Design for Care: New Areas Balance Function with Form
Spring 2005
Ask any architect about health care design, and you will hear about the challenges—not only building codes and Department of Public Health requirements, but the need to achieve a balance between the patient’s care and the patient’s experience. According to Glenn Smith, vice president for clinical and administrative services, today patients come to hospitals with certain expectations.
“People are looking for hotel-like accommodations—as spacious, comfortable and private as possible,” says Mr. Smith. “When people come for outpatient procedures such as diagnostic tests or day surgery, they look for convenience, and they often want enough room for family members to be with them.”
Three construction projects at Emerson Hospital—two just completed and one on the drawing board—demonstrate how thoughtful planning can result in attractive design that considers every aspect of a patient’s experience. Whether it is about an annual mammogram, physical therapy or surgery, good design makes a difference.
The Breast Health Center and the Rehabilitation Center are located across Route 2, giving patients easy access to free parking while opening up spaces in the hospital parking garage. “The current trend is to locate these kinds of services in a free-standing facility, away from the hospital, when possible,” says Mr. Smith.
Privacy is a strong theme. “When we talk with the architects, we convey the importance of privacy, which has a calming effect,” says Mr. Smith. “And we pay attention to details such as lighting and how we want family waiting areas to feel. We look hard at the clinical side of design to be sure the space serves the needs of our staff. But as the new construction projects illustrate, we are also making Emerson a more comfortable, welcoming place for patients as well as their families.”
Breast Health Center Combines Technology and Tranquility
Each woman who visits Emerson Hospital’s new Breast Health Center can name a feature she appreciates. For some it is the separate pre- and post-mammography waiting areas. Others like the small fountain that produces a relaxing trickle of water. Many say they simply like the fact that the center doesn’t feel like a clinical setting.
That is the point, says David Rose, MD, chief of radiology and director of breast imaging. “When we sat down to discuss what we wanted our new center to feel like, we used words like soothing and tranquil,” says Dr. Rose. “We wanted to provide efficient care, to make it as private as possible and to reduce our patients’ anxiety.”
The setting is now on the same par as the staff’s expertise and the technology they use, says Dr. Rose. “The center features all digital mammography, which offers specific benefits, including fewer delays. We can manipulate the mammography image—enlarge, lighten or darken it—which reduces the need to call patients back for additional views.”
The impressive technology is surrounded by a center that feels like a spa. According to Jack McCarthy, senior project designer at DiGiorgio Associates Inc., the architectural firm that designed the center, the shape of the new space presented a challenge. “It’s a long, narrow space located a half-story below ground,” says Mr. McCarthy. “Once we understood how patients moved through the center we developed a design solution based on a curving path; each change in the curve corresponds to a different area of the center.”
Patients follow the curve to waiting areas, procedure rooms and the education library, where they can read or use portable DVD players. “The curved corridor runs along the windows, giving the center a sense of ease and providing a way to enhance privacy in the exam areas,” says Mr. McCarthy.
Marsha Foye, chief mammography technologist, says patients have responded well. “Women who come for a mammogram tend to be anxious to begin with,” says Ms. Foye. “The design of our center is intended to relieve that anxiety.”
Dr. Rose says all the details count, from the color palette to the lighting to the sound system. “It took vision on the part of the hospital to develop a center like this,” says Dr. Rose. “Now our patients leave saying that we took great care of them—and it happened in a beautiful setting.”
New Rehabilitation Center: Designed for Privacy and Light
A former high school gymnasium has been transformed into Emerson Hospital’s new Rehabilitation Center. The gym’s tall ceilings, wooden floors and row of high windows proved to be the perfect starting point for a light-filled space designed for the full range of rehabilitation care, including physical therapy, occupational therapy, speech therapy and physiatry.
Patients are very impressed. “They immediately see how spacious it is; we have three times as much treatment space as before,” says Vivien Fiset, PT, outpatient rehabilitation services coordinator.
