health boom - Planning and Design of Behavioral Healthcare Facilities

Planning and Design of Behavioral Healthcare Facilities

Mental Health Facilities: The current state of design

According to most health districts, the market experienced a boom in the construction of facilities for the care of behavioral health. Contributing to this increase is the paradigm shift in the way society mental illness. Society places a high value heavy on the need to treat people with serious addictions such as alcohol, prescription drugs and encourage. A large percentage of people with behavioral disorders are affected by the behavior of both communities most of the back and not taxpayers or offenders become mentally and addictive.

These installations are generally not highly specialized health care give designers attention nowadays, and the amount is a small fraction of the construction of health. However, mental health projects multiply and are designed by large firms such as architects Cannon Design and Architecture Plus. Many people who create the state of the art, award winning modern facilities that defy what most of us think of the design of mental health care to be.

Changing the way we design the behavioral health facilities

As with all good planners and designers, A + D (as well as expert installation) to examine the direct needs of patients and staff, thinking about how new drugs and modern design can help cure rates patients, reduce environmental stress and increase security. This is changing the face of treatment and results in giving the practitioner more time to process because they require less time and resources to "manage" the population problem patients.

The face of mental health is rapidly changing. No longer are facilities designed to store patients indefinitely. And social expectations have changed. Patients are often treated with the belief that they can return to their communities and be a contributor to society. According to the National Association of Psychiatric Health Systems (NAPHS), depending on the severity of the disease, the average length of stay in a health care behavior is only 9.6 days.

What has changed?

James Laurence Black, AIA, president and CEO of New York City-based architects Dasilva says there are two main reasons for direct access time of admission:

1. The introduction of modern psychotropic accelerate recovery significantly

Two. Pressures from insurance companies for patients on how expensive care

To meet these challenges, the health professionals find it very difficult to effectively treat patients within the walls of outdated, the rapid deterioration of mental faculties. A large percentage of these facilities were built between 1908 and 1928 and was designed for psychiatric needs is based on the principles of belief in the "store" not "restore".

It also affects the need for behavioral health building is the reluctance of acute care centers to provide services to mental health patients for psychiatric or substance abuse. Recognize that groups of patients with behavioral health special needs, all of which must be handled and used only by health professionals highly experienced. This patient population also requires a higher level of security. Self-harm and injuring staff and other patients are the main concerns.

The Surgeon General's report "Epidemiology of mental illness" also reports that in any given year, approximately 20% of Americans suffer from a mental disorder and 5.4% suffer from a serious mental illness (SMI) - defined as bipolar, panic disorder, obsessive-compulsive disorder and depression and schizophrenia. Also believed 6% of Americans suffer from addictive disorders, a statistic that is different from the people who suffer from both mental and addiction. In a given year, it is estimated that more than a quarter of a good level of population mental health clinics in the United States. While these numbers have halved, you can not deny that a serious company.

With a growing population, the design effectively in the implementation of these measures is at the heart of public health.

Understanding the complexity of Mental Health Design

Therefore, the corrections, the principal planners and designers specializing in mental health delve deeper to better understand the complexity of the issues and be an activist to develop facilities that promote treatment and cure - and more secure community.

The following is a list of key design variables are studied and applied:

1. Resize

Two. Materials and color humanization

Three. Personal amneties and happiness centered

April. Safety and Security

May. Tenants therapeutic design

Right-sizing

The behavioral health services today are often one-story buildings on a campus size. Often debated by customers due to cost, this design choice is driven by demand for natural light, views of the window to nature for all patient areas, and outside of the outdoor gardens "enveloped" within. All this provides soothing for the patient, reducing anxiety, disruptive behavior counteracts and helps reduce the stress of staff.

"When you look at the combination of programs in these buildings, there is a strong demand basis, as there are many places that need natural light. Offices, classrooms, dining halls and patient rooms in natural light application, so you end up with a lot of the outer wall, forcing the building to have a very large footprint "-. James Muirhead Kent, AIA, Senior Associate at Cannon Design in Baltimore

These design principles are also thought to improve the working conditions of staff. Unlike a complex of several stages, at all times, staff can walk outdoors and nature of access, without visual barriers, and within a building that more accurately reflects the types of patients and staff buildings are in their communities.

