Reexamining the Exam Table (Programming)

Katelyn Nigus

Programming

IAPD

Fall 2014

Kansas State University

Reexamining the Exam Table

Table of Contents

1

Introduction

Project Statement ........................................... 5 Goals and Objectives .................................... 6 Background Research .................................. 8 Client and User Needs ............................... 20

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Health Care Environments ...................... 24 Codes & Cleanliness ................................... 26 Ergonomics ..................................................... 28

Human Factors

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Case Studies 2

Empath by Steelcase Health .................. 38 623 Barrier Free Examination Table .... 42 PF4000 Examination Table ...................... 46 Comparison ..................................................... 50

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Context

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Theories ............................................................. 54 Trends ................................................................ 72

Product Approach

Material Analysis ........................................... 80 Atmospheric Options .................................. 82 Product Strategy ........................................... 84 Marketing Strategy ...................................... 86

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Results ................................................................ 90 Overall Effectiveness .................................. 91 Bibliography .................................................... 92

Closing Thoughts

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1 Introduction Section Includes Project Statement Goals and Objectives Background Research Client and User Needs 4

1. Reduce surface contamination linked to healthcare associated infections 2. Reduce patient falls and associated injuries

Project Statement

Healthcare furniture and equipment has advanced in terms of providing increased patient comfort, accessibility, hygienic properties, and technological advances, while the modern exam table has remained relatively unchanged. In studying the established research, there are eight main goals for healthcare furniture research and development. These goals include:

3. Decrease medication errors 4. Improve communication and social support for patients and family members 5. Decrease patient, family member, and staff stress and fatigue 6. Improve staff effectiveness, efficiency, and communication 7. Improve environmental safety 8. Represent the best investment. (Furniture Design Feature, 2014) By implementing these eight goals an effective prototype of a new exam table can be created that is easy to use for doctors and nurses as well as comfortable for the patients. Creating this exam table establishes a more supportive piece of furniture for the type of healthcare provided today, more accessible for various ages and sizes of patients, is constructed of hygienic materials for increased comfort, cleanability, and durability, and ultimately assists physicians and nurses in carrying out their jobs. In doing so the prototype hopes to create a better holistic approach to the health environment and give the patient a more comfortable overall experience at the doctor’s office.

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• Incorporate tools for nurses and clinicians to use without causing work related injuries • Design ergonomic adjustments to accommodate varying generations (especially the elderly population in transferring patients on and off the table)

2. Incorporate hygienic materials (fabrics, metals, and plastics) to assist in infection control and for ease of maintenance for nurses and clinicians as well as janitorial staff.

• Integrate anti-microbial technology within selected materials to increase the sterile properties of the material • Ensure minimal joints and connections of materials at surfaces patients will come in direct contact with

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Levels of Adjustability

Goals and Objectives

1. Provide built-in adjustability for users of all capabilities.

3. Accommodate for new and changing technology within patient centered care specifically related to the exam room.

• Allow patients to incorporate personal technology into the healthcare experience to reduce error and further involve family or caretakers in the process • Ensure durability of integrated technology along with the ability to upgrade components as needed

4. Design an innovative and cost effective prototype with pneumatic functions for increased flexibility and expanded application.

• Allow the redesigned exam table to be available to the masses • Provide a new option to be to be integrated into healthcare systems to accommodate an aging population.

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Background Research

Exam Rooms that Empower People The quality of people's experiences and the human dimensions of healthcare are more important than ever before. As active participants versus passive participants, today's consumers of care are transforming past norms, driving rapid change across the industry as they seek a person-to-person approach and more control over decisions about their health and wellbeing.

Within the healthcare industry there are new tools, programs and approaches rapidly evolving which have healthcare organizations grappling with how to incorporate them successfully. At the same time, they shouldn't overlook an asset that's highly leverageable and pivotal to success: their spaces. Patient engagement is becoming the new clinical paradigm; exam rooms are critically overdue for a makeover (Exam Rooms, 2014). In the past exam rooms are seen as spaces where people receiving care in a more passive experience, and most traditional exam rooms are woefully inadequate to support the types of teaching and learning that is paramount for people's engagement in their health. Most of these exam rooms are almost intimidating environments that don't encourage patients to interact with information and the exam table put patients at a different height than the healthcare provider, making sharing information awkward and impersonal. For most patients, the exam room is at the center of their healthcare experience (Exam Rooms, 2014) and it is where the clinical and personal aspects of healthcare closely intersect. In order to create a more efficient and engaging exam room they need to be equipped for teaching and learning about health status, conditions, treatments, and healthy lifestyles. It also means providing better accommodations for more people than just the healthcare provider and patient. This could involve having family or loved ones in the exam room both physically and virtually to ensure that important information is heard, understood and retained.

For healthcare providers, it's important that exam rooms are efficient, well-equipped spaces that streamline the work processes. When elements of place, technology and people are holistically considered in exam rooms, the result can be more engaging, connected care. In doing so there is this new environment dynamic created where people don't feel like patients, they can just have an intelligent conversation with a colleague about something very important - their health (Exam Rooms, 2014). Today exam rooms are essentials tools for supporting the transition to consumer engagement in healthcare. When thoughtfully designed around user needs and furnished with innovative products, exam rooms can be efficient and flexible work environments for healthcare providers.

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(Source http://www.steelcasehealth.com/application/exam-spaces/)

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Background Research

Furniture Design Features and Healthcare Outcomes The healthcare industry has begun to embrace a growing body of work that examined the relationship between the physical environment, human responses, and consequent healthcare outcomes. Because of this, leaders in healthcare have created a design furniture checklist for the industry that include the following outlined below. The checklist was developed to support a healthier environment and have an overall evidence based design goal in the industry.

1.Reduce surface contamination linked to healthcare associated infections: within this section are three key factors: a. surfaces are easily cleaned, with no surface joints or seams b. material for upholstery are imperious (nonporous) c. surfaces are nonporous and smooth (Healthcare Outcomes, 2011).

High risk object within the healthcare environment include furniture closest to the patient, such as inpatient room chairs, over-bed tray table, and bedside tables, as well as medical equipment features like the bed and its rails must constantly be kept clean. Upon examining some specimens of hospital furniture it will seem that the "manufacturers have left angles and depressions which act as receptacles for dirt and germs. It is difficult and in some instances impossible to clean them." (Healthcare Outcomes, 2011).

2.Reduce patient falls and associated injuries: factors seen in this section are: a. chair seat height are adjustable b. chair has armrests c. space beneath the chair supports foot position changes d. chair seat posterior tilt angle and seat back recline facilitate patient egress e. chairs are sturdy, stable and cannot, be easily tipped over f. rolling furniture includes locking rollers or casters g. chairs have no sharp or hard edges that can injure patients who fall or trip (Healthcare Outcomes, 2011).

While not all chairs are made the same, if designer wish to put furniture in their building they must first look at these requirements to make sure that they limit the amount of falls within the hospital.

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3.Decrease medication errors: requirement for this section include: a. Lighting fixtures should provide 90-150 foot candle illumination and an adjustable 50-watt high intensity task lamp for furniture with built-in lighting that is used in a medication safety zone

b. furniture is configurable to create a sense of privacy to minimize visual distraction and interruption from sound and noise during medication transcription, preparation, dispensing, and administrative activities (Healthcare Outcomes, 2011).

