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SEPTEMBER 24-26, 2024
Austin Convention Center - Austin, Texas

Author: Jenabeth Ferguson

EMERGING TRENDS IN HEALTHCARE DESIGN: ENHANCING PATIENT EXPERIENCE AND EFFICIENCY

Media Contact:
Sophia Lapat 212.203.6536
[email protected]

Healthcare Facilities Symposium & Expo Offers Products and Services from 100+ Exhibitors

Austin, TX (July 9, 2024) — Healthcare Facilities Symposium and Expo, one of the country’s largest shows dedicated to healthcare design and facilities, returns for its 37th annual event to the Austin Convention Center, September 24-26, 2024. This must-attend event for architects, designers, engineers, contractors and healthcare providers features an expansive Exhibit Hall with 100+ Exhibitors including furnishings, lighting, flooring, wall coverings, solution providers, technology, and so much more.

As the healthcare landscape continues to evolve, so too does the design of medical facilities. The latest trends in healthcare design are revolutionizing patient care by prioritizing both functionality and the patient experience. These innovative approaches are reshaping the way hospitals and clinics operate and cater to their patients. Below are some of the latest trends shaping the healthcare design industry today and a selection of exhibitor highlights from HFSE 2024 exhibitors.

For more information on the 2024 exhibitors, please visit www.hcarefacilities.com.

Integration of Technology

Technology is playing a crucial role in modern healthcare design. From electronic health records to telemedicine capabilities, facilities are integrating advanced technologies seamlessly into their design. This integration not only enhances operational efficiency, but also improves patient care by facilitating communication between healthcare providers and patients.

 

Skyline Glass, Booth 408

Skyline Glass provides glass solutions for healthcare environments. Their products offerings focus on privacy, cleanability, adaptability, beauty and longevity. Glass lets in natural light, can accommodate artwork Addressing the shortcomings of traditional smart glass technologies, SDX3 SmartView, Powered by CliC introduces a film-free design utilizing liquid crystal technology—setting a new standard for clarity, efficiency, and design flexibility in healthcare spaces. Switchable glass technology has long promised the convenience of instantly transitioning windows from clear views to privacy with the flip of a switch. However, existing solutions have fallen short with issues such as haze, fogginess, and distortion compromising the clear mode. SDX3 SmartView employs liquid crystal technology applied directly to glass, offering a truly clear view in the transparent mode and maintaining privacy when activated.

 

Mantis Innovation, Booth 237

As more businesses journey towards increased sustainability, they need experienced partners to transform today’s operations into tomorrow’s results. Mantis Innovation delivers smart, sustainable solutions to improve facility performance from any starting point along this journey. Mantis provides managed facility services and turnkey program management with technology-enabled solutions that target the entire building footprint from roofs, walls, and pavement, to HVAC, lighting and power.

 

Mesa Electronics, Inc., Booth 101

Mesa Electronics specializes in meeting the unique needs and requirements of healthcare environments with audio/visual technology solutions that enhance the healthcare experience for patients, visitors, and staff. With decades of experience working in the healthcare market, Mesa Electronics has a legacy of designing, integrating, supporting, and servicing complex audiovisual solutions for inside and outside of the patient room.

 

Sustainability Initiatives

Environmental sustainability is becoming a significant consideration in healthcare design. Facilities are implementing energy-efficient systems, utilizing sustainable building materials, and incorporating features like green roofs. These initiatives not only reduce the environmental footprint, but also contribute to a healthier indoor environment for patients and staff.

 

CheckSammy Booth 527

CheckSammy is a national provider of same-day bulk waste removal and sustainability services. We find innovative ways to divert various waste streams from landfill and provide our customers with detailed data to fuel ESG improvements. Our other services include open-top containers, power washing, and commercial cleaning. At HFSE, they will be debuting the ESG reporting platform, Veridiant. Veridiant is the next-gen software platform to help track, analyze, and optimize material diversion from source to destination. Customers can view before/after pictures, track servicing updates in real-time, and download certificates of diversion/destruction all in one smart platform.

 

Lonseal® Flooring, Booth 426

Celebrating over 52 years of durability and performance in a variety of commercial industries, Lonseal offers a unique selection of resilient sheet vinyl in exterior and interior, embossed, smooth, sport and wood-grain surfaces. Lonseal’s commitment to the environment is as strong as their commitment to quality. With recycled content and an extended life cycle, the GreenVinyl Program offers a suite of resilient vinyl products that ensure a minimal environmental impact while handing the toughest traffic. Their low-emitting materials are FloorScore® certified, to help provide the purest in Indoor Air Quality (IAQ). Check out their LONWOVEN design that offers a timeless and elegant aesthetic that combines the natural texture of linen with the durability and convenience of sheet vinyl at HFSE!

 

Unicel Architectural, Booth 219

For 59 years, Unicel Architectural has built a reputation for the most advanced glass, timber and aluminum solutions. These solutions encompass louvered glazing, skylights,

timber or aluminum curtain walls and more, to enhance major global construction

initiatives with the utmost quality and reliability. Unicel Architectural’s proprietary technology transforms glass, timber or aluminum into one-of-a-kind, highly engineered structures, while Vision Control® delivers unprecedented comfort and control of vision, light, temperature and sound with a patented combination of integrated louvers between glass that are hermetically sealed and cordless. Unicel Architectural’s solutions are guaranteed for longevity, optimized for energy efficiency, and customizable to any design, environmental or cultural requirements.

 

Emphasis on Safety

In recent years, safety in hospitals has emerged as a pivotal trend, driven by a heightened awareness of patient well-being and regulatory standards. Hospitals are increasingly implementing comprehensive safety protocols to minimize medical errors, prevent infections, and enhance overall patient care outcomes. Key initiatives include the adoption of advanced technology for patient monitoring and safety, inspections, and improved communication among healthcare teams.

 

RPS America, Inc, Booth 519

RPS America provides high quality Uninterruptible Power Systems to customers with critical power needs, like Data Centers, Healthcare Imaging Machines, Airport Security Scanners. The UPS provides clean power and in case of power failure it continues to provide clean power until the Generator starts or the utility returns via batteries. At HFSE, RPS will debut two of their UPS’s, one is a new product which is a modular UPS, and they will have one of their existing UPS’s that has been used by Healthcare, Data Center, and Airport Security customers for the last 10 years.

 

Smith-Emery, Booth 208

On-site safety inspections are conducted during construction to establish that approved plans, specifications, and processes are being upheld and followed. Smith-Emery promotes peace of mind by observing and testing materials for conformance with the approved and permitted construction documents. We can provide a full-service team to undertake all facets of a site inspection, or a single individual for a one-day call-out inspection. Regardless, our experienced inspectors provide quality control assurance regarding the fabrication, installation, and placement structural components and construction materials like fireproofing, soils and foundations.

 

Accurate Lock and Hardware, Booth 326

Accurate’s team of experts are dedicated to developing innovative solutions for specific challenges including retrofit scenarios, custom openings and bringing doors to compliance. Designed with patient care and staff safety in mind, all Accurate products are made entirely in the USA, which allows the ability to quickly adjust, adapt and produce the best solutions to meet the ever-changing needs of the healthcare industry.