Jesse Tobin, a Carlisle resident who recalls the former facility, is more than pleased with the new center. “It’s spacious, light and bright,” says Ms. Tobin, who had shoulder surgery at Emerson Hospital last fall. “It’s beautifully laid out.”
The 6,800-square-foot center was two years in the making. When the senior rehabilitation staff initially met to discuss the new Rehabilitation Center’s design requirements, privacy was at the top of their list. “The gym provides enough room for all of our exercise equipment, and we now have plenty of treatment space that is flexible enough to meet our needs,” says Ms. Fiset.
There are ten rooms for physical therapy, including specialized programs devoted to sports medicine, balance disorders, lymphedema, incontinence and spine stabilization. The center features state-of-the-art equipment for care of athletic injuries or orthopedic or neurologic conditions, including a multi-station shoulder rehabilitation apparatus and the Elliptical, a closed-chain lower-extremity unit.
Speech therapy has two rooms, one with a one-way mirror that allows parents to observe their children’s session so that they can duplicate what the speech therapist does at home. Occupational therapy has expanded its highly regarded hand service and upgraded the featured equipment, the Baltimore Therapeutic device. “The computerized unit provides resistance and can replicate the movements required for driving, working with tools, climbing a ladder and swinging a golf club,” Ms. Fiset explains.
A private exam room is dedicated to physiatry services—the non-surgical treatment of orthopedic and neurologic conditions such as head injury, back pain and carpal tunnel syndrome. “We now have the combination of private areas and open areas that works well for our patients,” says Karen Bougas, MD, who provides physiatry services and is the center’s medical director. “Therapy staff now have private areas where they can write in a patient’s chart or phone a patient’s physician.”
The staff agree the new center is “1000 percent better” than the former facility, says Ms. Fiset. “As for our patients—it knocks their socks off.”
Day Surgery: A Smooth Operation for Patients and Families
Few people look forward to surgery. Fortunately, advances in surgery have made many procedures less invasive and less painful, leading to quicker recovery times. As a result, 75 percent of the surgery performed at Emerson Hospital is day surgery, with patients safely going home the same day.
Emerson is preparing to make surgery a better experience through a new design of the areas where patients spend their time before and after their procedure. “This new design project is intended to make the entire surgery environment more comforting and reassuring,” says Paul Re, MD, chief of orthopedic surgery. “Surgery affects the patient’s family, so we are designing for their needs, too.”
According to Dr. Re, each step in day surgery has been carefully considered, beginning with the patient’s arrival. “We’re creating a better way to welcome patients and then move them into the pre-surgical area so that they can comfortably meet with their surgeon and the nurse who will care for them,” he says.
While the patient is in surgery, family members will pass time in an expanded waiting area where trained volunteers will provide updates on the progress their loved one is making. Once out of surgery, patients will go to an upgraded recovery area featuring more spacious rooms. “Most day surgery requires that patients spend only about an hour in a recovery room,” says Dr. Re. But it is an important hour, so the new rooms are being designed to comfortably accommodate nursing staff and the necessary monitoring equipment.
While the patient is in recovery, the surgeon speaks with family members in one of the private consultation rooms. “It’s an opportunity for the surgeon to tell them about the procedure and answer any questions,” says Dr. Re. “The consultation room concept has been successful, so we are adding another room.” Patients then leave the recovery area and spend their additional recovery time—typically at least another hour—with their family.
According to Glenn Smith, the design upgrade represents the first phase in a larger plan for surgery at Emerson. “This construction will result in 24 patient rooms—an expansion that will improve the experience of patients who come for day surgery,” he says. The next phase will add additional operating rooms, including one dedicated to urology surgery, and expand the post-anesthesia care unit.
Improved surgical techniques and pain control are making surgery easier on patients, but the new Surgery Center is aimed at taking patient satisfaction to the next level. “We know that surgery can cause a degree of anxiety,” says Dr. Re. “Everyone at the hospital wants to present an environment where patients and families feel reassured—even soothed—when they come to Emerson.”