4.Improve communication and social support for patients and family members: considerations to take into account: a. furniture can be configured into small flexible groupings that are easily adjusted to accommodate a varying numbers of individuals in a variety of healthcare settings, b. wide-size and age variations are supported, and c. acoustic and visual patient privacy are supported (Healthcare Outcomes, 2011) 5.Decrease patient, family member, and staff stress and fatigue: these factors include: a. materials suggest a link to nature b. appearance is attractive and non-institutional c. furniture is tested for safe and comfortable use by all, including morbidly obese individuals (Healthcare Outcomes,2011) 6.Improve staff effectiveness, efficiency, and communication: factors include, a. furniture is easily adjustable to individual worker’s ergonomic needs b. design enables care conditions and information sharing, and c. materials are sound absorbing (Healthcare Outcomes, 2011) In order to create these aspect designers must look at eco-diversity, spatial transparency, neutral zones, human scale, and functional inconvenience, by doing this they can create a more efficient environment.

7.Improve environmental safety: for this section the main factor is that materials don not contain volatile organic compounds (VOC), such as formaldehyde and benzene (Healthcare Outcomes, 2011). One of the ways this can be accomplished is by having the building LEED certified, (Leadership in Energy and Environmental Design). One of the credit requirements is that all furniture components contain less than 100 parts per million of at least four of five chemical groups:

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1. Urea formaldehyde 2. Heavy metals including mercury, cadmium, lead, antimony 3. Hexavlaent chromium in plated finishes 4. Stain and non-stick treatments derived from Perfluorinated Compounds (PFCs) including Perfluorooctanic Acid (PFOA) 5. Added antimicrobial treatments (U.S. Green Building Council, 2011, p. 61).

8.Represent the best investment: these factors include: a. reflect and reinforce the organizational mission, strategic goals, and brand b. integrate new with existing furniture and objects for facility renovation projects c. pieces can be flexibly reconfigured and moved to support changing and emerging missions d. provide casters or glides to reduce floor damage e. check that there are no hard protuberances that may damage walls; check chair rail heights f. manufacturer provides results of safety and durability testing g. manufacturers describes the specific evidence that has been used to design the product h. manufacturer includes a warranty appropriate to use, such as furniture used all day, every day i. replacement parts are available j. repairs can be done in the healthcare facility k. manufacturer or local dealer can assist with furniture repair and refurbishing l. environmental services (housekeeping) staff can easily maintain furniture m. a Group Purchasing Organization (GPO) can be used when purchasing furniture (Healthcare Outcomes, 2011) There is a focus on furniture as one of many structural elements that research has revealed can play an important, but often unconsidered role, in quality care outcomes. With the checklist, it cdesigners can be equipped with a helpful evaluation and communication tool when developing furniture solutions for their clients.

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Furniture, Fixture, & Equipment (FF&E)

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Background Research

Time for Change: New Solutions for Healthcare Places For most people, the exam room is the center of the healthcare experience. It is a space where consulting, learning and person-to-person sharing happens. Exam rooms are hardworking, highfunctioning spaces that support the activities and relationships that create connected, satisfying health experiences. In doing this designers create spaces that humanize, empower, and connects the patients, partners and providers.

Based on Steelcases' research they have found four insights in creating a better exam room which include: 1. Learning is an essential part of effective healthcare: patients are taking a more active role in the healthcare world. Exam rooms must be equipped for teaching and learning about health status, conditions, and treatments and healthy lifestyles (Time for Change, 2014). This means leveraging multiple methods of connection people and information 2. Family or other support persons are often in the exam room as important partners in the patient's health: Accommodating their presence - whether physical or virtual - helps to ensure important information is heard and understood, increasing the chances for good outcomes 3. There's pressure on clinicians to make every moment count: efficiency and effectiveness have become more important than ever. At the same time, patients don't want to be rushed through appointments. Efficient, well-equipped spaces can be a time savers as well as a pathway to better outcomes and improved patient satisfaction.

4. Technology is opening new opportunities in healthcare, and is should be fully incorporated in exam rooms: smart devices, apps and web-based information are new tools for diagnosing and treating patients, accessing and sharing information and communication effectively.

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In keeping with these design insights in mind, this helps provide opportunities for personal amenities, same-level seating, having family as partners, having technology incorporated, a productive way of teaching and learning, and supports appropriate procedures (Time for Change, 2014). In doing so designer can create a more impactful environment not only for the patients, but helping the needs of the healthcare provider as well.

15 Source: Steelcase Health (2014)

Background Research

Ten Recommendations for Advancing Patient-Centered Outcomes Measurement for Older Persons For over the past 50 years, there has been great progress in the measurement of patient-based outcomes for older populations. The challenges for the health assessment of older persons can be seen in the form of 10 "D’s" for patient-centered outcome.

1. The first “D” involves definitions of health status and quality of life. With the various measurement tools available there is a lack of shared agreement about what constitutes functional status, wellbeing, and quality of life. Many instruments developers rely excessively on selection items from existing measures, thus leading them to overlook exactly what they seek to measure: the patient point of view (Ten Recommendations, 2003). In making the transition to a more tailored assessment of patients, it will be imperative to develop item banks that are driven by a clear conceptual framework.

2. The next “D” undergoes discovery methods, with the use of these methods patients can identify the need for new items to fill in gaps along the functioning and well-being continuum and can help purge redundant items. With the U.S. population living longer, our measurement tools need to reflect the objective and subjective states and perception of health that characterize older population in the 21st century.

3. Next understands the differential item functioning which has been identified in studies of many outcome tools used in older populations, including measures of functional status, cognitive status, and mental health. There are dimensionality concerns within in various measurements which help to provide old and new applications of measures, and be a comprehensive aspect of instrument development and validation.

4. The fourth “D” talks about unidimensionality in reference to the measurement of a “single unitary trait (for example, functional status) rather than a multidimensional attribute (for example, pain)” (Ten Recommendations, 2003). Unidimensionality is an important underlying assessment of the health of the patients.

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5. The next “D” refers to item difficulty which people endorse the rated behavior, feeling, or attitude towards various measurements. Most items assessing basic and instrumental activities of daily living are at the easy end of the item-difficulty continuum for elderly persons.

6. Moving to the next “D” talks of item discrimination in which discrimination is an item’s ability to distinguish among persons who have different levels of the trait being measured.

7. From there we go to Dispute and divisiveness, because items often have unequal discrimination, research could needlessly remove potentially informative items, perhaps compromising the content validity of the resulting item bank.

8. This “D” deals with dynamic testing, in doing so there are optimal applications for testing “for example, individual-level versus group-level ability estimation, or high-stakes versus low-stakes testing” (Ten Recommendations, 2003).

9. The ninth “D” involves the Dangerous and Detrimental aspects to expanding testing. For many patients they do not have a full understanding of various procedures and are in harm’s way if they do not demand and receive complete and comprehensive disclosure on crucial question of a procedure.

