Hospital Design: Thesis Research Book

HOSPITAL DESIGN JASMINE SNYDER Thesis Research Book Environmental Effects in Healthcare Melbourne, Australia

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TABLE OF CONTENTS

INTRODUCTION

4

Problem Statement Thesis Statement

Project Goals and Objectives Consultant

MELBOURNE, AUSTRALIA Base Building

6

Site Analysis

7

Socioeconomic Research

8

Local Considerations

9

CASE STUDIES Marin General Hospital

12

MHP Major Hospital

13

Sidney & Lois Eskenazi Hospital

14

PROGRAMMING Adjacency Matrix

17

Space Considerations Code Analysis

18

Accessibility

19

Plan Prototypes

21

RESEARCH Summary

26

Color and Material

27

Environmental Responsibility

28

RESEARCH STUDY

30

SOURCES

32

INTRODUCTION

PROBLEM STATEMENT This project consists of a 50,000 square foot hospital that specializes in treatment for burn victims located in Melbourne, Australia. The average amount of time spent in a hospital for burn treatment is 4-9 days. Long hospital stays can affect a patient’s mood with the most common mental health issues being delirium, dementia, and depression. These common issues may stay with patients even after they leave the hospital. This hospital will provide an environment that can help prevent or diminish the mental issues that can afflict a patient.

GOALS AND OBJECTIVES Create a soothing environment ·

Assess what furniture, materials, and colors

soothe patients and caregivers/ support system.

Research different companies and compare studies to decide what is the best fit.

Work with doctors and nurses to create an effective space for them ·

Utilize the contacts with Wake Forest

Hospital to design spaces that are functional by collaborating with professionals.

Evaluate what a healthcare facility needs ·

Survey patients and employees of healthcare

facilities through a series of questions that can help determine what works and what is lacking.

Plan spaces appropriately ·

Use research, documents, and consultants to

make spaces that meet the dimensional needs

THESIS STATEMENT

for ADA and medical tools.

Hospitals are a place where patients

Emphasize wayfinding

and staff alike are under a lot of stress,

·

physically and mentally. Hospitals are

features to create clear paths and make it easy

solely designed for function right now,

for patients and visitors to navigate the space.

·

Put spaces together that relate to each other

and maximize efficiency.

Use lighting, signage, and architectural

and current design does not consider human behaviors and how the environment they are surrounded by can affect their emotions.

CONSULTANT: FRED PRICE NURSE MANAGER IN BURN UNIT WAKE FOREST BAPTIST HEALTH

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MELBOURNE, AUSTRALIA Base Building Site Analysis Socioeconomic Research Local Considerations

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BASE BUILDING

INFORMATION

AXON OF BUILDING

LOCATION: Melbourne, Australia Southbank VIC 3006, Australia TOTAL AREA: 53,935 SF FIRST FLOOR: 15,912 SF SECOND FLOOR: 16,858 SF THIRD FLOOR: 16,419 SF COLUMN SPACING: 19'-4", 24'

CIRCULATION

First Floor

Second Floor

Third Floor

6

7

SITE ANALYSIS

SUN STUDIES

SUMMER

LOCATION AUTUMN

Opportunities: Close to hotels Near the University of Melbourne Accesible by tram

WINTER

SEASONS

SPRING

SUMMER

AUTUMN

WINTER

(DEC.-FEB.)

(MAR.-MAY)

(JUNE-AUG.) (SEPT.-NOV.)

WARM TO HOT

MILD

COOL

SPRING

COOL TO MILD

SOCIO ECONOMICS

DEMOGRAPHICS Median age: 27 Avg. children per family: 1.3

Male 48.7%

World's 10th largest immigrant

Female 51.3%

population Hosts over a million international visitors Resident types: young professionals, international students, older couples Official language is English

CITY LIFE Government and city council value

500,000 AUD

safety, health, and cleanliness Center for arts and culture, education, dining, and shopping

400,000 AUD

Focused around a central business district

300,000 AUD

200,000 AUD

INNER CITY AREAS: AFFLUENT, GENTRIFIED OR BOHEMIAN SUBURBAN AREAS: MIDDLE CLASS

100,000 AUD

OUTER SUBURBAN AREAS: LOWER INCOME INCREASE IN PROPERTY PRICE IN

0 AUD

Lowest Avg.