Royalty more total footprint size of the building, is for the patient's internal sizing and support staff area. As we have seen movement in the correctional system to decentralize local support, mental health wards moved to / patients decentralized called "neighborhoods". With mental health centers are a great concern for the distance and space adjacencies over the patient's room and support areas, such as the treatment of patients and social spaces. Frank Pitts, AIA, Facha, President OAA Architecture Plus, Troy, New York, recommends that districts averaged 24-30 beds arranged into subgroups called "houses", 8-10 beds. Thus, each area consists of three houses. Often, these facilities include a common area where patients meet and socialize with a separate living room, so that patients can choose to avoid crowded places, assets. Pitts also said: "There is a move away from central facilities catering. Therefore, while facilities will always have a central kitchen, which is much easier to move the food are the patients." However, it is important to mimic outside the normal routines of daily life, so patients are often encouraged to leave their neighborhoods to attend treatment sessions, and outdoor patios.

Humanizing materials and colors

In all the institutions involved in the rehabilitation, the design aims to create spaces that humanize, calm and relaxation. Patients of mental health care need to feel they are in a familiar environment, therefore the architectural vocabulary should feel comfortable and natural. Because these facilities are in rehabilitation (if possible) and encourage patients to be merged into the company, the facility should feel like an extension of the community. Its spaces should reflect the nature and architecture of the region and so yes, there are two facilities must not look very similar.

"Our approach to the design of these facilities is to consider the system as an extension of the community in which the patients when they are finally released. Interior finishes are also dependent on geography, and you want to play patients are accustomed environment. Wants to -stigmatize the installation as much as possible "-. Tim Rommel, AIA, ACHA, OAA, director of Cannon Design in Buffalo, NY.

Therefore, the materials and the colors in these areas want to feel familiar with your region and daily life. To soothe the psyche and rehabilitation, they want to feel soft and comfortable, but visually stimulating. An interior that is too difficult or neutral appearance is not adequate. Materials should reduce noise, and colors should lift your spirits. This can help create an environment in which the patient can learn, socialize and be productive while relieving anxiety, delivery dignity, and behavior modification. As noted above, behavioral studies advocate the use of soft materials such as rugs interior doors, wood and tiles. This translates directly to the patient and staff well-being, including security personnel, and makes it a more pleasant place to work. In addition, the staff has more resources to "treat" instead of managing heat situations. When the experiences of the staff are relaxed and happy, morale is strengthened and the rules and policies of the jackets are more likely to be applied.

And happiness Based Personal Services

While reducing stress and fatigue of personnel through a positive healing environment seems to be an obvious target, there are relatively few studies that have examined this issue in detail. Increased attention to the health of patients. However, many large hospitals have adopted therapeutic tenants in their newly built environments have seen great improvement in their "business models" and financial information.

In one example, the Mayo Clinic, a national leader in the implementation of the concept of healing in its facilities, has reported a reduction in turnover of nursing national average 20% to a rate of 3% to 4% . In another example, when Bronson Methodist Hospital incorporates evidence-based design to a new hospital of 343 beds, cited turnover of nurses -20% 19% 5% reduced drastically.

Now both the Mayo Clinic and Bronson Methodist Hospital had to start a waiting list for nurses seeking positions. It becomes a better trained and qualified staff, and lower error rates. Therefore, most health institutions invest in support staff areas, such as lounges, changing rooms and temporary sleep. Within these areas, the hospital staff and through facilities are also aware of the need for better materials, better natural lighting and an interesting use of color: We realize intertwine soon as the need for patients and personnel, each with a positive or negative influence on the other.

Safety and Security

Without discussion, the damage and injury to personnel is a major concern of psychiatric institutions manage. Often the safety and concern for the safety of patients can do to hurt. "There are three rules that had instilled in me," said Mark Hanchar. Director of preconstruction services for strengthening Gilbane Company, Providence, RI "First of all, can be a way for people to hang Secondly, there can be a way for them to create weapons. Thirdly, there to eliminate the things that lift. "Hanchar said the typical installation is." Hospital with building medium security prisons "This means unbreakable glass, solid surface countertops (laminate can be detached), toilets and sinks stainless steel (porcelain can break), converters and furniture locks can not be separated and used as a weapon. These are just to name a few.