10. The last “D” deals with debate, what is unclear is “whether it is desirable, intellectually or scientifically, for health status and outcomes assessment to move in this direction” (Ten Recommendations, 2003) without serious debate about the merits and shortcoming of this approach. As health status and outcomes assessment begins to move toward the development stage, critical thought is needed to see whether the profit motive will corrupt developments that are on the rise.

In the past 50 years, healthcare provides have accomplished much in the measurement of function and well-being of older persons. Measurement specialists are at the threshold of a paradigm shift away from the classical test methods. This form of methodology may be used at platform for informing and stimulating discussion about how and where measurement advances might proceed in the years ahead.

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Background Research

2013 State of Clinicians and Nurses Report Within the healthcare system clinicians and nurses play a key role in shaping the healthcare environment and the patient experience. Yet this group is highly susceptible and vulnerable to work place injuries. While we look to advance our healthcare model, experience and environment overall, we need not only think of the patient but also the professional caregiver. Steelcase Health, a healthcare furniture company, conducted a survey of U.S. and Canadian clinicians to better understand the key challenges clinicians and nurses face while at work and to quantify and evaluate their perceptions regarding potential risks to their well-being and their patients' well-being (Nurses Report, 2014). They found five key insights in their research.

1. The first key insight was high risk of injury on the job with over "35% of clinicians and nurses report being injured at least once on the job" (Nurses Report, 2014) while 24% had to modify activity of movement during at least one shift.

2. The next insight was that the bulk of the clinicians and nurses were to bed to chair transfers of patients, saying that at least "one in three clinicians and nurses" (Nurses Report, 2014) have experienced an injury in moving patients from bed to chair and that 47% of those surveyed perform patients transfers more than once a week. Because of this it causes clinicians and nurses to try to personally maintain their health on the job, in doing so clinicians and nurses rely on help from colleagues or choose to stay fit on their own terms.

3. Another important factor that is seen is that clinicians and nurses desire change in their work environment, while half feel their work environment is supportive in preventing discomfort, injury or pain (Nurses Report, 2014) 4. The most desired change clinicians and nurses want out of their work environment center around updating equipment and furniture, followed by rearranging the physical space to be better aligned with patient needs.

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5. The final insight is supporting a selfless profession. The study found that clinicians were more likely to get hurt than patients during patient movement. 35% of clinicians had been injured but only 10% of clinicians had patients who were injured (Nurses Report). Yet, clinicians are more concerned with their patients being injured than they are with being injured themselves. This is a major reason why it is so important for the places and the products to support the clinician.

Bibliography

After looking at these insights it is easy to conclude that clinicians are more focused on the patients’ needs than their own physical needs. In order for clinicians to care for patients they must lean, bend, crouch, and get in other compromising postures in order to help patients, which many times leads to clinician injuries.

This study helped to provide a starting point in understanding what the clinician’s needs and wants. It also confirms that the environment has a big effect on people’s experiences, emotions and behaviors. As a result the design must create a space with these aspects in mind in order to have a better functioning hospital (both physically and mentally).

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Client/User Needs

Types of Generations

Baby Boomers Major Demographic Focus in Healthcare

• Born between 1946-1964 • Retiring at a rate of 10,000 people every 24 hours • Participation in the workforce has made them the wealthiest generation

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• Major target market for health, fitness, retirement housing, financial planning, and appearance

Gen X

Gen Y

Millenials

• Born between 1965-1976

• Born between 1977-1994

• Americans born since 1994

• Are seen as selfreliant, supportive of racial and ethnic diversity, and better educated than any previous generation

• Are interested in memorable, and personal experiences and are very adept at managing work-life balance

• Interests in sustainability influences colleges, graduate schools, and employers

• Like lifestyles that are a blend of caution. pragmatism, and traditionalism

• Are strong-willed, passionate about the environment, and optimistic

• A dominant force in many markets such as food, apparel, and entertainment

• Influence music, sports, computers, video games, and forms of communication and networking

• Are attracted to purposeful work where they have control

(Hartley, Kerin, Rudelius, 2014)

Dissecting the Baby Boomer For many, hospital visits are inevitably likely in the future.

According to an article by AARP these are the common causes of hospital admissions for older adults.

For many Baby Boomers heart related issues are the biggest reason for hospital visits with

1,294,000 adults over the age of 65

being treated for various conditions such as cardiac arrhythmias and congestive heart failure Lung problems such as COPD and emphysema bring in as many as

822,500 adults 40 and over

Things that affect the immune system including infection and pneumonia, bring in

1,171,000 adults over the age of 85

as patients get older their immune system are more vulnerable to a variety of infections

Another factor that comes with this age generation is a loss in bone density, other wise known as

Osteoporosis. Because of this falls, injuries, and accidents are more dangerous in causing damage to their skeletal system.

*Other common ailments in this generation include diabetes and adverse reactions to medication

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Human Factors Section Includes Health Care Environments

Codes & Cleanliness Ergonomics 22

“It is not the strongest of species that survives, nor the most intelligent, but the one most responsive to change.�

- Charles Darwin 23

Healthcare Environments

Source: midmarkclinicalsolutions.com

A product cannot live to its full potential without realizing the environment it is intended to be in. An exam table is obviously intended for use in a variety of healthcare environments. But what other aspects of the exam room are needed to provide a more satisfactory visit for their patients as well as an efficient workplace for staff and practitioners. In the photos show there are 5 common physical elements within each that include: • • • • •

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Exam table Movable seating for doctor Place to hold computer Cabinet storage for medical supplies Some for of patient/guest seating

Upon further examination of these patients rooms, there were three major strategies used in the design and efficiency of how a patient room works. The three photos below give examples of these strategies which include:

Traditional Workflow Patient care is divided into separate zones for the patient interview (1) and patient exam area (2). While the traditional exam room supports immediate patient care, many times historic patient data and additional medical data that support patient care are retrieved from outside the exam room.

Supply Proximity A mobile supply cart with well-organized drawers can be retrieved from a dock in the adjacent cabinet to be in close proximity to patient care. The supply cart also provides an additional work surface, positioned left or right of the caregiver.

Public/Private Zones This setup provides a public zone with side chairs to seat family/ visitors, as well as a dressing nook for patients (1). The patient care zone, also known as the private zone, allows access to equipment and supplies (2) . Space is provided for the initial patient interview, including a work surface to review paper records.

1 2

Source: midmarkclinicalsolutions.com

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Codes & Cleanliness 26

Bariatric Codes: Patient Rooms:

Furniture Requirements:

• 10 - 20% of inpatient rooms should support the needs of bariatric patients

• Basic bariatric bed size: 44” wide x 84” long

• Bariatric patient rooms should be a minimum of 200 square feet (around 14’ wide x 15’ long) • Ingress/egress: minimum width of 44” to allow for movement of larger pieces of equipment

• Patient bed scales at 1800 lb capacity • Furniture structures (i.e. chairs) should be at least 30” - 40” wide and support at least 750 lbs

Cleanability Recommendations: Non-upholstered surfaces:

Upholstered Furniture (or Surfaces):

• Should be capable of being easily cleaned; minimize surface joints and seams.

• The following types of high-performance (durable, stain-resistant and easy-to-clean) upholstery fabrics are currently used extensively in healthcare patient spaces.

