Design That Cares

Acknowledgments xv Foreword xvii Authors' Introduction to the Third Edition xix About the Authors xxi Chapter 1: Introduction 1 Learning Objectives 1 Projections and the Direction of Healthcare 1 Healthcare: Changing Within 4 Design as a Component of High-Quality Healthcare 5 Designing for Patients and Visitors 7 Wayfinding Ease 9 Physical Comfort 9 Control over Social Contact 10 Symbolic Meaning 10 The Facility Design Process 10 Pre-Design Programming 10 Design 11 Concurrent Planning 12 Design Review 13 Construction 13 Activation 13 Post-Occupancy Evaluation 13 Summary 14 Discussion Questions 14 References 15 Chapter 2: A Look at Current Healthcare-Facility Design Research 19 Learning Objectives 19 Design Research in Relation to Current Trends in Healthcare 19 Focusing on Marketing 19 Valuing Healthcare-Facility Design 21 Sensitivity to Patient Experience 22 Recognizing the Role and Needs of Visitors 23 Emphasizing Accessibility and Universal Design 23 Conducting High-Quality Healthcare-Facility Design Research 24 Ensure That Research Is Planned and Carried Out by Trained, Experienced Researchers 24 See That the Research Builds On Existing Knowledge 25 If the Research Involves Clinical Investigations, Look Into Institutional Review Board Certification 25 See That the Research Has a Clearly Stated Purpose Related to Healthcare-Facility Design 25 Provide a Clear Research Design and Related Hypotheses 25 Carry Out the Project as Objectively as Possible 25 Skillfully Word Questions 26 Use Visual Images, if Possible 26 Carefully Sample Respondents 26 Make Sure Participants Give Informed Consent 27 Use State-of-the-Art Data-Collection Methods 27 Use Multiple Data-Collection Methods, if Possible 27 Use State-of-the-Art Data-Analysis Methods 27 State the Limitations of Findings and Their Generalizability 27 Consider Whether or Not the Research Is Replicable 28 Make Design Implications Explicit 28 Communicate Findings in a Way That Is Clear to Non-researchers 28 Research Claims 28 Integrating Design Research into the Design Process 29 Characteristics of a Humanistic Design Process 29 Objectives for Future Healthcare-Facility Design Research 31 Awards for Buildings Sensitive to User Needs 31 Training for Designers in Research Methods 31 Training for Researchers in Design-Relevant Research 32 Long-Term Studies of the Effects of Healthcare Facilities on Users 32 Translation of Research Findings into Design Guidelines 32 More Research Funding 32 International Research Agenda 32 Summary 32 Discussion Questions 33 References 34 Chapter 3: Arrival and Exterior Wayfinding 37 Learning Objectives 37 Traveling to a Healthcare Facility 37 Arriving by Car 38 Arriving by Taxi or Van 38 Arriving by Public Transit 38 Exterior Wayfinding 40 Exterior Signage 40 Environmental Cues 42 Exterior Handheld Maps 43 Main Entrance Drop-Off Area 45 Parking 46 Valet Parking 47 Parking Lots 47 Parking Structures 48 Park-and-Ride Options 49 Long-Term Parking Rates 49 Transition between Parking and the Building Entrance Area 49 The Main Entrance Area 50 Becoming Oriented 50 Access for People with Functional Limitations 52 Waiting in the Main Entrance Area 54 First Destinations 55 Information Desk 55 Admitting or Registration 55 Visitor Information 58 Summary 59 Discussion Questions 60 Design Review Questions 61 References 69 Chapter 4: Interior Wayfinding and the Circulation System 71 Learning Objectives 71 Finding One's Way through a Health Facility 71 Costs of Unsuccessful Wayfinding 73 Building Layout and Landmarks 76 Floor Numbering 77 Room Numbering 79 Sign Messages 81 Symbols and Pictograms 84 Sign Updating 85 Sign Spacing and Location 85 Interior You-Are-Here Maps 88 Color Coding 91 Signage and the Americans with Disabilities Act 93 Directions Given by Staff 93 Wayfinding during Periods of Construction 93 Wayfinding Technology 94 Corridor Functions and Amenities 94 Carpeting 95 Lighting 96 Handrails and Seating 97 Traveling from Floor to Floor 98 Elevators 98 Stairways 100 Unplanned Uses of Corridors, Elevators, and Stairways 102 Summary 103 Discussion Questions 104 Design Review Questions 105 References 114 Chapter 5: Reception and Waiting Areas 119 Learning Objectives 119 Entering a Reception and Waiting Area 119 Reception Areas 120 Waiting Areas 123 Size and Location 123 Waiting-Area Activities and Television 125 Seating Arrangements 126 Seating Comfort 128 Flooring, Wall Coverings, and Lighting 