Avg. Salary

Highest Avg.

PUBLIC TRANSPORT AREAS

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9

LOCAL CONSIDERATIONS

MATERIALS

CONSTRUCTION METHODS Rammed earth

FRAMING

from local quarries

Solid brick

Brick

Clad

Post and

veneer

frame

beam

Australian ashcrete is made from quality fly ash, a fine, grey powder coming from coal power plants

FLOORING

1

Australian-made bricks Concrete

Australian timber

Stumps

ROOFING

Truss

Pitched system

"ARCHITECTURE IS NOT CREATED, IT IS DISCOVERED – THE HAND WILL FIND SOLUTIONS BEFORE THE MIND CAN EVEN COMPREHEND THEM." ~ GLENN MURCUTT

CASE STUDIES Marin General Hospital MHP Major Hospital Sidney & Lois Eskenazi Hospital

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MARIN GENERAL HOSPITAL GREENBRAE, CA PERKINS EASTMAN Project composed of 3 separate buildings Replace the required acute care program Provide adequate parking Provide necessary outpatient support 294,000 SF Acute Care building 80,000 SF Ambulatory Services building 415-space parking structure Acute care building Four-stories plus a basement Emergency, diagnostic imaging, and interventional platform Private rooms: 18 ICU beds, 7 NICU beds, 91 surgery beds Patient interaction zones Referred to as "lanterns" Provided on every nursing unit facing Mt. Tamalpias Indoor/ outdoor patios Designed to support staff flexibility and efficiency Support space, staff areas, and storage all right sided for efficiency

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MHP MAJOR HOSPITAL

SHELBYVILLE, IN BSA LIFESTRUCTURES Replacement facility Flexibility Patient and family-centered care Staff efficiencies Improved medical outcomes History of the hospital was kept in mind Stone arch salvaged and incorporated into the entry vestibule Photography of architectural features from original hospital is displayed Patient experience drove all major design decisions Focus on outpatient services with a small percent of inpatient Entire second floor designated to physicians offices and exam space Inpatient unit Third floor Central bath and spa with massage room

SIDNEY & LOIS ESKENAZI HOSPITAL INDIANAPOLIS, IN HOK 1.3 million SF hospital and health campus Promote prevention, health and wellness, and an uplifting, dignified care experience 37-acre campus 315 bed hospital 100 bed emergency department 275 room outpatient center and faculty office building One of the world's largest LEED Gold healthcare campuses Design team was committed to providing patients and their families with the best possible environments for positive health outcomes Easy for visitors to navigate the building and grounds Heath-enhancing views to the outdoors Clear wayfinding Strategically placed windows in patient rooms and visitor areas Sunshine and natural environment Bright, airy feeling Materials are simple, clean, easy to maintain Moments of joy Open plazas Landscaped gardens Water features Indiana limestone Extensive public art program Highly efficient plan Serves 20% more patients Less sq ft Air quality and infection control HVAC systems uses 100% outdoor air Reduces the risk of contaminants

"AS MUCH AS THE NEEDS OF FACT, THE NEEDS OF THE SPIRIT AND THE SENSES, MUST BE SATISFIED. ARCHITECTURE IS AS MUCH A PART OF THE REALM OF ART AS IT IS OF TECHNOLOGY; THE FUSION OF THINKING AND FEELING." ~ HARRY SEIDLER

PROGRAMMING Adjacency Matrix Space Considerations Code Analysis Accessibility Plan Prototypes

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ADJACENCY MATRIX

USAGE TYPE B 27.7%

A-2 2% S-2 4%

I-2 66.3%

SPACE CONSIDERATIONS Thermal: Individual control for patient rooms Control sun temperatures Outdoor spaces need sun protection Acoustic: Natural noise from medical devices can be disturbing Design for acoustic control to alleviate stress A redesign had white noise installed in the ceilings in the hallways to help mask some of the sounds Air quality: Needs good filtration since immune systems are compromised Prevent airborne illness

CODE ANALYSIS

USE GROUPS

MAXIMUM TRAVEL DISTANCE TO EXIT

Employee Spaces: B (Business) Reception, Cafeteria, & Conference: A-2 (Assembly) Inpatient Spaces: I-2 (Institutional) Outpatient Spaces: I-2 (Institutional) Closets: S-2 (Storage)