1. Coated fabrics such as PVC (vinyl), PU (polyurethane), composites, silicone.

2. Woven fabrics treated with stain-resistant finishes and fluid barriers that are designed to prevent moisture and liquids from penetrating the fabric.

3. 100% polyester woven fabrics that utilize high-energy dyes, stain resistant finishes (or both), with fluid barriers.

• A space between the chair back and seat can facilitate cleaning.

• Smooth solid surfaces such as laminate or poly resin products facilitate effective cleaning. Textured surfaces may result in additional cleaner dwell time or cleaning cycles, however, they may also decrease skin/surface contact area.

• Surfaces that require high levels of cleaning/ disinfecting, such as armrests, should have large radii along edges.

• Abutting surfaces should have minimal radii to avoid creation of crevices that are difficult to clean. Example – adjacent worksurfaces.

• Joints and seams complicate effective cleaning, creating organism reservoirs that can further the spread of contact transmitted healthcare associated infections.

• Upholstered surfaces should be durable and resist tearing, peeling, cracking or splitting; damaged surfaces are more difficult to clean effectively.

• Upholstery fabrics that are flatter (or have minimal texture) are preferable and easier to clean.

• Surfaces should also be uninterrupted whenever possible. Avoid crevices, reveals, piping, zippers and other areas that trap dust, dirt and other contaminants.

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Ergonomics

In figuring out how to design an exam table for the user, one must look into the ergonomics.

Websters dictionary defines ergonomics “an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely.� By looking at various relationships of furniture in the healthcare environment, it enhances the design process of the table.

Major aspects in determining key dimensions for the exam table are looking at basic chair and bed dimension, along with hand and cabinet clearance dimensions.

Linkage System

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Source: Human Dimension & Interior Space (1979)

Basic Seating

Source: Human Dimension & Interior Space (1979)

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Hand Measurement

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Source: Human Dimension & Interior Space (1979)

Bed Measurement

Source: Human Dimension & Interior Space (1979)

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Exam Room Measurements

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Source: Human Dimension & Interior Space (1979)

Patient Bedroom Measurements Source: Human Dimension & Interior Space (1979)

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Wheelchair Dimensions

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Source: Human Dimension & Interior Space (1979)

Patient Bedroom with Wheelchair Measurements Source: Human Dimension & Interior Space (1979)

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Case Study Section Includes Empath by Steelcase Health 623 Barrier Free Examination Table PF4000 Examination Table Comparison

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“Failure is the only opportunity to begin again more intelligently.�

- Henry Ford

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Summary

Empath by Steelcase Health • Project Type: Healthcare Furniture • Environmental Location: Hospital • Developed by Steelcase Health • Has over 2,000 hours of logged research to understand how recliners were used in the healthcare environment.

• Client/Intended User: Patients in the hospital would sit in the seat and nurses and clinicians help transfer patients from bed to recliner • Brought to market in spring of 2013 Quality features include: • Tested to support 300 pounds dynamic, 750 pounds static • Back frame, seat frame and chassis are welded tubular steel • Upper arms are strengthened by die-cast aluminum inserts • Recline mechanism is heavy-duty plate steel

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Furniture Overview An In-Sight Driven Solution: The Empath recliner is a crucial step forward in the patient care process.

Across healthcare applications, Empath is designed to reduce stress and the potential for injury for both patients and clinicians while increasing physical and emotional connections.

Suited for many Spaces: The Empath recliner offers the safety, versatility and quality needed to serve a number of healthcare environments and applications. With both essential and advanced features, it adapts to a wide range of uses - including patient rooms, treatment areas, exam spaces, emergency departments and outpatient centers.

Made to Last: Empath adheres to stringent Steelcase standards for durability and performance and a thorough testing process that exceeds industry standards. The result is exceptional ease of movement and a long product lifespan.

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• Convenient Central Lock:

• Easy-Access Arms: It was discovered that chairs with fixed arms made patient transfers difficult. Empath dual flip-down arms allow for easy access no matter where the chair is positioned in a space.

Often, the observation of the arms were less than forgiving. Empath arms are cushioned to avoid injury, while remaining supportive enough to steady patients. They’re also contoured for easy grip when getting in and out of the chair.

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Supportive Design

• Supportive Design:

Easy-Access Arms

After seeing clinicians struggle to lock multiple individual casters, Steelcase developed a central locking system with easy-to-activate pedals that are located where caregivers need them – tucked in toward the front, on both sides of the chair.

Central Lock

Key Features

Final Thoughts In looking at Steelcase’s research it revealed that clinicians’ top concerns are keeping patients comfortable and safe while promoting overall quality of care. Empath is built to meet these needs, with the versatility and durability needed to adapt to a wide range of uses – including patient rooms, treatment areas, exam spaces, emergency departments and outpatient centers.

Empath provides great options within the health care environment by having many uses. From a useful chair in a post operation room to an alternative to an exam table in certain exam rooms, the Empath offers support for both patients and healthcare providers.

Source: http://www.steelcasehealth.com/productresources/empath/ (2014)

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Summary

623 Barrier Free Examination Table • Project Type: Exam Table • Environmental Location: Hospital • Developed by Midmark • Client/Intended User: Patients and healthcare staff • Brought to market in 2005 Quality features include: • Power height and back • 400-pound patient weight capacity • 18-inch to 37-inch seat height adjustment • Hand and foot control (standard) • Receptacle and rear storage pod (standard)

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Furniture Overview Break Down the Barriers: The percentage of patients healthcare practitioners who are elderly, disabled, obese or have other mobility concerns is steadily on the rise. To keep up with this shifting demographic, healthcare practitioners must make changes in healthcare delivery.

Accessibility for All Patients: The patients doctors see are all different. But the one thing they may have in common is difficulty accessing the exam table. Easy access to the exam table can decrease strain on patients and staff, and ensure that nurses can position all patients effectively for a more thorough and accurate exam.

Comfort, Safety, and Efficient Patient Care: To meet the needs of all patients, including those who are disabled or those with mobility concerns, as well as the physicians who care for them, Examination tables should be designed to decrease the chance of injury and reduce patient anxiety.

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• Accessible Controls: Upholstery and drawer heater controls are easily accessible for healthcare professionals.

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Premium Comfort System

• Premium Comfort System: This patented feature stretches elastomer material over a seat cutout to enhance patient comfort for a “chair-like” feel on an exam table.

Removable Upholstery

• Removable Upholstery: Allows for color change in seconds or additional access for a thorough cleaning. It’s also easy to remove without the need for tools.

Accessible Controls

• Multi-Function Foot & Hand Control: The foot control moves the seat and back section independently or simultaneously for the most efficient patient movement. The 623 hand control gives an alternative method of positioning patients.

Foot & Hand Controls

Key Features

Final Thoughts At the core of Midmark is a new way of providing caregiver-patient interaction and the delivery of efficient patient care. By working with nurses and doctors to redefine the future of the clinical space – from the examination room to the procedure room – providing the tools doctors need to rethink and redefine their workflow.

Public & Private Zones

This type of examination table regards various aspects in examination rooms: i.e. table height, age of patients, comfort and adjustablity of the table. Midmark puts quality and user experience at the forefront of their needs when designing any piece of furniture. From this designers can create a more fulfilling environment for patients and healthcare providers.