 

Oval Fire Products, Booth 432

The world needed a slimmer profile fire extinguisher without sacrificing an ounce of performance – so that’s what Oval did. Their engineers spent thousands of hours creating a fire extinguisher that is oval, not round and projects less than 4” from the wall, instantly achieving ADA compliance. Making things simpler and saving costs in the long run. They are on a mission to make facilities safer – one fire extinguisher at a time.

 

Patient-Centered Design

Modern healthcare facilities are continuing to adopt patient-centered design principles. This approach focuses on creating spaces that are comfortable, welcoming, and conducive to healing. Patient rooms are designed to maximize natural light, incorporate soothing colors, and provide ample space for families. Waiting areas are being transformed into calming environments with comfortable seating, artwork, and even amenities like refreshment stations.

 

Stance Healthcare, Booth 402

Founded in 2006, Stance Healthcare manufactures furniture for healing environments, with a particular focus on hospitals and Behavioral Health facilities. They have a reputation for providing high-quality products that meet ever-evolving demands in the areas of design, comfort, safety, durability, renewability, infection control and environmental sustainability. With a strong understanding of patient-centered design, we are committed to providing innovative furniture solutions that improve the healthcare experience for all.

 

Wieland Healthcare, Booth 305

Wieland builds patient room and lounge furniture designed to assist caregivers and families.  Industry-leading sleep sofas and patient recliners are available in a variety of styles. Wieland is committed to moving patient care forward. We look beyond the ordinary, seeking new solutions for patient spaces within various healthcare environments. At HFSE, Wieland will debut NEW options for infusion applications on our Accord Recliner; including heat + massage, charging port for devices, and removable fold-down table.

 

MDC Interior Solutions, Booth 304

MDC is transforming spaces with their bespoke interior finishes including custom wall graphics with personalized visual storytelling, tailored acoustical solutions to optimize sound dynamics, and an innovative art program that integrates distinctive art pieces enhancing both aesthetics and emotional resonance.

“These trends reflect a shift towards human-centered design principles in healthcare,” said Jenabeth Ferguson, Vice President, Symposium Director. “By prioritizing patient comfort, operational efficiency, and sustainability, healthcare facilities are enhancing the overall healthcare experience.”

For more information or to register, please visit www.hcarefacilities.com

 

ABOUT

The mission of the Healthcare Facilities Symposium & Expo is to create a multi-disciplinary environment that inspires you to evoke change and the advancement of a better delivery of healthcare through the physical space. Competitors, clients, and colleagues come together as friends to collaborate, share research, hear fresh perspectives and participate in the ever-changing conversation of your industry.

 

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HEALTHCARE FACILITIES SYMPOSIUM AND EXPO RETURNS SEPTEMBER 24-26, 2024 TO THE AUSTIN CONVENTION CENTER

Media Contact:
Sophia Lapat 212.203.6536
[email protected]

Inspiring Programming, Product Launches, Keynotes, Industry Leaders, Facility Tours, Emerging Leaders, and Networking Events

Austin, TX (June 14, 2024) — Healthcare Facilities Symposium and Expo, one of the country’s largest shows dedicated to healthcare design and facilities, returns for its 37th annual event to the Austin Convention Center, September 24-26, 2024. This must-attend symposium and expo brings together architects, designers, engineers, contractors and healthcare providers to collaborate, share research, hear fresh perspectives and participate in the ever-changing healthcare industry. Attendees will have a chance to sit in on compelling Keynote Presentations, explore 100+ Exhibitors, be inspired by industry leaders at daily Conference Sessions, explore two of Austin’s biggest Healthcare Facilities, enjoy Networking Events and much more.

 

“The success of the Healthcare Facilities Symposium and Expo can be attributed to the collaborative environment we foster each year, and we look forward to bringing together architects, designers, contractors, healthcare providers and more to Austin,” said Jenabeth Ferguson, Vice President, Symposium Director. “Through powerful Keynotes, informative sessions that inspires dialogue, and the latest product innovations from hundreds of exhibitors, we hope to continue to help transform the landscape of healthcare design and delivery.”

 

Robust Conference

The Symposium features three jam-packed days of educational and insightful sessions, case-studies and three keynotes meant to inspire and improve current and future healthcare facilities. The sessions will span multiple topics including Pediatrics, Behavioral Health, Safety, AI in healthcare, Sustainability and more. A few highlights include:

 

Hear about the new Lyndon B. Johnson (LBJ) Hospital which stands amidst the giants of the Texas Medical Center, as an unsung hero who tends to the historically disadvantaged and those most in need within the community. The upcoming 1.2 million SF LBJ heralds a new era of transformative design and you’ll hear from architects and engineers on this project during the “Architectural Avenger: Championing Health Equity in a Safety-Net Hospital” session.

 

Tackling important issues of the day, “Culturally Inclusive Care: Healthcare Design for Black Communities”, will hear from black voices in healthcare about disparities they have experienced and discuss examples and strategies of how design can change the narrative.

 

Understand how Disaster Recovery and Future Planning took place for the Governor Juan F. Luis Hospital during the “Disaster Recovery and Future Planning for the Governor Juan F. Luis Hospital after Hurricane Maria in the US Virgin Islands.”. The executive director of the Territorial Hospital Redevelopment Team, Government Hospitals and Health Facilities Corporation (USVI) will travel to the US to share the hospital’s story with the architect and engineer who served on the project.

 

Exhibit Hall

The Expo Hall features the most innovative products and services in the healthcare facilities industry from some of the country’s top manufacturers and providers. Many exhibitors will launch new products at HFSE, getting in front of important decision makers from healthcare facilities, architecture and design firms. This year, the Expo Hall will feature more than 30 NEW exhibitors hailing from around the globe including Kingsway Group, MedViron, Skyler Design Build, RPS America Inc., MDC Interior Solutions, PEVCO, PABCO Gypsum, Amico Lights, EquipWare, LLC, Chesapeake Healthcare Planning, Lonseal Flooring, Calico Building Services, Inc., Walters Healthcare Resources, Hallmark Building Supplies, Johns Manville and more.

Experience the latest furnishings, technology, flooring, lighting, modular operating rooms and mobile clinics from WIELAND Healthcare, Pineapple Contract, Stance Healthcare, Belden, MazeMap, Tarkett, Mohawk Group, Interface, vHealth Lighting, Modular Services Company, SLD Technology, OWA USA, Odulair and many more. Don’t miss mini sessions on the Expo Floor presented by architecture firms in the Design Solutions Theaters where the design team galleries come alive in these 15-minute presentations. Back by popular demand, there will be two design solutions theaters so double the chance to hear about the latest projects in this exciting format.

Get ready for an interactive experience as returning exhibitors La- Z-Boy | Knu Comfort and Whitehall MFG/Acorn VAC rev up their mobile showrooms for more hands-on displays this year!

