chemicals. The furniture industry has also adapted LEED for Healthcare- MR5. 

Conclusion
When providing for patients’ physical and emotional comfort, hospitals can ease heightened emotions and make healthcare a less stressful event. By integrating furniture and casework solutions to better support patients, their families and caregivers, hospitals can provide better experiences and enhance their reputation for delivering quality care. 

Research shows staff satisfaction affects patient satisfaction. When staff collaborate more successfully with less stress, patient outcomes are likely to improve. The appropriate selection of furniture and casework plays a crucial role in the healing process of individuals, as well as the comfort of families and caregivers, providing successful interconnected healthcare in both inpatient and outpatient settings.

Posted in Health, Interiors
Tagged Ana Pinto-Alexander, Debra Klimenko, Pat Schultz, trends in healthcare furniture