It has been an interesting year for healthcare.
As December draws to a close I would like to take a moment, look back, and see just what on Earth happened!
We have a new form of healthcare payment; remember Medicare and Medicaid have been around for some time so taxpayer-funded healthcare is not new.
We have a hard push for hospitals to follow the essence of the Hippocratic Oath, “First do no harm,” and be accountable (pay for) problems that arise on their account.
We have rankings and ratings and patient opinions that indicate how well hospitals are performing.
We are dropping medical service lines that are no longer financially viable.
The community hospital is most often affiliated or owned by someone other than the community.
I think it is official . . . Healthcare is now a business.
Shaping My Design Perspective Through Experience
I have had the dehumanizing experience of sitting in a public corridor with male and female patients and numerous hospital staff walking just past my rubberized grip clad booties, as I sat in a loosely fitted robe anxiously waiting to get my mammogram.
I have also aimlessly walked around a hospital floor for many hours in labor with no natural light, vistas nor distracting elements to focus on during the intense moments of pain. In retrospect, when I revisit these events and put my architect lenses on, I see how each space that I had these uniquely female experiences within, had let me down by compromising my rights for privacy and integrity, or simply neglecting to understand what I needed in order to provide a positive patient experience.
As an architect at IKM Incorporated, I have designed a number of healthcare spaces for both male and female patients. After having these personal experiences, I began to approach the design for gender specific facilities with a different perspective. We never lose focus on the design goals that address excellent patient care: putting the patient first, creating efficient flows for patients, staff and material, accommodating complex medical technologies and infrastructure, and designing aesthetic solutions that support the needs of multiple stakeholders. When a client would ask for a Breast Center that reduced the stress the patient was experiencing to the greatest degree possible, I was forced to overlay those goals with the question “what causes and reduces the stress of these patients?” As an architect, I cannot alter the circumstances that bring patients to a facility or the results of their testing or procedure being conveyed, but I can create a built environment which helps them to feel more comfortable, respected and connected.
When I was a child growing up in Latrobe, Pennsylvania in the 1960’s I often heard my grandparents say “If you have your health you have it all.” I thought that was silly. There are a lot of things more important than your health, a nice house, a summer vacation at the beach, Christmas presents, or a new car were on my list. What were these old people talking about, “your health”? Everybody is healthy in our family. Are they crazy? They even talked about having all their own teeth like that was something rare.
Little did I know that my grandparents spoke with a great perspective and wisdom. It would take me many years before I began to understand what they were talking about. Whether we know it or not, our entire lives do revolve around our health, and the health of our family and friends. From one generation to another health implications may differ, but the core value of good health is always there. My wise grandparents, who were born in the 1890’s, had lived through two World Wars and the Great Depression. They had a reverent point of view and respect for personal health. They had seen and experienced first-hand what it was like not to have your health. Experiences such as:
- Childhood diseases that resulted in death.
- Epidemics that killed thousands.
- Tuberculosis and polio that disabled.
- Deadly infections that could not be treated.
- Industrial accidents that maimed and killed long before safety regulation were in-place.
- The loss of a child or family member to one of the unsolved health issues of their era.
- The physically or emotionally wounded soldiers who returned home.
If a person is hospitalized today, they have a 1 in 20 chance of acquiring an infection – of those who acquire an infection there is a 1 in 20 chance of dying from that infection. 4.5% of hospitalized patients develop healthcare acquired infections, annually. In the US, Healthcare Associated Infections (HAI’s) claim the lives of 100,000 people each year. Resistant pathogens require expensive drugs, extended hospital stays and readmissions increasing healthcare costs by as much as $45 billion a year.
Copper is essential to the development of all forms of life and is naturally present in the earth’s crust. It is the oldest metal used by man. Microbes were not understood until the 19th century, but copper’s hygienic properties were well known through experience and tradition. The Egyptians, Romans, Aztecs and the Greeks (Hippocrates himself) used copper as a sterilization agent for drinking water, treatment of wounds, boils, eye infections and venereal ulcers. Today, copper is an active ingredient in many different types of antimicrobial products: fungicides, antifouling paints, antimicrobial medicines, oral hygiene products, hygienic medical devices, and antiseptics.
The Healthcare Industry is currently undergoing a major process redesign. The redesign began in the manufacturing industry that was forced to learn how to do “more with less” in order to compete.
This effort is now being embraced by many healthcare organizations across the United States. Hospitals are being forced to provide high-level medical care for an ever shrinking reimbursement, more with less.
Architects and healthcare planners have traditionally brought facility solutions to the industry based on evidence and their experience. Design ideas were presented to key administrators or department leaders, sometimes tweaked, and subsequently put into place. Experience was the great teacher.
Recently, I had a family medical emergency that required my husband and me to visit a healthcare facility where we spent quite a few hours in an Emergency Department Waiting Room. To say this space was “clinical” would be kind. The lighting was poor, laminate was chipping off the desk, torn-vinyl seating was arranged so we could see everyone and everyone could see us. Communal sleeping bags were thrown about for guests to use. Shortly after arriving – a security guard asked to search my purse. I felt very uncomfortable.
We had arrived feeling stress – this atmosphere made those feelings worse.
As an interior designer I am aware that surroundings influence feelings as well as a sense of security and safety. These feelings are amplified while idly sitting in a Hospital Waiting Room. Everyone at some time is placed in a position of waiting for themselves or a loved one.
By Richard Bowser P.E.
Hospitals worldwide face a common nemesis. In the United States nosocomial infections (hospital acquired infections) affect 1.7 million people annually, are a leading cause of death reportedly killing 100,000 people, and costs an estimated $45 billion annually.
What can be done to reduce nosocomial infections? An effective remedy is to educate the staff, and others who come into contact with the patient, of the risks. Protocols like hand washing, maintaining sterile fields, using contact precautions, and properly disinfecting spaces will go a long way in addressing the problem. The building systems can also help.
Nosocomial infections begin as bacteria, viruses, protozoa, and fungi. These microorganisms can reproduce at a rapid rate if the environment allows. A properly designed domestic water supply and HVAC system can help prevent such an environment.