 

Symposium Distinction Awards

The annual program recognizes design teams, projects and individuals who have made a profound contribution to the healthcare design industry. The program accepts submissions of all types and sizes of patient care-related facilities. In addition, it recognizes the best and most innovative new products within the healthcare design & construction industry. All entries are due August 2 and submissions can be made here: https://hcarefacilities.com/awards/

 

Networking Events

Mix and mingle with new and old friends at daily events including the Grand Opening of Exhibit Floor and Symposium Party, the Ice Cream Social, the Happy Hour and many more fun and engaging events.

 

Emerging Leaders Welcome

The Healthcare Facilities Symposium and Expo’s successful Symposium Emerging Leaders Scholarship Program returns in 2024 offering recognition to those individuals with less than 10 years (non-consecutive) of experience in healthcare design and construction including research and/or education. The recognition includes attending the 2024 HFSE in Austin, TX September 24-26 and participating in all activities surrounding the event.

 

RECIPIENTS RECEIVE:

  • A Full Access registration to the 2024 Healthcare Facilities Symposium & Expo (travel expenses are not included)
  • Welcome breakfast for all emerging leaders to meet each other at the beginning of the event
  • Recognition at the Opening Keynote at the 2024 HFSE
  • Recognition on a display board at the 2024 HFSE
  • Invitation to the VIP Reception at the 2024 HFSE and be paired with a Board Member to offer guidance
  • Featured in the October 2024 Leaflet issue

 

For more information and to apply, visit https://hcarefacilities.com/elp/

 

Facility Tours

On Monday, September 23, HFSE will be offering two Facility Tours at Texas Children’s Hospital and Lillibridge Healthcare Services for attendees to learn about two major health construction projects in Texas. Texas Children’s Hospital, one of the top-ranked hospitals in America providing pediatric and maternal-fetal care, recently opened a brand-new, greenfield hospital for children and women in Austin, Texas. The design for this facility began in February 2020 and opened in February 2024, just in time for the institution’s 70th birthday. Lillibridge Healthcare Services, Ventas’ wholly owned medical office operating subsidiary, and development partners at HKS Architects and Rogers O’Brien Construction began designing a full scale modernization of Medical Park Tower in 2019. Concept design was completed in early 2020, and construction began in the fall of 2020.

 

For more information or to register, please visit www.hcarefacilities.com

 

ABOUT

 

The mission of the Healthcare Facilities Symposium & Expo is to ignite change and advance healthcare delivery through innovative physical spaces. Here, competitors become collaborators, clients become friends, and colleagues share fresh perspectives, research, and insights, driving forward the dynamic conversation of our industry.

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Removing Barriers: How an Automated Parking System is Improving Patient Care at Fred Hutchinson Cancer Center

By Michelle Wendler, AIA, Principal, Watry Design, Inc.,

The opening of the new outpatient clinic at Fred Hutchinson Cancer Center in Seattle ushered in a new era of care in the areas you would expect, with expanded facilities and state-of-the-art medical equipment, but also somewhere you might not: parking.

Parking in medical centers can be a stressful experience. In addition to confusing layouts with different specialists in different locations, patients often have more physical constraints than the general public. Often, the parking structure is separate from the facility where they will receive care, requiring additional mobility from patients who are highly likely to have mobility limitations. Sloped floors can also pose a hazard to patients at high risk of falling, which creates safety concerns in addition to the mental and physical stress of getting to the right location on time for an appointment.

At Fred Hutch, however, a combination of factors allowed designers of the recently opened outpatient clinic to explore new ways of overcoming these challenges in the form of a fully automated parking system that removes many of these barriers.

 

What is a Fully Automated Parking Structure?

Many types of mechanical and automated parking systems exist, from simple mechanical lifts to fully automated systems, such as the system found at Fred Hutch. As each project is unique, there is no straightforward formula to a successful selection. Choosing the right solution requires careful study, expertise and innovative thinking.

While fully automated parking systems come in many different forms, they all share one notable thing in common: a transfer cabin. The vehicle is driven into a transfer cabin outfitted with sensors. The driver then exits the car and follows a set of instructions to engage the system. Once the door to the transfer cabin closes, no further human involvement is necessary to park the car. The system itself is completely responsible for selecting a space, storing, and later retrieving the vehicle. In the case of Fred Hutch, a robotic shuttle system in the form of a rack and rail system retrieves the car from the transfer cabin and delivers it to an available parking space. What this means for patients is a streamlined, simpler parking process. There is no searching for a space or navigating a large parking structure on foot. Patients deliver their vehicle to the transfer cabin via a valet and can then proceed directly to their care destination.  At Fred Hutch the system is further enhanced because the patient leaves their car outside the transfer cabin for the valet to load into the system so they do not have to park in the automated system at all.

Why Fred Hutch Chose Automated Parking

Automated parking typically becomes viable when site constraints exist that make traditional parking impractical. Deep subterranean excavations, high water tables, and constrained footprints  are all factors that can make automated parking worth exploring.

When the new outpatient facility was under design, early plans called for it to be interconnected to an existing building on the upper floors with a continuous underground layout that would include parking. However, code restrictions made this approach cost prohibitive, which resulted in a very constrained building site. An alley between the planned and existing building contained utilities that could not be relocated. To fit within the available footprint, a traditional parking facility would not only have been saddled with an extremely inefficient layout, but it also would have been difficult to achieve the 160 spaces required to meet the needs of Fred Hutch’s patients without a much deeper excavation. Therefore, the design team turned to automated parking as a possible solution.

This approach solved the space constraint problems by utilizing the available volume to park more cars in the same amount of space and offered the opportunity to create a safer, more user-friendly parking experience to relieve some of the stress patients face when visiting a care facility.

To ensure that the facility design succeeded in meeting patient needs, Fred Hutch engaged a patient care advisory committee to review the project development – including the parking. “The big topics that we got a lot of feedback on concerned ease of use, patient safety, and navigating mobility limitations,” says Alyssa Stein, an associate with ZGF Architects, who designed the project. “Patients were generally in favor of any technology that helped their experience.”

Selecting a System

Deciding to pursue an automated system is only part of the journey. Selecting the right one to meet a project’s unique needs requires a great deal of careful consideration, from both a design and operations standpoint. Engaging parking experts who have experience with these unique systems can help navigate these challenges and ensure they effectively integrate into the building.

From a design perspective, different systems have different requirements, from the number of transfer cabins required to how cars are stored and retrieved and the density of the parking. Adequate queuing and loading areas also need to be considered.

For example, several systems evaluated by the design team required more lift bays than the site could accommodate. Many systems are produced overseas, which introduces other complexities such as coordinating international shipments into the construction schedule and field certification that components make a compliant UL system.

From an operations perspective, a number of logistics had to be taken into account. Unlike traditional parking, in which users can go straight to their car and drive away, automated parking systems have limitations on capacity and throughput, or how many cars a system can handle and how quickly they can be retrieved. Therefore, everyone needed to be on the same page regarding performance expectations at peak times, and how that would impact the patient journey. This included designing lobby areas with ample seating to ensure patients were comfortable while waiting for their car.