Efficient Care Zone

Supply Proximity

Source: midmarkclinicalsolutions.com(2014)

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Summary

PF4000 Examination Table • Project Type: Exam Table • Environmental Location: Hospital • Developed by Oakworks • Client/Intended User: Patients and healthcare staff • Brought to market in 2013 Quality features include: • Powered Height, Backrest, Trendelenburg (tilt), Leg Rest • Designed to maximize comfort for extended treatments • 550 lb bariatric, twin tower design • Industry leading 3 year warranty

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Furniture Overview With Oakworks Medical, they focus on creating a product that is helpful and efficient for various users.

For the Practitioner: • Ergonomically advanced design to help lengthen careers • Ability to create a product that has the features doctors need • FDA listed to ensure safety For the Patient: • Comfortably padding options for extended treatments • Zero gravity recliner position • Easy access on & off table, wheelchair accessible For the Purchaser: • FDA listed to ensure safety & compliance • Wide choice of fabric and finishes • Warranty: 3 year parts, 1 year labor

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QuickLock Head Rest

Stirrups

Key Features Major Features that can be added to this exam table include:

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• Universal Table Extender: perfect as a head rest or foot rest, it has two rods that fit into outlets on the table.

Extends table to 84”.

Universal Table Extender

• Adjustable Side Arm Rests: incredibly versatile, removable arm rests rotate horizontally always stays level

Casters

• Hand Control: controls all functions when lifting the chair

Adjustable Side Arm Rests

• Paper Roll Holder: adjustable to accommodate different size rolls up to 21” wide & plugs into the tables outlet holes.

Hand Control

• QuickLock Head Rest: platform allows precise cervical flexion and height positioning over a wide range for both prone and supine treatments

Paper Roll Holder

• Stirrups: adjusts to a wide range of angles & lengths to accommodate any patient or procedure. Stores inside the table.

Final Thoughts The PF Exam Table is a powered positioning table used for routine treatment and examination procedures. It is intended to be operated by a healthcare professional in a medical environment.

With the use of this examination table it provides a more comfortable experience for the user as well as becomes easier for nurses or clinicians move around to get patients to this comfortable position. The zero gravity technology has help in finding a more ergonomic component to their overall design and overall comfort.

Source: http://www.oakworksmed.com/pf400. asp (2014)

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Comparison Name Empath

Midmark 623

Oakworks PF4000

Dimensions

Weight Capacity

• • • • • • • •

Overall depth 31 1/4” Overall width 31 5/8” Overall height 46 5/16” Seat depth 21” Seat width 23” Seat height 20” Arm height 26 3/8” Full recline 73 3/16”

•

Vinyl Upholstery

300 Lbs Dynamic

•

Antimicrobial Plastic for arms and foot rest

700 Lbs Static

•

Dimensions (top): 28.5” W x 59.5” L (72.4 x 151.1 cm)

•

Vinyl Upholstery

400 Lbs

•

Plastic

•

Metal

•

TerraTouch Upholstery

•

Theroform Plastic

•

Metal

•

Wood Laminate Finish

•

Length with footrest extended: 75.5” (191.8 cm)

•

Height: Minimum 18” (45.7 cm)Maximum 37” (94.0 cm)

•

Top: 31” (79cm) wide x 73” (185cm) long Electric Height Range: 22” 38” (56-97cm) Electric Height Range: PF200: 21” - 37” (5394cm) Electric Trendelenburg/Reverse Tilt: ±20° Electric Backrest: PF400: 0-53° Lift Assist Backrest: PF250: 0-80°

•

• • •

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Materials

550 Lbs

Electric Options N/A

115 VAC, 50/60 Hz, 13.5 Amps (with heaters – 008)

Adjustability

Aligns with Goals & Objectives

Sustainable Attributes

Dual flip-down arms Trendelenburg (dual-sided) Adjustable headrest Push bar Pull-out footrest

89% recyclable 25% recycled content May contribute toward 1 point awarded for 30% or 2 points for 40% total value of freestanding furniture and medical furnishings because it meets one or more of the three options for this credit .

N/A

Pelvic Tilt (5 degrees) Adjustable Arm System (right and left side arms included)Factory installed only

Product Provides: •

Built-In Adjustability

•

Hygenic Materials

•

Cost Effective

Product Provides: •

Built-In Adjustability

•

Accomodating Technology

Articulating Knee Crutches

Motion 1 Electric Height: 22”-38” (56-97cm)

Electric Trendelenburg/ Reverse Tilt: ±20°

Motion 2 Electric Tilt: 20º/20º

Electric Backrest: PF400: 0-53°

Motion 3 Electric Backrest: 0-53º

Lift Assist 0-80°

Backrest:

PF250:

Biological Evaluation of Medical Tables & passes testing for Cytotoxicity, Skin Irritation & Sensitization as well as CA TB117 Fire Retardance testing.

Product Provides: •

Built-In Adjustability

•

Hygenic Materials

•

Accomodating Technology

Motion 4 Electric Leg rest

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4

Context Section Includes Theories Trends

52

“We define innovation as the successful implementation of creative ideas within an organization.�

- Theresa Amabile 53

Theories -Color Theory 54

What is Color Theory?

Color theory is best explained in three categories • The Color Wheel • Color Harmony • Context of how color is used

The Color Wheel was created by Sir Issac Newton in 1666 • The main colors derive from the primary colors; red, yellow, and blue • When two primary colors combine they create secondary colors, which include; orange, green, and violet • The final segment of tertiary colors occur when a primary color and secondary color combine Source: https://blog.kissmetrics.com/art-of-color-coordination/?wide=1 (2014)

• Within the color wheel colors can be separated in to cool and warm colors • As a general rule, excessive combination of warm and cool colors can confuse the client and the environment around them • Warm colors reflect passion, happiness, enthusiasm, and energy • Cool colors give a sense of calm or professionalism

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Color Harmony

• Color harmonies (or color schemes) consists of two or more colors with a fixed relation on the color wheel • Picking certain color harmonies can be challenging. While some color combinations can be very pleasing, others can be painful and abrasive to look at.

• The six combinations seen on this page and the next are the most common combinations in the design world, these include: • Complementary: colors that are directly opposite on the color wheel.

With such contrast one color can be a dominant and the other a highlight • Analogous: colors which lie on either side of any given color. Are often found in nature and create serene and comfortable design

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• Triadic: three colors which are situated 120 degrees from each other on the color wheel. Is considered on of the best color schemes.

Source: https://blog.kissmetrics.com/art-of-color-coordination/?wide=1 (2014)

• Split-Complementary: a variation of complementary colors. In addition to its base color it uses two colors adjacent to its complement. Has a high degree of contrast, but not as extreme as complementary colors. • Rectangular (Tetradic): uses four colors arranged into two complementary pairs. Offers plenty of possibilities for variation.

Designers much also pay attention to the balance of warm and cool colors • Square: similar to the rectangle, but with all four color evenly spaced around the color wheel. Designers need to be careful when using square color schemes, these combinations can be a problem for good harmony.

Source: https://blog.kissmetrics.com/art-of-color-coordination/?wide=1 (2014)

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Color Context • The infographic shown explains the meanings of various colors and how they can be best implemented • Within the infographic it explains not only the meaning and main descriptors of each color. But goes further into discerning which colors are warm and cool colors and what most popular industries use a particular color.