129 Waiting-Area Amenities 130 Main Lobby 137 High-Stress Waiting Areas 138 Summary 139 Discussion Questions 140 Design Review Questions 141 References 147 Chapter 6: Diagnostic and Treatment Areas 151 Learning Objectives 151 Accommodating Patients' Needs in Diagnostic and Treatment Areas 152 Undressing and Dressing 152 Waiting While Wearing a Hospital Gown 155 Maintaining Privacy 155 Optimizing Comfort 157 Considering Lighting 159 Reducing Noise 162 Listening to Music 164 Experiencing Positive Distractions 166 Using Digital Devices 168 Using Restrooms and Water Fountains 168 Facilitating Contact between Patients and Staff 169 Accommodating Companions 169 Summary 169 Discussion Questions 170 Design Review Questions 171 References 177 Chapter 7: Inpatient Rooms and Baths 183 Learning Objectives 183 Acute Care Inpatient Rooms 183 Size and Layout 183 Number of Occupants 190 Control Over Social Contact 191 Color 195 Lighting 199 Style in Healthcare Settings 202 Inpatient Room Furnishings 202 An Outside View 212 Reducing Noise on Acute Care Units 215 Using Music Therapeutically 215 Inpatient Bathrooms 220 Inpatient Lounges 226 Accommodating Visitors 228 Providing for Mealtimes 229 Providing a Place to Spend the Night 229 Family Lounges 229 Intensive Care Units 231 Providing Control Over Social Contact 232 Addressing Sensory Overload and Challenges of Maintaining Family Support 233 Reducing Noise in ICUs 235 Music in ICUs 240 Patient Comfort in ICUs 240 Addressing ICU Visitors' Needs 241 Summary 243 Discussion Questions 245 Design Review Questions 246 References 261 Chapter 8: Access to Nature 273 Learning Objectives 273 The Importance of Nature in Healthcare Facilities 274 Facilitating Recovery from Stress 275 Facilitating Recovery from Mental Fatigue 275 Valuing Access to Nature in Healthcare Facilities 279 Designing Outdoor Spaces for Healthcare Facilities 282 Planning and Designing Outdoor Areas during New Construction 283 Creating a Preferred Nature Setting 284 Bringing the Outdoors In 295 Views to the Outdoors 296 Summary 298 Discussion Questions 299 Design Review Questions 300 References 307 Chapter 9: Users with Disabilities 311 Learning Objectives 311 Statistics Regarding Users with Disabilities 312 Federal Legislation on Disability Rights 314 Americans with Disabilities Act 314 Patient Protection and the Affordable Care Act 315 Section 504 of the Rehabilitation Act of 1973 316 Designing to Comply with Federal Legislation on Disability Rights 316 Universal Design 317 Design Considerations for Patients and Visitors with Mobility Disabilities 323 Guidelines for Accessible Exam and Treatment Rooms 324 Guidelines for Accessible Medical Equipment 326 Design Considerations for Patients and Visitors with Hearing Disabilities 327 Design Considerations for Patients and Visitors Who Are Blind or Have Low-Vision 329 Design Considerations for Older Patients and Visitors 332 Physiological and Psycho-Social Changes 332 Design-related Issues for Older Patients and Visitors 334 Design Guidelines Regarding Older Patients and Visitors 335 Design Considerations for Obese Patients 348 Guidelines for Inpatient Rooms for Obese Patients 349 Guidelines for Furniture and Medical Equipment for Obese Patients 350 Summary 350 Discussion Questions 351 Design Review Questions 352 References 367 Chapter 10: Special Places and Services 373 Learning Objectives 373 Special Places 373 Food Service Areas 373 Sacred Spaces 376 Consultation and Grieving Spaces 377 Emergency Departments 379 Rehabilitation Units 391 Patient and Visitor Information Areas 394 Special Services 396 Overnight Accommodations 396 Shops 397 Hair Care 398 Fitness Centers 399 Spas 399 Summary 400 Discussion Questions 401 Design Review Questions 402 References 413 Chapter 11: User Participation in Healthcare-Facility Design 421 Learning Objectives 421 What Is User Participation in Design? 422 Benefits of User Participation 422 User-Experts in the Design Process 423 The Evolution toward Co-designing 425 Examples of User Participation in Healthcare-Facility Design 426 Developing a User Participation Process 429 Necessary Conditions 429 Mechanisms for User Participation 429 Techniques for Information-Gathering 431 Timing of User Participation 433 Selecting Participants 434 Managing User Participation 435 Implementing Resulting Recommendations 436 Documenting the User Participation Process 436 Summary 437 Discussion Questions 438 References 439 Index 443