Automated parking systems also have ongoing maintenance considerations that need to be factored into both ongoing budget and operations plans. This includes how to handle unexpected system outages, annual costs of preventive maintenance and logistics of repairs. “Fred Hutch took a strong interest in this, because they would ultimately be responsible for maintenance,” Stein explains. “If something breaks, how does it get fixed, and how long will it take?”

The unique maintenance needs of these facilities means that they require a specialized maintenance provider. Understanding who will service and maintain the system, expectations for response times, turnaround time on repairs and how parking will be managed during an outage are all questions that need to be addressed before committing to a system. As Fred Hutch desired valet service to further elevate the patient journey, a valet vendor was selected and trained to operate the system as efficiently as possible.

Ultimately, WÖHR Multiparker 730 was selected to provide the 160 spaces needed to support the project, with the goal of retrieving up to 100 vehicles in an hour with a maximum recall time of 150 seconds.

Design Challenges

While automated parking systems are common elsewhere in the world, they are still relatively new to the US, which poses a number of design challenges, starting with code. “Code requirements are limited in their coverage of fully automated parking, so a lot of communication has to happen in order to get everyone on the same page to build it,” says Stein. Due to the project’s complexity, Watry Design was brought in as a mechanical parking expert to review the design and help navigate the approval process.

One example of the complex code requirements the team tackled was intake and exhaust requirements. Garage ventilation requirements  were created around the needs of traditional parking, in which cars operate within a structure that must also accommodate people. Fully automated systems, however, are designed so that when a car enters the system, it is turned off and unaccompanied by a human, making air change needs minimal. Therefore, the team worked closely with the city, including sharing case studies of similar projects, to find a middle ground that would meet design and budget needs while also satisfying city requirements.

Another common design challenge faced by automated parking is whether or not lifts get classified as elevators. Elevator codes are designed around human safety, however a human never rides in a lift in a fully automated parking system. Therefore, the life and safety considerations typically associated with elevators may not apply. Design teams need to carefully define project terminology to ensure the code interpretation appropriately meets the building needs without triggering unnecessary design criteria. Watry Design and ZGF worked closely with both Fred Hutch and the city to review the design early and keep the approval process as smooth as possible. “We had a lot of conversations with the city to interpret the code and decide what was required,” says Stein. “Ultimately, I think everyone was satisfied and comfortable with where we landed.”

The contractor  also needed to navigate  the constructability of the system with the  mechanical parking vendor and steel subcontractor. A rack and rail automated parking system like the one installed at Fred Hutch utilizes a shuttle that moves along a set of tracks on each floor. The vehicle lift moves vertically to bring the car to each floor. The movement and speed of the lift and shuttle is controlled by lasers that need to be carefully calibrated to ensure the smooth transfer of vehicles from the transfer cabin to the rail system to the vehicle lift. The concrete floor levelness and placement of hundreds of steel embeds had to be meticulously coordinated with little room for error.

This level of design, however, is what makes the system so effective. “The complexity of the design is fascinating,” Stein says. “The palates are so well-engineered that they rotate with just a gentle push of the hand. It’s really special.”

The End Result

The new outpatient clinic building at Fred Hutch opened in March of 2023. When patients arrive, they deliver their vehicle to a valet who then delivers it into the transfer cabin and initiates the parking sequence, taking the stress and logistics of parking away so they can focus on what’s most important: their care.

In addition to convenience, the structure also offers a few extra perks. It is one of the first fully automated parking systems to offer EV charging pallets. Ten of the 160 parking spaces are equipped to autonomously charge electric vehicles, with the ability to expand to additional spaces as needed.

Despite the automated system being closed to people, you can still get a glimpse of it in action. “We realized during construction that this system functioned entirely behind closed doors, which felt like a missed opportunity,” Stein says. “So we designed a viewing window that would let people watch the system in operation. It’s one of the most appreciated parts of the project.”

Looking to the Future

While fully automated parking systems pose many advantages, they are not a blanket replacement for a traditional parking facility, and still face a number of challenges. Each project requires a dedicated review of its programming needs to determine the right parking system, and parking experts with detailed knowledge of how these systems work are invaluable for selecting the right approach.

However, when the conditions are right, they can offer a groundbreaking, innovative solution, and not just for medical centers. These systems are being integrated into residential buildings, public parking and even university housing, and the more common they become, the fewer barriers they will face.

Photography credits: Ben Benschneider.

 

Transition and Activation Budget Planning

Capitalizing on Opportunities to Capitalize Costs

By Jeff Agner, MPH

The delivery of most healthcare services requires regular upkeep, periodic renovation, and the occasional new construction of physical facilities and infrastructure. Construction projects allow a healthcare organization to remain compliant, competitive, and operationally efficient. A formal project is established to plan and execute the work, and the necessary time and resources are allocated. When the cost is high and the useful life of the resulting asset is long (typically more than 10 years), the project is considered to be a “capital project.” Even though these projects likely require a financial investment (often referred to as “capital”), the term “capital” in this context refers to the fact that the resulting asset can be capitalized. Capitalization is an accounting method that allows an organization to break up the full cost of building or purchasing assets into smaller expense activities over the expected life of the asset through processes known as amortization and depreciation.

When an organization can record such a large investment as an asset on its ongoing balance sheet versus an expense on its annual income statement, the financial health of the organization is seen as far more favorable. This means that the organization has greater freedom to borrow money, attract investors, and conduct business. This article will further explain the concept of asset capitalization and will explore its applications in a healthcare construction project.

When can costs be capitalized?

The capitalizable costs of a healthcare project include the amount paid for constructing, acquiring, and/or improving an asset. As expected, this includes the design and construction labor, materials, and fees necessary to deliver the project, but it can also include expenditures for utilities, interest on debt during construction, and other resources engaged in putting the asset into service. In many cases, these costs are not part of the construction budget but are included in a separate Transition and Activation Budget related to the capital project. Regardless of how the activities are funded, a plan to address the accounting requirements is critical.

Per generally accepted accounting principles for new construction, project costs can be capitalized if at least one of the following conditions are met:

  • Costs contribute to the value of the asset
  • Costs enhance the use/value of the asset
  • Costs ensure or extend the useful life of the asset

Additionally, to qualify for capitalization, these expenditures must occur prior to the asset being put into service.

 

What costs are typically capitalized in a construction project?

Each organization must abide by its specific capitalization policies and procedures and comply with state-level mandates or requirements. The following table lists some common costs encountered during a facility renovation or construction project and whether or not they can typically be capitalized. Final determinations of cost capitilization must be made by the financial leadership team.

Manage and track opportunities to capitalize project costs

Once a Transition and Activation Budget is developed, the healthcare organization’s financial leadership team should evaluate all expected costs and categorize them based on their capitalization potential. Separate cost centers can be established if there is no easy mechanism to flag capitalizable costs as they are incurred so they are not mistakenly accounted for as an expense. All costs should be tracked closely and documented clearly so that the accounting treatment can be applied at the conclusion of the project. Once the new space is operational, the organization’s balance sheet should be updated to reflect the full value of the completed capital project as an asset. This action must be performed within a few months (typically 90-120 days) of the asset being put into use; otherwise, taxes and other financial penalties may apply.