B: 300' A-2: 250' I-2 (Inpatient): 200' I-2 (Outpatient): 200' S-2: 300'

AREA PER GROUP B: 3,4OO SF A-2: 4,800 SF I-2 (Inpatient): 10,200 SF I-2 (Outpatient): 5,800 SF S-2: 720 SF

OCCUPANT LOAD

INTERIOR FINISH CLASSIFICATION

B: 22 A-2: 320

USE

EXIT PASSAGE

CORRIDORS

ROOMS

I-2 (Outpatient): 58

B

B

C

C

S-2: 2

A-2

B

B

C

TOTAL OCCUPANT LOAD: 444

I-2

B

B

B

S-2

B

B

C

I-2 (Inpatient): 42

RESTROOMS PER SPACE Inpatient Rooms: 1 per room Employee Spaces: 1 Visitor Spaces: 1 Assembly Spaces: 5

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ACCESSIBILITY

EXAM ROOM

SURFACES

TURNING CLEARANCES

ACCESSIBLE ROUTE

MINIMUM # OF WHEELCHAIR SPACES USE

MIN. NEEDED

B

1

A-2

6

I-2 (Inpatient)

2

I-2 (Outpatient)

4

ACCESSIBILITY

ADA RESTROOM

PUBLIC RESTROOM

PRIVATE RESTROOM

MOUNTING HEIGHTS

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PLAN PROTOTYPES

PLAN PROTOTYPES

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PLAN PROTOTYPES

"WE NEED BETTER ARCHITECTURE AND PLANNING: MORE IMAGINATIVELY EXCITING, MORE INVOLVING, MORE OUR OWN." ~ ROBIN BOYD

RESEARCH Summary Color and Material Environmental Responsibility

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SUMMARY

THESIS RESEARCH The average amount of time spent in a hospital for burn treatment is 4-9 days,

IMPACT ON MENTAL HEALTH OVER TIME

but the stay may be longer if the patient receives surgery and needs to

Full Recovery 33.3%

recover. If the burn is serious enough a patient may need to go to a rehab facility before going home.

Since physical health is the primary goal, a burn victim may cope with

Did not fully recover 66.7%

psychological trauma from surgeries, pain, and intensive care by themselves.

Hospital stays can affect a patient’s

DEPRESSION

1 month 15% 12 months 6%

mood with the most common mental health issues being delirium, dementia, and depression. These common issues may stay with patients even after they leave the hospital.

A study that analyzed patient mental

79%

1 Month 16%

health with recovery and how long they spent in a hospital showed a higher depression score at baseline

ANXIETY

12 Months 10%

and spending more nights in a hospital were associated with significantly reduced odds of recovery.

Designing a space where patients and

74%

caregivers feel comfortable can increase their satisfaction in the time spent in the hospital. Clear navigation can also increase the level of satisfaction patients and caregivers feel while staying at the hospital.

HIGHER DEPRESSION SCORES AT 1 MONTH WERE ASSOCIATED WITH LOWER ODDS OF SELF-REPORTED RECOVERY AT 12 MONTHS, AS WERE SPENDING MORE NIGHTS IN A HOSPITAL AND GREATER LEVELS OF PAIN

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COLOR & MATERIAL

COLOR

MATERIAL

Australia uses Western color theory; no

Materials for healthcare design must

specific color has a different meaning

meet certain specific requirements to

to them than as recognized by

ensure the safety and health of

Western culture.

patients and doctors alike.

Warm colors are associated with passion, happiness, enthusiasm, and energy.

Orange is a vibrant and energetic color

Flooring should be non-slip and high

that can be associated with change

durability.

and movement. It is considered a friendly and inviting color.

Yellow is associated with hope and is considered the brightest and most energizing of colors.

Furniture fabrics should be antibacterial/ anti-microbial and

Cool colors are calming and relaxing.

finish surfaces on tabletops, counters, etc. should be able to handle harsh

Light blues are considered refreshing

chemical disinfectants.

and friendly. The shade of blue can have a varying impact on the tone it is creating.

Ideally, inpatient rooms would include blankets and pillows that are able to be thoroughly disinfected, or, if the hospital policy is to throw everything away, they are made from sustainable materials.