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Source: http://dailyinfographic. com/true-colors-branded-colors-infographic (2014)

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Examples of Color Context & Harmony • The most prominent example of how color theory is best implemented is within branding and logo design (as seen on the bottom of the next page) by using the right colors to send the right message to their customers • Other examples of color theory also involve symbology of colors (Seen below). As seen with the chakra symbols each symbol has a color coordinated with it to represent that energy.

• The form of color harmony seen on the next page helps to suggest how physical aspects (i.e. nature) create color pallets as well as making adjustments to transform them into a digital palate (i.e. web design pallets).

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Source: http://www.pinterest.com/kat4ever/color-palette/(2014)

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Theories - Biophilia

Biophilia Edward O. Wilson is credited with the introduction of the term biophilia which he defined as the “innate tendency to focus on life and lifelike processes” (Wilson, 1984, 1). This act of focus is deeply rooted into the survival of mankind and our associations, preferences, and emotions are related to these natural systems. Within the natural environment there are a special set of psychological benefits and becomes an important factor in human-environmental relationships, well-being, and stress reduction.

• At the heart of the theory of biophilia are the values, meanings, or benefits people attach to nature.

• One of the interesting issues when considering the category of nature and this theory is the fact that people from different geographical regions and cultural experiences have certain similarities for natural settings and the density or type of plants within these environments as well as the understanding of the restorative value of nature.

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(Kaplan, R., 1992, 125; Park, 2006, 7; Ulrich and Parsons, 1992, 95)

Photo of Edward O. Wilson

• “Nature employs the mind without fatigue and yet exercises it; tranquilizes it and yet enlivens it; and thus, through the influence of the mind over the body, gives the effect of refreshing rest and reinvigoration to the whole system.â€?

- F.L. Olmsted, 1865 There are 9 methods related to how humans value nature that are influential in their physical, material, emotional, psychological, and spiritual well-being (Kellert, 2005, 34, 50): 1.

Aesthetic: physical allure of nature

2.

Dominionistic: control of nature

3.

Humanistic: emotional attachment to nature

4.

Moralistic: Spiritual association to nature

5.

Naturalistic: direct experiences with nature

6.

Negativistic: fear of nature

7.

Scientific: empirical observation and study of nature

8.

Symbolic: metaphoric value of nature

9.

Utilitarian: physical and material benefit of nature

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Nature exhibits biophilic qualities at varying scales, pattern, and form. Regardless of what aspect it is being applied to, they still remain interconnected; the same should apply to the human built environment.

One of the central concepts of this dimension is the notion of “sense of place� which refers to the identity and meaning that individuals begin to project onto the built environment or the landscape and how these metaphors begin to affect personal or collective identities.

There are two basic dimensions of biophilic design: organic or naturalistic and place-based or vernacular (Kellert, Heerwagen, and Mador, 2008, 5-6).

2. Place-based or vernacular: buildings and landscapes that connect to the culture and ecology of a locality or geographic area

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Representation of biophilic design

1. Organic or naturalistic: shapes and forms in the built environment that directly, indirectly, or symbolically, reflect the inherent human affinity for nature

• The sensory expression of biophilia is crucial in the creation of design that elicits positive responses, engagement with place, well-being, and values in nature.

• The aesthetics of nature in the built environment are communicated through the use of materials, colors, light, air, spatial structures, patterns, textures, movement, and openings that connect the interior to exterior.

• It is an inherent quality, but the extent of value is learned or greatly influenced by individuals’ experiences and cultural support.

• These qualities can be categorized into seven attributes which reinforce the interconnection of sensory aesthetics and biophilia (Kellert, Heerwagen, and Mador, 2008, 229, 234): 1. Sensory richness 2. Motion 3. Serendipity 4. Variations on a theme 5. Resilience 6. Sense of freeness 7. Prospect (visual access) and refuge (enclosure) • The healthcare environment is commonly seen as stressful environment that produces a wide variety of emotions. The contribution of stress from the healthcare environment can “directly influenced the level of care the nurse is able to administer” (Locklear, 2012). Research has identified psychological responses to stress and developing new ways of reform and change the effect on medical outcomes and recovery time.

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Biophilic and context-responsive design functions can be performed by the 3 spatial planes forming built environments that can effect how furniture is placed: Plane

Element

Design Function

Ground

Paving, groundcover, plants , flooring

Orientation, separation, linkage, buffering

Wall

Buildings, wall, fences, trellises, trees, shrubs

Enclosure, screening, buffering, framing, orientation, background

Overhead

Roofs, trees, shelters, awnings, pergolas

Enclosure, shading, rain protection

Selected design functions performed by a pedestrian circulation system can also influence our experience with a site: Movement Through a Space

Making a Space Plan

Access

Oasis

Entry

Refuge

Linkage

Node Source: Locklear, 2012

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Theories - Patient Centered Care

Patient Centered Care

pioneered and championed by Harvey Picker Harvey challenged the health care system to improve patient care by considering the totality of the experience through the eyes of the patient. He recognized that while science and technology were thriving in medicine, humanity and empathy were the antidotes needed to fix a broken system. Harvey understood that health care must be delivered in a way that is sensitive to patients’ concerns and comfort, is responsive to their personal values and preferences, and actively involves patients and family members in shared decision making about their care.

• The Institute of Medicine (IOM) defines patient-centered care as: Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. • Patient-centered care supports active involvement of patients and their families in the creating new care models and in decision-making about individual options for treatment.

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Photo of Harvey Picker

• Within the Patient-Centered Design philosophy designers want to “promote developing spaces to be used by patients and their families. This principle takes into account the needs of patients and their families, and methods for delivering the best care to them.” (http:// patientcentereddesign.org/aboutus.html).

Comprehensive

Patient & Family Centered

Continuous

Coordinated

Accountable

• At the heart, truly patient-centered care cannot be achieved without active patient engagement at every level of care design and implementation. The application of patient-centered care is often referred to simply as patient engagement or patient activation.

Accessible

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The following considerations are paramount in understanding the principles of Patient-Centered Design: 1. Good design reflects an understanding of the patient’s day-to-day experience.

2. Patient experience should inform design, but we should not presume all patients are the same. -Jamie Heywood, Pioneer grantee PatientsLikeMe. 3. Personalized care is most important: that may be personalizing one-on-one interactions with patients or thinking about how can we design systems, materials, equipment and interactions to reflect knowledge gathered over time while still allowing them to be tailored for the individual - Dr. David Sobel, Kaiser Permanente.

4. “We need to get better at understanding and considering the unique experiences of underserved and vulnerable populations.” (http://www.rwjf.org/en/blogs/pioneeringideas/2013/03/patient-centeredgo.html).

5. Unit configurations and layouts: When considering which approach—from a race track configuration to a compact triangle—designers should measure which model creates an optimal environment for staff travel distances, patient safety, patient visibility and easy communication with staff, proximity of patient rooms to nurses’ stations, standardization in same-handed configurations, and use of on-stage/off-stage areas, along with the pros and cons for varying approaches to each.