Take advantage of the full value of your investment

The purpose of capitalizing costs is to align the cost of using an asset with the length of time in which the asset is providing a benefit to the organization (aka generating revenue). Finance industry and government-level capitalization policies guide organizations on items that should be capitalized versus those that should be expensed on large construction projects. This guidance is intentionally general in nature to be as broadly applicable as possible. It is up to the organization to understand and comply with its specific guidelines to maximize the financial benefits of capitalization when renovating or constructing a healthcare facility.

Illuminating the Path to Healing

Elements of Effective Lighting Design in the Behavioral Health Facilities

By: Ellie Motevalian- Lighting Designer, LC, LEED GA and Toranj Noroozi, Lighting Designer, LC, P2S, a Legence company

 

Lighting design plays a crucial role in creating supportive environments in behavioral health facilities, promoting well-being, and facilitating healing journeys.

Beyond its technical aspects like anti-ligature and vandalism, lighting serves as a companion, subtly influencing wellness. Join us as we explore how this understated element, with its artful touch, profoundly shapes the healing experience in behavioral health facilities.

Biophilic Design:

Biophilic design is an architectural and interior design approach that seeks to reconnect people with nature within the built environment to encourage them to co-exist with it. Rooted in the idea that humans have an innate connection to the natural world, biophilic design incorporates elements and features inspired by nature to enhance the well-being and productivity of occupants.

There is much research supporting the hypothesis that biophilic design will enhance physical, mental, and cognitive health and has positive impacts on stress relief, cognitive skills, and sensitivity both in children and adults.

There are various ways lighting can be incorporated into the biophilic design:

  • Light Therapy
  • Natural Daylight
  • Circadian Rhythm through Artificial Lighting
  • Shapes, Finish and Pattern

Light therapy, also known as phototherapy, has emerged as a crucial tool in addressing Seasonal Affective Disorder (SAD), which is characterized by symptoms such as low energy, mood fluctuations, and a general sense of lethargy. Light therapy involves exposure to a bright light that mimics natural sunlight, stimulating the production of serotonin and regulating melatonin levels to alleviate symptoms of depression. Beyond SAD, the importance of light in treating mental health issues extends to various conditions, as exposure to natural or artificial light influences circadian rhythms and affects neurotransmitter levels. Light therapy has shown promise in treating other forms of depression, bipolar disorder, and sleep disorders. The role of light in regulating mood and overall mental well-being underscores the significance of incorporating light therapy into comprehensive mental health treatment strategies.

Exposure to natural light has been consistently linked to improved mood, enhanced cognitive function, and regulation of circadian rhythms. Integrating daylight into these spaces creates a more pleasant and uplifting environment, reducing feelings of confinement and fostering a sense of connection to the external world.

By introducing daylight, as much as possible into the architecture through windows, light wells, skylights, and clerestories, the therapeutic impacts of natural light can be harnessed to create a supportive atmosphere for individuals seeking behavioral health services.

Given the constraints within architecture and construction, coupled with varying durations of time users spend within interior spaces, the thoughtful integration of architectural lighting becomes pivotal for the enhancement of circadian rhythms. Not all architectural designs allow for abundant natural light to penetrate indoor environments, and users may find themselves exposed to artificial lighting for extended periods. In such cases, leveraging architectural lighting becomes a strategic tool to simulate the effects of natural light on the circadian system. The usage of a diffused indirect lighting approach as an expansion and continuation of daylight perception into the interior space provides an opportunity to integrate biophilic design with architectural lighting.

In applications where the users are deprived of receiving enough natural light throughout the day incorporating human-centric lighting within the architectural lighting to provide the blue wavelength (490nm) for maximum daytime circadian impact is essential. The sky-blue wavelength which mainly lies within the invisible spectrum can be provided for several hours depending on the technology used to balance the circadian rhythm through Melanopic and skin pathways.

Quality sleep plays a crucial role in maintaining good mental and behavioral health. As the sun sets, much of the blue light is scattered, signaling to our bodies that it’s time to wind down and prepare for sleep. In residential and relaxation spaces, lighting can be strategically utilized to promote healthy sleep patterns, particularly through the use of “zero-blue” light fixtures. These fixtures eliminate the blue spectrum of light to mimic the natural pattern of sunlight. Additionally, during nighttime hours, it’s recommended to use amber night lights to illuminate pathways for safety while still supporting the body’s natural sleep-wake cycle.

Another way the lighting can be part of the biophilic design is through effects and forms. One example is in interior nature spaces, by creating lights and shadows, lighting will enhance the vibrant nature-like environment.

In addition to the quality of light and its impact on the space, the shape, form, and finish of the light fixtures are influential design factors in the mental and overall emotional state of the occupants. One of the main driving factors is to implement lighting to create a calm, inviting atmosphere that provides a sense of safety and tranquility. This can be achieved by the implementation of light fixtures that offer soft edges and earthy color tones, with more of a hospitality aesthetic. By opting for fixtures with gentle curves and natural finishes, the overall design can further enhance the soothing ambiance of the space. These fixtures not only provide functional illumination but also contribute to the overall design cohesion, promoting a harmonious environment.

Figure 1 Example of lighting in common spaces, using indirect sources of light to reduce glare, providing multiple layers of light including vertical illumination, in addition to using nature-inspired finishes and shapes.

Figure 1 Example of lighting in common spaces, using indirect sources of light to reduce glare, providing multiple layers of light including vertical illumination, in addition to using nature-inspired finishes and shapes.

Shaping serenity: optimal visual comfort and glare management

In the behavioral health facility setting, where individuals may already have higher sensitivity and emotional challenges, the importance of creating a visually soothing environment should not be ignored. Effective lighting design is characterized by glare reduction, flicker-free illumination, and appropriate color temperature selection. The overall lighting effect should be continuous, soft, and even to minimize any discomfort or agitation. Harsh patterns and shadows created by light should be avoided, as they can exacerbate feelings of anxiety and disorientation. It’s also important to eliminate dark corners and avoid extreme contrasts between light and dark spaces, which can induce feelings of unease. To create a more dynamic and therapeutic environment, it’s recommended to incorporate various layers of light, including vertical illumination and accentuating features and materials.

Indirect lighting, edge-lit light fixtures, and fixtures with louver and diffuser can minimize the harsh glare. One of the metrics to evaluate the light fixture glare is UGR. Many lighting manufacturers provide fixture UGR information on their cut sheets or IES files. Based on some of the standards like LEED Well, UGR below 16 is considered a low-glare fixture and can help with visual comfort in behavioral health facilities. Choosing the appropriate lighting color temperature (in most cases warmer CCT in the patient area) contributes to creating a calming atmosphere that facilitates relaxation and promotes a sense of security for the user.

Some conditions such as autism spectrum disorder are more sensitive to lighting fixtures flicker. Providing flicker-free lighting solutions minimizes visual disturbances that could decrease anxiety and stress levels among the patients. Several key aspects warrant consideration to minimize light fixture flicker, including High-quality drivers with higher frequency, compatibility of the driver and light control, and light fixtures with certifications like Energy Star.