ENVIRONMENTAL RESPONSIBILITY

COMMUNITY 10%

AIR 10%

MIND 10%

MATERIALS 10%

WATER 10%

WELL V2

SOUND 10%

NOURISHMENT 10%

THERMAL COMFORT 10% LIGHT 10%

MOVEMENT 10%

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ENVIRONMENTAL RESPONSIBILITY

Aims to achieve high levels of indoor

Promote human productivity and

air quality across a building’s lifetime.

provide a maximum level of thermal comfort among all building users

Covers aspects of the quality,

Bolster occupant health and well-

distribution, and control of liquid

being through the identification

water in a building

and mitigation of acoustical comfort

Requires the availability of fruits and

Reduce human exposure, whether

vegetables and nutritional

direct or through environmental

transparency

contamination, to chemicals that may impact health

Promotes exposure to light and aims

Promotes mental health through

to create lighting environments that

policy, program, and design

promote visual, mental, and biological

strategies

health

Promotes physical activity in everyday

Support access to essential

life through environmental design,

healthcare, build a culture of

policies, and programs

health that accommodates diverse population needs

RESEARCH STUDY TEAM: JASMINE SNYDER & HANNAH RICHARDS

HOW CAN DESIGN IMPROVE HEALTHCARE?

INTERVIEW: WILLIAM WINSTEAD

For our research study, we created a survey to learn how patients viewed healthcare facilities and if they felt there were areas that needed improvement through design. There were 17 questions varying between multiple choice, ranking 1-5, and short responses. Additionally, we interviewed 2 healthcare professionals

MEDICAL STUDENT SCRIBE AT CARETODAY CLINIC As a scribe and medical student, William

and asked their opinions on how

brought unique insight to our research. He

healthcare environments could

put a strong emphasis on the importance of

improve.

communication, especially between different parts of a medical facility and how

STIMULATION THEORY Arousal perspective: behavior is influenced by how stimulated we are by our environment.

In hospitals, patients can be overstimulated by noise, lighting, etc. which can affect their recovery

the layout can play a role in the success or failure of this. He also talked a lot about how important he believes access to daylight is not only for his patients but also for the medical staff’s own health and sanity.

William further added to his point about daylight when he discussed his favorite place being the lobby where there is a large atrium and windows that let lots of light into the space.

process.

In this research study we looked at how the environment can impact patients and employees in the healthcare system.

KEY THEMES & TOPICS:

WAYFINDING PRIVACY LIGHTING COMFORT

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RESEARCH STUDY TEAM: JASMINE SNYDER & HANNAH RICHARDS

SURVEY RESULTS

INTERVIEW: FRED PRICE

8 1y - 2y 7.1%

6

4 6m 1y 35.7%

Within 6m 57.2%

2

0

LAST TIME IN A MEDICAL

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2

3

4

5

NURSE MANAGER

LEVEL OF COMFORT

WAKE FOREST BAPTIST HEALTH

FACILITY

As a person who has worked in several burn units, Fred knows what is missing from an effective hospital unit. He believes the nurses

8

Specialist 7.1%

station should be barrier free, the nurses

ER 7.1%

need a break room that does not look as 6

Clinic 28.6%

sterile as the environment they work in, and the more access to daylight the better. He knows that patients need their rooms to be a

4

safe space and that hallways need good acoustic control in order to minimize stress

2 Hospital 7.1%

on patients. Fred thinks it is good to

Primary Care 50.1%

0

TYPE OF MEDICAL FACILITY

QUALITY OF PATIENT ROOM

1

2

3

4

5

incorporate areas of outdoor space for both employees and patients so they can have fresh air and sunshine.

10

Support Role 21.4%

7.5

INCORPORATION OF OUTDOOR SPACE SHOULD BE IMPORTANT

5

NURSES HAVE NEEDS THAT, WHEN MET, CAN Patient 64.4%

COVID Testing 14.2%

EMPLOYEES- MAKING THE PATIENT 0

REASON FOR VISIT 31

MAKE THEM BETTER AND MORE EFFICIENT

2.5

1

2

3

QUALITY OF LIGHT

4

5

EXPERIENCE BETTER ACOUSTIC CONTROL IS AN IMPORTANT FACTOR OF INPATIENT AREAS

SOURCES APA

SOURCES APA