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6. Decentralized nursing: While the traditional approach of using a centralized model has long been a design staple, research supports the move toward a decentralized (or possibly a hybrid of centralized and decentralized) stations that can improve staff efficiency, reduce walking distances, and increase the time nurses can spend with patients. However, one drawback may be a sense of isolation felt by the staff. And when laying out these areas, their should be the integration of health information technology in workspaces.

7. Family-centered care: Since patients’ health is often linked to the health of their family members, creating spaces where relatives can have a sense of self-efficacy and empowerment is a significant component of patient-centered design. The four key concepts to family-centered care are: a. Active participation of patients and family in the healthcare decision-making process b. Relevant information provided to patients and their family to make those decisions c. A choice offered on what level of participation is preferred in decision-making d. Involvement on institutional issues, including facility design and delivery of care.

Specific design elements supporting family-centered care include single-family rooms with family accommodations.

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Trends - Healthcare Furniture 72

A major trend in the health care furniture world is revolving around new patients needs which focus on: • Family engagement • Personalized interaction • Understand patient day-today experience

Source: http://www.nemschoff.com/products/collections/palisade

In the case of Herman Miller’s healthcare brand, Nemschoff focused on patient guest comfort and hide away seating.

By incorporating family and friends into patient centered care, the designers created a piece of furniture that was efficient enough for guests to help out with the patient when needed and to be more personal with the doctors.

Steelcase Health focused patient centered care around the exam room. Their goal was to create a personal atmosphere for the patient, while being efficient for doctors with the use of new technology, and more easily adjustable furniture.

Source by http://www.steelcasehealth.com/application/exam-spaces/

Assuming this rend and innovation continue, it will be highly likely that healthcare environments will continue to focus on patient center care with these environments becoming even more influenced by the hospitality and residential design sectors.

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Trends - Bariatric Care

What is Bariatric Care?

According to Merriam-Webster: • The term “Bariatric,” from the Greek word “heavy” or “large,” refers to patients who are morbidly obese • “The branch of medicine that deals with the causes, prevention and treatment of obesity” (American Heritage Dictionary) • “Relating to or specializing in the treatment of obesity” (Merriam -Webster) To fully understand bariatic care one must also understand obesity.

Obesity: • Body Mass Index (BMI) of 30 or higher • BMI of 40 or more is considered morbid obesity • BMI of 25-29.9 is considered overweight BMI: • A measure of an adult’s weight in relation to his or her height (kg/m2) Causes: • Weight and its regulation is affected by genetics, gender, physiology, biochemistry, neuroscience, as well as cultural, environmental, and psychosocial factors.

• Obesity is associated with increases in mortality and suffer from social stigmatization and discrimination. Source: NIH, NHLBI. 1998

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Within obesity there are different levels based on how high the patients BMI is. The higher the BMI is, the more likely they are at higher risk of: type 2 diabetes, coronary heart disease, gallbladder disease, dyslipidemia, stroke, osteoarthritis, gynecological problems, cancers (endometrial, breast colon cancer), sleep apnea, and repritory problems.

Classification

BMI (Body Mass Index)

Overweight

25-29

Class I Obesity (Moderate)

30-34

Class II Obesity (Severe)

35-39

Class IIII Obesity (Very Severe)

>40 Morbidly Obese

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In 1990, ten states had a prevalence of obesity less than 10% and no states had equal or greater than 15% In 2008, only one state had prevalence less than 20%. Thirty-two states had a prevalence equal or greater than 25%; six of these states had a prevalence equal to or greater than 30%. Source: CDC 2008

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As the baby-boomer generation approaches retirement age, the continuing obesity epidemic signals a likely expansion in the population with obesity-related comorbidities.

Source: Wang et al, 2007

baby-boomer generation

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5

Product Approach Aspects Include Material Analysis Atmospheric Options

Product Strategy Marketing Strategy 78

“Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.”

- Saint Francis of Assisi

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Material Analysis

Documents pertaining to codes and cleanliness for healthcare identify three main materials that were recommended to use in the healthcare environment these materials included: 1. Coated fabrics such as PVC (vinyl), PU (polyurethane), composites, silicone.

2. Woven fabrics treated with stain-resistant finishes and fluid barriers that are designed to prevent moisture and liquids from penetrating the fabric.

3. 100% polyester woven fabrics that utilize high-energy dyes, stain resistant finishes (or both), with fluid barriers.

Considering these material compositions, major contract textile manufactures were researched to provide options for consideration based on the following performance criteria: • Non-Woven (easier to clean) • Abrasion Tested: 30,000+ double rubs (ACT high performance threshold) • Impermeable • Has little to no Environmental Impact After looking over the various options there were three brands that stood out the most.

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Shimmering Tide by Designtex • Content: 100% Nylon Microfiber • Abrasion: 100,000 rubs Wyzenbeek • Impermeable • Antimicrobial • Disinfectable: Cleanable with diluted bleach (1/10 solution), Cleanable with quaternary cleaner • Environmental Impact: alternative to pvc, compatible for closed loop, chemically optimized, energy use, water use, reutilization of production waste, green cleaning compatible low emitting recyclable

Rise by Maharam

Beeline by Momentum

• Content: 100% Vinyl • Abrasion: 70,000+ double rubs (Wyzenbeek) • Impermeable • Antimicrobial • Disinfectable: Cleanable with diluted bleach (1/10 solution), Cleanable with quaternary cleaner • Stain Cleanability: Blood, Iodine, Oil, Urine • Environmental Impact: Less than 100 ppm per fluorinated compounds

• Content: 100% Polyurethane • Abrasion: 500,000+ double rubs (Wyzenbeek) • Impermeable • Antimicrobial • Disinfectable: Cleanable with diluted bleach (1/10 solution), Cleanable with quaternary cleaner • Environmental Impact: Does not contain PVC, Less than 100 ppm phthalates, Less than 100 ppm of heavy metals including mercury, cadmium, lead, antimony, Less than 100 ppm per fluorinated compounds.

Less than 100 ppm of added antimicrobial treatments

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Atmospheric Options

Standard Exam Room: • Seen as very static, can only be in one place • Exam table the focal point in the room • Must use ADA forms of egress to and around the room • Walls are bland with little information

Source: http://www.ada.gov/medcare_mobility_ ta/medcare_ta.htm

Modern Exam Room: • Acts as a hub of medical knowledge • Various seating option create a more freeflowing atmosphere • Integrated technology helps provide great visuals on the walls as well provide information to the patient

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• Furniture become more inviting to use and has less of a clinical feel

Source by http://www.steelcasehealth.com/ application/exam-spaces/

Moving Forward In looking towards the future of patient centered care, both the standard exam room and modern exam room needs to be taken into consideration. By blending the two it can create a helpful environment that meets code standards while being a welcoming area for patients to communicate their health issues more comfortably.