Figure 2 Example of corridor lighting, using an indirect source of light as a continuation of natural lights, to minimize glare and enhance visual comfort, providing even illumination on horizontal and vertical surfaces.

Figure 2 Example of corridor lighting, using an indirect source of light as a continuation of natural lights, to minimize glare and enhance visual comfort, providing even illumination on horizontal and vertical surfaces.

Balancing safety with patient autonomy (independence)

Effective lighting design should consider the specific needs of patients, ensuring adequate visibility for staff while minimizing potential hazards like sharp objects or ligature risks. At the same time, providing patients with control over their environment can significantly reduce their stress and anxiety levels, increase their self-esteem, and improve the patient’s mental well-being.  By collaborating with healthcare professionals this delicate balance can be achieved in the design, and it will enhance the overall quality of care and patient experience.

In high-risk areas of the facility like patient rooms, anti-ligature light fixtures can be considered. Using this type of fixture can reduce the risk of self-harm and ensure the patient’s safety. Design strategies such as using tamper-resistant fixtures, avoiding protruding elements, and selecting durable materials are critical to mitigate the risk of ligature-related incidents.

There are no specific codes or regulations governing anti-ligature fixtures. While various organizations offer guidelines and recommendations, there is no mandated standard applicable across all jurisdictions. One commonly referenced source is the New York State Office of Mental Health recommendation that many lighting manufacturers rely on to design anti-ligature fixtures. Designers can use this reference when selecting fixtures for high-risk areas.

While utilizing anti-ligature fixtures in high-risk areas is critical for patient safety, the design should still provide patients with a degree of control over their environment.  Examples of these controls can be:

  • Adjustable lighting settings to allow individuals to customize the light fixture brightness based on patient preference.
  • Personalized bedside reading light fixture with dimmer switch.
  • Natural light control options like adjustable blinds or curtains.

Figure 3  Typical lighting design for patient room.. Access to daylight, dimmable anti-ligature reading light, and low glare recessed downlight. Tamper-proof dimming switch for controlling the lights.

 

In conclusion, the careful orchestration of lighting design elements explored in this paper underscores the pivotal role played by environmental factors in shaping the healing process within behavioral health facilities. By embracing the principles discussed above, the designers can craft spaces that enhance the well-being of the users and empower individuals in their recovery journey. As we advance in our understanding and implementation of lighting design strategies, designers must remain vigilant in implementing evidence-based practices to foster environments that nurture both physical and psychological healing.

 

References:

  • S. Department of Veterans Affairs (2021), Design Guide for Inpatient Mental Health And Residential Rehabilitation Treatment Program Facilities.
  • New York State Office of Mental Health, 30th edition (2023), Patient Safety Standards, Material and Systems Guidelines.
  • Perkins , Deborah (2024), How Designers can Use Flicker Safe Dimming.
  • Amber Roguski, Philipp Ritter, Daniel J. Smith – Sensitivity to light in bipolar disorder: implications for research and clinical practice (2024. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists)
  • Bios Lighting. (2024). Technology – Bios Lighting. Retrieved from https://bioslighting.com/architectural-lighting/technology-2/

 

 

 

 

 

 

YOU + The Symposium = Better Futures

by Dr. Wayne Ruga 

The Symposium is a resource that supports you in being more effective in the work that interests you.  It is a catalytic cauldron, a crucible for forging the fusion of diverse elements to make better futures for everyone.  You are the passion that fuels this dynamic fusion.

The Symposium, importantly, is not what it may appear to be – although it might look like a conference, if you engage with it like an ordinary conference, its magic will elude you.

Yes – of course, it is a conference, but it is so much more.  Consider this assertion:  the Symposium is an entirely democratic community where you have the explicit liberty and freedom to speak your mind.  In fact, you are encouraged to speak your mind to share your unique perspective on how we can – all – be more effective in our quest to create the best possible healthcare facilities.  The Symposium is a place where your voice is valued.

How would you know that your unique voice is valued?  One of the many unique aspects of the Symposium is that relationship matters, human interaction matters, and someone you strike up a conversation with will listen to you – actively listen to you and genuinely care about what you say.

Jenabeth Ferguson, the Symposium Director, is always open and available to suggestions and feedback.  In fact, since the very first Symposium in 1987, there has been a volunteer Advisory Board representing the many diverse voices comprising the professions and industries the Symposium engages with.  This group is much like the US Congress – it is a formal mechanism representing all stakeholders in healthcare and design, actively seeking to bring current and emerging issues into the Symposium programs.

Think about it – the Symposium is not a membership organization – this is by design.  The first time someone attends, it is because they are hoping to receive returns that exceed their investment.  When they return the next time, it is because they know their returns have exceeded – and will exceed – their investment.  Loyalty is strictly a product of outcomes – if you don’t get what you came for, you won’t return.

The original design vision of the Symposium was for it to be a community.  It was never designed to be a conference.  In fact, this is exactly why it is named a symposium.  It is supposed to be a catalytic experience where we can all – as a cross section of like-minded stakeholders in health, healthcare, and design – share our resources, learn from each other’s perspectives, and collaborate in building a better world.

It only works when YOU do that.

Authentic sharing vitalizes the Symposium experience.  Sharing, not in the sense that – if I give you half of my sandwich, I have now diminished my ability to properly nourish myself.  Rather, in contrast, Symposium-style sharing means that the receiver is better off, and the giver is also better off, having not – in any way – being diminished by the sharing.

 

For example – if I share with you my interest in designing facilities that actively contribute to the reduction of the rate of medical non-adherence, and that also increase the rate that employees give of their discretionary effort – I lose nothing by this sharing, and it may excite you as much as it excites me, encouraging you to go on to become an expert in developing new approaches to design that enables unprecedented improvements to be made – – – we would all be better off, then, and neither of us would be diminished.

As a very practical matter, investing in attending the Symposium is costly – the costs of travel, accommodation, meals, and the registration fee can add up to a sizable sum.  What can you do to maximum the returns you receive on your investment?

Come prepared.  Give thought, in advance, to what you would most value taking home with you.  What are you interested in?  What resources are you looking for?  What is your own unique perspective, or resource, that you can share with others?  What is your passion?

Bring lots of business cards and make an active effort to come home with none left, and a pocket full of cards from people you’ve never met before.  Do not hang out only with people you already know – every time you sit down, sit next to someone you don’t know and introduce yourself.  Ask them where they are from and what they do – you’d be amazed how much you will learn AND how these simple exchanges can change lives.

The Symposium is designed to provide opportunities to continuously meet new people:  from the hosted Happy Hour, to the events in the Expo, the facility tours, the breaks, the concurrent session programs, the Keynotes, and the Awards Luncheon.  Also, if you are a product manufacturer, the Expo is a designed experience that maximizes the potential to meet new individuals with an interest in your products.

The various award programs can put the spotlight on you, becoming an Advisory Board member can engage you with a group that has built friendship spanning decades, writing a Leaflet article can serve as a platform for broadcasting your voice, giving a concurrent session program can open many new doors, and becoming a Symposium sponsor has promotional benefits that benefit you and your organization.

