From hospitals to ambulatory surgery centers (ASCs), the setting of a healthcare environment is important to the healing and wellbeing of patients, patient’s family and friends, and staff. From the waiting room to the Operating Room, visual appeal, efficiency, and cleanability all play a role in healthcare design decisions hospital planning and design teams must make.
The time patients spend in the waiting room may even contribute to their overall satisfaction: 63% of patients say the most stressful aspect of their appointment is waiting. Modern healthcare facilities understand an inviting – and efficient – facility design ultimately promotes a healing environment for patients and staff alike.
Many modern healthcare facilities take an evidence-based approach to the design of a building’s interior: They use credible research to influence an environment’s design to improve patient and staff outcomes.
Over the years, numerous theories and studies have delved into the psychophysiological effects of color. In 2003, a comprehensive review of that work was published by the Coalition for Health Environments.
The impact light has on outcomes in healthcare settings has also been the topic of extensive scientific studies. Lighting in healthcare environments can have an impact in five main areas:
Performance of Visual Tasks
The most obvious requirement for lighting in healthcare is the need for the surgical staff to see clearly during a procedure. The light allows for visual discrimination which is vital for surgeons during a procedure. For minimally invasive (MIS) procedures, it’s important the ambient light is conducive to the visualization of the surgical monitor. When it comes to lighting color, green has proven to cause the least eye fatigue.
Lighting and Risk for Error
The quality of lighting in a healthcare environment also impacts the risk of errors. Higher lighting conditions are correlated with fewer errors. Dark MIS rooms have been shown to increase the risk for errors by OR staff including medication errors and errors in counts. Ideally, room lights during MIS procedures could use high levels of complimentary light to achieve both surgeon comfort and visual acuity as well as high levels of light for visual task performance.
Lighting and Human Circadian Rhythms
Circadian rhythms are biological events that repeat themselves at regular intervals. They are responsible for synchronizing the body’s internal clock to 24 hours and are comprised of three components – internal oscillator, external oscillators, and the melatonin hormone. The internal oscillator is located in the hypothalamus of the brain. External oscillators respond to external stimuli such as the light and dark cycles of the day. Finally, melatonin carries “time” information to all parts of the body through the bloodstream.
Lighting, Mood, and Perception
There is strong evidence exposure to bright light in the morning is effective in improving mood and maintaining proper internal timekeeping. Providing cycled lighting in the healthcare environment can improve staff sleep quality and alertness.
Staff Stress and Satisfaction
Some studies have examined the impact of light – both artificial and natural – on mood and task performance in healthcare settings. One such study indicates nurses exposed to three hours of daylight conditions daily experienced less stress and were more satisfied. Furthermore, surveys of surgical nurses reported having increased natural light had a positive impact on their work life.
The physical environment can have a significant impact on safety and human performance, and this is exceedingly relevant in the healthcare environment. Many clinicians, architects, and hospital administrators believe the hospital environment can benefit the satisfaction of healthcare providers as well as patient satisfaction and outcomes.
Today’s caregivers acknowledge patient satisfaction and convenience as contributors to healing which has led to an understanding design is a means to change the perception of patient care and enhance the overall patient experience. Studies suggest the physical attributes of the hospital have had an impact on patient perception of quality of care. For example, lighter colors are often associated with cleaner environments.
Imagery and motifs may also play a role in patient satisfaction within the healthcare setting. Evidence shows even brief periods of exposure to a nature scene in a healthcare environment makes a difference for patient satisfaction. Consistent with other studies, the use of positive distractions (both visual and auditory) can affect patient outcomes. The design of the environment may have an effect on perceived care, even when patients are under some form of sedation.
The type of wall material in the healthcare setting plays a role in the overall facility design, cleanability, and sustainability.
Stainless Steel is a non-porous, flat panel typically made of AISI 304 stainless steel. Panels attach to a steel substructure utilizing clips or screws. The surface requires an anti-corrosive finish to prevent oxidation/rust. Cut-outs for monitors, electric outlets, accessories, etc. may be completed in a factory or at the jobsite.
High Pressure Laminate (HPL) panels are composed of a resin impregnated kraft paper, a decorative paper, and a clear melamine overlay. These sheets are bonded at high pressures and temperatures to substrates such as medium density fiberboard (MDF) or particleboard. Cut-outs for monitors, electric outlets, accessories, etc. are completed at the job site.
Drywall is a porous, flat panel made of gypsum plaster sandwiched in between two sheets of thick paper. Panels attach to metal or wood studs using nails or screws. Cut-outs for monitors, electric outlets, accessories, etc. are finished at the jobsite. Exposed surfaces must be finished with paint, epoxy, or other materials after installation to protect the visible paper layer.
Glass is a non-porous, flat panel composed of natural and abundant raw materials (sand, soda ash, and limestone) that are melted at very high temperatures. Panels attach to a steel substructure utilizing clips or screws. The surface does not require any additional coatings or finishes. Cut-outs for monitors, electric outlets, accessories, etc. are prefabricated in a factory setting.
Made of specially tempered security glass, MEDglas™ Prefabricated OR Walls combine beauty, strength, ultra-durability, and cleanability. With a virtually limitless range of Operating Room wall finishes including colors, patterns, and images as well as lighting options, these modular glass walls for the OR provide a long-lasting and aesthetically pleasing combination of a hospital healing environment and functional workspace to support the wellbeing of both patients and clinicians.
The ceiling is another element of the healthcare environment that plays a role in infection prevention and future-ready design. Modular Operating Room ceiling systems such as CLEANSUITE® OR Ceiling System use a prefabricated structural frame that installs faster and cheaper than traditional on-site laminar-flow ceiling systems.
The hermetically sealed door has been specifically designed for use in areas where hygiene and the control of air leakage are critical. The door has a unique patented track system which enables it to seal perfectly when closed helping to reduce air handling costs, cross-contamination and wound infections.
Lena Elias-Fogle, BSN RN, CNOR
Director, Global Clinical Solutions
Lena is a seasoned healthcare leader with extensive experience leading complex perioperative environments as well as new program development, continuous process improvement, clinical outcomes, operational excellence, and stakeholder experience.
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