Aspects incorporated from the two designs include: • ADA Codes • Integrated technology • Inviting furniture • Clear paths of egress

Source by http://www.steelcasehealth.com/application/exam-spaces/

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Product Strategy

Features/Benefits:

Technology:

• Can hold up to 750 lb capacity

• Lift system for easy access onto table

750 LBS

• Easy grip handles (to ease into the chair more safely, specifically for baby boomers)

• Can adjust from bed to seat

• Pneumatic system to make adjustments easier to maneuver for nurses and doctors

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Materials:

Value Pricing:

• Looking into vinyl or polyurethane textiles

• Good: Lowest cost $ • Simple pneumatic system (can only adjust from bed to chair) • Better: Average cost $$ • Advanced pneumatic system • Adjusts from bed to chair • Easy lift system • Best: Highest Cost $$$ • Advanced pneumatic system • Adjusts from bed to chair • Easy lift system

• Focusing on various aspects: • Environmental impact: • No PVC • Less than 100 ppm of heavy metals • Easily cleanable & disinfectable • High performance abrasion textile

Source: http://finishlibrary.steelcase.com/ (2014)

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Marketing Strategy

Branding: • In looking through color theory there were various option that were popular in healthcare: • Blue • Cool Color • Descriptors: trustworthy, dependable, secure, responsible • Purple • Cool Color • Descriptors: royalty, sophistication, mystery, spirituality • Green • Cool Color • Descriptors: wealth, health, prestige • Orange • Warm Color • Descriptors: vitality, fun, playful, exuberant, • White • Cool Color • Descriptors: pure, noble, clean, soft • Looking at shapes for logo design, healthcare logos tend to be comprised of circular or rounded shapes to make it seem more soft and inviting.

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• Healthcare symbology, evoke various aspects of healthcare. These shapes to the right are common forms within the healthcare environment.

• In consideration of typography associated with branding there are two primary options:

• Serif

• Serif fonts are easier to read in printed works. Because the individual letters are more distinctive and easier for the brain to recognize quickly • Sans Serif • Sans serif fonts are better digital platforms. The use of minimalism is easier on the eye when looking at the computer or other technology.

• Printed works generally have a resolution of 1,000 dots per inch; whereas, computer monitor are typically 100 dots per inch.

Marketing Approach: • The first aspect in marketing is understand the target market compared to the intended user of the exam tables. When the table is put out to market the majority of consumers who will buy the exam table are hospitals, doctors, and the healthcare industry. These consumers are the target market where as the patients are the intended user.

Exam Tables are Cool

• Within advertisement and promotion, the exam table should focus on product pioneering, it focuses on telling people what the product is, what the product can do, and where it can be found.

• After choosing a type of primary advertisement the product must then find a form of media to be advertised in. In looking at the various forms of media, the best two approaches include: • Direct Mail Marketing: options of advertisement include; catalogue, brochures, trade magazines, informative letters.

• Internet: popular options of advertisement include; paid search, display (banner) ads, classified ads, and video.

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6

Closing Thoughts Aspects Include Results Overall Effectiveness Bibliography

88

“I have been impressed with the urgency of doing. Knowing is not enough; we must apply.

Being willing is not enough; we must do.�

- Leonardo da Vinci 89

Results

In examining the mass amounts of research and synthesizing in the form of a program, the next phase involves design synthesis and the end goal of an actual prototype. Within the design phase, the designer will go more in depth into the ergonomics and materiality as well as incorporate the use of product and marketing strategy to potentially bring the prototype to market.

With the creation of this prototype, one can hypothesis that if this product is brought to market, it will have a significant impact on the way the healthcare industry views exam tables and the overall approach to patient centered care.

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Overall Effectiveness

Within the documented program, an evidenced-based design basis has been established for the design phase. The in depth look into varying theories and trends, along with descriptive diagrams from ergonomics to the intended user makes the intent of this thesis very effective and able to understand the overall goal at the end of the spring semester. With these consideration in mind, the goal of creating a prototype seems very attainable.

Look forward to more adventures of reexamining the exam table in the spring of 2015.

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Bibliography

Literature Reviews: “2013 State of Clinicians and Nurses Report”. Nurture. Accessed 9/17/2014 http://tempnur.wpengine.com/wp-content/uploads/2013/12/Clinician_Survey_Report_Summary.pdf Eileen B Malone, RN MSN, MS, EDAC and Barbara A. Dellinger, MA, AAHID, IIDA, CID, EDAC. “Furniture Design Features and Healthcare Outcomes,” Published by The Center for Health Design, May 2011, Accessed September 2, 2014, https://www.healthdesign.org/chd/research/furniture-design-features-and-healthcare-outcomes “Exam Rooms that Empower People” Wellbeing: A Bottom Line Issue. 360, Issue 67. Accessed 9/17/2014 http://360.steelcase.com/wp-content/uploads/2014/01/360Magazine-Issue67.pdf McHorney, Colleen A., “Ten recommendations for advancing patient-centered outcomes measurement for older persons”. Annals of Internal Medicine; September 2, 2003; 139, 5. Accessed September 30, 2014 “Time for Change: New Solutions for Healthcare Places”. Steelcase Health (2014) Client and User Needs: Hartley, S.W., Kerin, R.A., Rudelius, W. (2014) Marketing 12th Edition Foltz-Gray, Dorothy (2012, March 1) Most Common Causes of Hospital Admissions for Older Adults. retrieved from http://www.aarp.org/health/doctors-hospitals/info-03-2012/hospital-admissions-older-adults.html Codes & Cleanliness: BIFMA, (2014, October 6) Healthcare Furniture Design - Guidelines for Cleanability Gable, L., Mucheno, E., (2012, August 25) Understanding the Special Needs of the Bariatric Population: Design, Innovation, and Respect Kim, H. (2009) Universal Design: Meeting the Needs of the Bariatric Population Ergonomics: Panero, J.m Zelnik, M. (1979) Human Dimension & Interior Space Theories: Brady, C., Frampton, S., Guastello, S., Hale, M. Horowits, S., Smith, S., Stone, S. (2008) Patien-Centered Care Improvemnet Guide. Retrieved from http://planetree.org/wp-content/uploads/2012/01/Patient-Centered-Care-Improvement-Guide-10-28-09Final.pdf

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Institute on Medicine. “Crossing the Quality Chasm: A New Health System for the 21st Century”. Retrieved 26 November 2012.

Kilzer, C. True Colos, Branded Colors [infographic], (2012, July 3) Daily Infographic. Retrieved from http://dailyinfographic.com/true-colors-branded-colors-infographic Locklear, Kendra M. (2012), Guidelines and Considerations for Biophilic Interior Design in Healthcare Environments, The University of Texas at Austin, 16-22 Sepucha, Karen; Uzogarra, Barry, O’Connor, Mulley (2008). “Developing instruments to measure the quality of decisions: early results for a set of symp tom-driven decisions”. Patient Educ Counsel. 73 (3): 504–510.

Silvis, J. (2013) 3 Consideratons for Effective Patient-Centered Design. Healthcare Design. Retrieved from http://www.healthcaredesignmagazine.com/blogs/jennifer-kovacs-silvis/patient-centered-design-3considerations-effective-spaces?page=2 The Art of Color Coordination (2014) KISSmetrics. Retrieved from https://blog.kissmetrics.com/art-of-color-coordination/?wide=1 Trends: Gable, L., Mucheno, E., (2012, August 25) Understanding the Special Needs of the Bariatric Population: Design, Innovation, and Respect Kim, H. (2009) Universal Design: Meeting the Needs of the Bariatric Population Marketing Strategy: Hartley, S.W., Kerin, R.A., Rudelius, W. (2014) Marketing 12th Edition

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