The equation is a simple one:  the more you invest of yourself, the greater the benefits you will receive.  There are a surprising number of individuals who have attended the Symposium, regularly, for decades.  The reason why is simple to understand: the benefits exceed the costs.

The Founder’s Award was first given in 2011, at the 24th annual Symposium.  It is an award that cannot be applied for and there is no nomination process.  It is given to individuals who have, over time, actively given of their own discretionary effort and demonstrated their  support of giving wings to the ideals of what the Symposium aspires to accomplish.

To date, 14 individuals – from every imaginable background, profession, and industry – have received this award and become distinguished Fellows, to their own surprise.  Voluntary community leadership has its costs – nevertheless, the investment of personal energy that produces a more flourishing community, and a better world for everyone, is a personal reward that extends beyond any, and all, financial consideration.

If there is ever any way that you feel the Symposium can better support you, please always feel welcome to discuss this with Jenabeth, an Advisory Board member, or myself.  I hope to see you in Austin, in September, at the 37th annual Symposium.

 

Wayne Ruga is the Founder of the Symposium and a Special Advisor to its management.  He can be reached at:  [email protected] .

 

 

 

 

Still Different by Design

The Symposium is totally different from your average industry event; our mantra is “different by design”. There are a lot of ways that mantra manifests itself in how we plan the event each year.

Attending an event is a lot. You not only loose time in the office to be getting to all those tasks on your schedule, but it impacts your personal life. There are arrangements to be made for kids, elderly parents, pets and homes. It is one of the driving forces in making sure the event we produce each fall is worthy of the effort it takes all of you to attend. Let’s be honest, there are a lot of events for you to choose from each year and so it is always our mission to make sure the Symposium is worth your effort, time and resources.  It is why our event rotation is Tuesday to Thursday and our hours are condensed so you still have time to work during the week, you don’t loose time away from your family on the weekends and can still attend educational sessions, network with with peers and source products on the exhibit floor.

Networking is such an important part of attending events.  Connecting with clients and partners while meeting new friends. We offer several unique networking opportunities every year.  The highlight is our raffle where you have the chance to talk to exhibitors and laugh with other attendees trying to win the amazing prizes, all in the name of donating money to a worthy charity.  Since we started the annual raffle, the Healthcare Facilities Symposium & Expo community has donated over $200k to many worthy charitable organizations.  A lot of those organizations are small and the donation we made was a game changer.  Every year the exhibit floor closes with an ice cream social – who doesn’t love ice cream!  It’s a fun way to spend the last hour visiting exhibitors and enjoying other attendees.

We truly embrace the ENTIRE design team. Our roster of speakers and the advisory board is the best demonstration of this, as you can see, we have architects, engineers, contractors, interior designer from both design firms and healthcare providers.  Yes, we have different sessions for all the disciplines but at the same time, we have case studies that everyone is interested in, or keynotes that inspire all. This melting pot of attendees network and engage so they can learn from each other and become better together.

We have often done things a little different than the other industry events and it works not just for the sake of being different. It works because it gives all our attendees, speakers, exhibitors and partners great value when they spend 3 days each year at the Symposium.

As you plan your fall schedule and decide which trips are worth packing up and leaving your family and home, I hope you keep in mind why the Symposium is different and put us on your calendar.

I look forward to seeing you in Austin in September!

Jenabeth Ferguson
Vice President, Symposium Director
Healthcare Facilities Symposium & Expo

P.S. Have a thought about the Symposium? Please feel free to contact me at any time at [email protected].

All’s Well with Single-Source Envelope Solution

By: Ron Laramie, Regional Sales Manager – Business Development, Nucor Insulated Panel Group

St. Michael Medical Center expansion builds on health care legacy rooted in community service

The recent $500 million, 500,000-square-foot acute care expansion of the St. Michael Medical Center (formerly Harrison Medical Center) in Silverdale, Washington, is a project that builds on a caring legacy started by the Harrison family more than a century ago. With a keen focus on providing the best in health and wellness to the Kitsap and Olympic Peninsula communities, the new state-of-the-art medical facility features the latest in technology and patient-centric design—geared toward serving the community “without a trip across the river,” and centralizing the center’s nationally recognized cardiac and surgical care.

The nine-story, light-filled facility can also boast that it is the most energy-efficient hospital in the state. Ketul Patel, CEO of project owner CHI Franciscan Health (now part of Virginia Mason Franciscan Health), is quoted in the Puget Sound Business Journal, sharing, “The facility was … built to use 50% less energy than the average hospital in the Pacific Northwest, use 36% less water and save the carbon output of the equivalent of 700 homes.”

To help meet the ambitious design and sustainability goals, CENTRIA dealer Flynn Group of Companies—an industry leader in North America when it comes to the total building envelope—worked with CENTRIA to incorporate the array of panels, windows, sunshades and louvers that would make the project a stunning success.

Ron Laramie, the CENTRIA district sales manager on the project, recalls that Balfour Beatty, the general contractor, called him in to discuss the design and how CENTRIA’s diversified abilities could support the architectural vision. He says, “They liked the idea that we could not only provide metal panels, but also windows, sunshades, and louvers as a complete envelope package. This is something unique to CENTRIA compared to our competitors—the ability to provide a single source solution for the exterior skin, with one set of details, and typically one installer.”

Essentially becoming part of the design team, the representatives from CENTRIA and Flynn met regularly with the architect, the engineer, and the GC to develop the project specifics and details. In the end, the CENTRIA/Flynn team was successful in securing the project award, ensuring a smooth construction process from start to finish.

CENTRIA provided project management for the insulated metal panels, single-skin panels, and integrated windows, as well as louvers and the design of a special, customized sunshade. Laramie explains, “We partner with Construction Specialties (CS) for sunshades and louvers, which are integrated into our systems. For the St. Michael Medical Center, the architect wanted a sunshade design that didn’t exist. The team at CS designed a sunshade specifically for this project that provided the aesthetic and performance requirements the architect wanted.”

He explains further that sunshades are normally an outrigger, meaning that at the top of the window, there’s a horizontal support to which the sunshades attach, like an eyebrow. “For this project, the design called for individual blades attached vertically to the window. We were able to modify our window system to accommodate the CS custom design.”

The louvers, too, are all integrated, meaning there’s no flashing, extrusion, or anything between the systems. “The joinery of the louvers and windows fit into the joinery of our panel, so it’s all just one system,” Laramie adds.

As for the wall panels, CENTRIA’s Formawall Dimension Series (FWDS) IMPs were used, which are flat panels, as well as FWDS-60, which is a ribbed profile panel. Additionally, the single-skin IW-40A 22-gauge panel, a 12”-wide concealed fastener panel with an 11”- flat and a 1” recess was used on the project. All CENTRIA IW panels share a common lock-joint design, which makes them interchangeable on a project.

 

Another benefit that CENTRIA brings, according to Laramie, is the ability of its products to integrate efficiently into the overall design, which includes other building materials and work with other trades. He says, “One of the interesting features on the front of the building is the incorporation of our foam insulated metal panels with vertical ribbons of CMU block, which looks like stone. From a design perspective, it goes back and forth—panel, window and then the vertical section of stone and then panel, window, etc. Those details required a lot of work and coordination to provide what the architect wanted from both a design and performance perspective, as well as from a thermal standpoint.” He adds that another area of the building is a full glass curtain wall, and again, CENTRIA developed details where they connect into that element as well.

CENTRIA’s integrated windows are exceptionally efficient, Laramie notes, explaining that normally when a window is put in, there is thru flashing around the rough opening where you set the window, and there’s a transfer of heat all the way around that window. “With CENTRIA integrated windows, we don’t have that issue,” says Laramie. “Our window is fully, thermally broken, and the panels are fully, thermally broken, making the complete wall system significantly more thermally efficient than traditional window systems.”

The completed St. Michael Medical Center, which opened in December 2020, is part of Virginia Mason Franciscan Health’s system of 10 hospitals and 230 specialty clinics. With its beautiful appearance, inside and out, along with its superior efficiencies, the facility is ready to welcome and care for its local community members, living up to its “mission to heal, a promise to care.”

Visit www.centria.com to learn more about Formawall Dimension Series IMPs.

 

 

Neuroarchitecture, Biomimicry & Natural Environments for Behavioral Health

By: Stephen Parker & Robyn Linstrom

Often the stress experienced by mental health and addiction patients can be mitigated with access to outdoor spaces. Outdoor spaces should be designed to create a safe, therapeutic environment with a close connection to nature.
Elopement prevention should be discreet and effectively detailed, with limited hand and foot holds on vertical surfaces, especially with relation to building devices and systems in need of coordination by the architect.

Harrel Family Center for Behavioral Wellness Patient Courtyards, Lakeland, FL – HuntonBrady Architects, Stantec (landscape architecture, program management)
Youth Crisis Center Recovery Garden, Confidential Client/Site – Stantec

Natural elements should be safe in case of accidental ingestion while providing a variety of sensory opportunities in terms of color, tactility and olfactory stimulation to mimic biophilia. Trees should be limited in height without easily accessible branches for climbing and prevent elopement while enhancing the feeling of a calming, natural environment. Plants should be selected that prevent their use as weapons or for self-harm while being native species and limit the need for excessive maintenance or irrigation, such as drought tolerance. Materials for walking paths should be selected to avoid loose materials such as small gravel and stones that could be thrown or ingested.

Natural elements, especially those as part of gardening therapy, have a proven stress-reducing effect per evidence-based design strategies. These concepts can aid in staff respite as well. Green micro breaks facilitate stress reduction for overburdened staff, aiding in staff retention in the process. The use of green houses for these adjunctive therapies should be considered as a balance between therapeutic value and patient safety.

If these outdoor environments create views of nature for patient bedrooms or social spaces, then patient privacy should be addressed. Translucent film on windows or vegetative screening are possible solutions to consider.
Landscaping rocks and features should not be able to be moved, thrown or otherwise used for damage to property, others or self-harm. Ample lighting that is exterior-rated and tamper-resistant should be provided for after-hours monitoring. At the Nanaimo Psychiatric Emergency Department on Vancouver Island, British Columbia, this is pushed further with inclusion of a water feature, raised beds and culturally relevant vegetation.

Nanaimo Regional General Hospital Emergency Department and Psychiatric Emergency Services – Patient Courtyard, Nanaimo, British Columbia – Stantec
Brockville General Hospital Redevelopment – Phase 2: Complex Continuing Care, Mental Health and Rehabilitation, Brockville, Ontario – Stantec

Furniture is often fixed and immovable, so the design of seating arrangements to facilitate patient choice is paramount. These more substantive seating arrangements limit damage while providing comfortable seating for individual self-reflection, one on one conversations or various social gatherings as chosen by patients in a safe manner. Furniture should be sited to mitigate elopement in coordination with other site features. The building could serve as an implicit barrier, defining the space while not aiding in the institutional feel of the mental health hospital. Such outdoor furniture selections should limit contraband opportunities as well as mitigate barricading. All of these considerations should strive to maintain a clear line of sight from staff observation areas to ensure patient safety. Ample camera coverage should be provided in outdoor spaces with clear coverage of exits and entrances, and blind spots should be eliminated. Cameras should be impact-rated for exterior use and coordinated with other outdoor devices and features, such as exit signs, lighting and scuppers to avoid creating a climbing opportunity.

Use of outdoor environments should be considered based on client population, but should include a variety of opportunities. Labyrinths and walking paths allow clients to pace to self soothe and self-regulate helping with de-escalation. Basketball courts and other sports focused areas allow for release of energy or anger. Alternate seating types and areas for reflection all contribute to a healing outdoor environment.

Advisory Board Back in Chicago

At the end of January, advisory boards members once again met in Chicago for a day long brainstorming session. Over 20 members of the all-volunteer group traveled to Chicago to meet in person with another 9 members joining us virtually.  The primary goal of the advisory board meeting is to ensure that the Symposium addresses the most pressing challenges and opportunities facing the healthcare design and construction industry today. We start with asking the group “what is keeping you up at night?”

This year the rule was you could not say you “staff shortages” or “too much work” because everyone is in that same boat. One of the main points of discussion was the pressing need to effectively pass on the accumulated expertise of the baby boomers to the younger generation of healthcare design professionals. Millennials, characterized by their digital fluency, innovative thinking, and collaborative approach, represent the future of the industry. However, there are a lot of challenges including with the transfer of knowledge between these generations including differing communication styles, technology integration, cultural shifts and retention of institutional knowledge.

Baby boomers prefer face-to-face interactions and formal communication channels, while millennials gravitate towards digital platforms and informal networks. While the boomers may possess a deep domain knowledge they lack familiarity with the latest technologies shaping healthcare delivery or even offer productivity.  The meeting underscored the importance of fostering a culture of continuous learning and mentorship within healthcare and AEC organizations.  As baby boomers retire or transition into advisory roles, there is a risk of losing institutional knowledge vital for maintaining operational efficiency and quality of care.  Finding a way to bridge the communication gap, integrate new technologies, creating platforms for intergenerational collaboration and strategies to capture institutional knowledge will be critical as this transition continues.

In 2023 we launched the Symposium Emerging Leader Scholarship program to give recognition to individuals with less than 10 years (non-consecutive) of experience in healthcare design and construction including research and/or education.  We had nearly 25 scholarship recipients at the event in Charlotte and they were invited to interact and engage with our advisory board with the hope that we’ll not only support their professional development but also find the next generation of advisory board members who will help us continue to shape the event in a way that serves their needs.

These conversations are going to need to continue not only at board meetings but at the annual event each fall. We also hope to incorporate sessions that talk about healthcare organizations and AEC firms that are finding ways to effectively bridge the communication gap, use new technologies, create platforms for the intergenerational collaboration and capture institutional knowledge. The future of the industry depends on it.

Best,
Jenabeth

Jenabeth Ferguson
Vice President, Symposium & Expo
Healthcare Facilities Symposium & Expo

PS. If you have a suggestion or comment about the Symposium please feel free to reach out at any time at [email protected].