Furthermore, the removal of barriers between patients and caregivers is a safety factor. Frank Pitts, AIA, Facha, President OAA Architecture Plus, explains what might be counter-intuitive for safety, "Glass Walls around nursing stations only aggravate the patients." Removing glass or less in the nursing station so that patients can feel a human connection nurses often soothes patients. There is also talk of eliminating nursing positions together, and placing these needs directly decentralization care clinical areas and community spaces. Pitt said: "The point is that [the medical team] has to be there to treat their patients."

Tenants therapeutic design

As medicine is moving toward a more medical evidence based "," where clinical choices are informed by research, the design of health care is increasingly driven by research linking directly to the physical environment outcomes for patients and staff research teams from Texas A & M and Georgia Tech sifted through thousands of scientists and identified more than 600 items -. most prominent magazines - quantify hospital design play a direct role in clinical outcomes.

The research teams have found a large amount of evidence showing the design features such as increased natural light, access to nature, noise reduction and increased patient monitoring helped reduce stress, improve sleep and increased staff efficiency - all of which promote healing rates and cost saving installations. Therefore, the improvement of the physical parameters can be an essential tool to make hospitals and health insurance, and the best places to work.

Current therapeutic areas were developed to excel in three categories:

1. Providing clinical excellence in the treatment of body

Two. Meeting the psychosocial needs of patients, families and staff

Three. Produce positive patient outcomes and measurable and staff efficiency

Considering the cost of treatment of mental illness, which is very high and the facilities they want to have effective results, a new practice of incorporating therapeutic design is increasing. The National Institute of Mental Health (NIM H) estimated in 2008 that serious mental illness (SMI), costs the country $ 193 billion per year in lost revenue. Indirect costs are impossible to estimate.

The estimated direct cost of treating clinically it's $ 70 billion and $ 12 billion spent on addiction disorders. In addition to the growing need for attention and the construction boom mental health becomes an obligation to ensure that we, facility managers, architects, designers and manufacturers therapeutic planning and design of these facilities.

Note that in 2004, "The role of the physical environment in the hospital for the 21st century: A once in a lifetime" published by Roger Ulrich PHD from the University of Texas A & M, has been released. At the culmination of evidence-based research, the research team found five design principles that have contributed significantly to achieving therapeutic design.

The report identifies five key factors that are essential for the psychological well-being of patients, families and staff, including:

1. Access to the nature

Two. Providing positive distractions

Three. Provide social support spaces

April. It gives a sense of control

May. Reduce or eliminate environmental stress

Access to the nature

Studies show that nature could have the most powerful impact to help patient outcomes and staff effectiveness. Nature can be literal or figurative - natural light, walls of water, views of nature, large prints of plants and geography, materials indicating the nature and above all, stimulating color that evokes nature . Several studies strongly support that access to nature, such as natural lighting and appropriate colors can improve health outcomes, such as depression, anxiety, sleep, circadian rest-activity rhythm and length of stay for patients with dementia and people suffering from seasonal affective disorder (SAD).

These and other studies continue to affirm the powerful impact of the natural elements of the patient's recovery and stress reduction. Therefore, it is obvious that interior designs that incorporate natural elements can create a more relaxing therapeutic environment that benefits both patients and staff.

Positive Distractions

This is a small set of environmental features that provide the patient and family a positive deviation of "hard" and therefore also cancel institutional feel. These can be seen in nature, water, illustrations, stunning graphics imposed, sculpture, music walls - and, if possible, all who want to focus on the nature and, where appropriate, an interesting use of color. Therapeutic environments that provide patient-centered features can empower patients and their families, but also increase their confidence in the institution and staff. This helps to open the lines of communication between patient and caregiver.

Areas of social support

Spaces are designed in part to the patient but also for comfort and socialization of family members and friends of the patient and, therefore, the halls of the library resources of the family, chapels, halls and bedrooms view all play an important role. When friends and family play a key role in the recovery of a patient, these spaces encourage families to play an active role in the rehabilitation process.

Sense of Control

In a time when patients and families feel out of control, is very healing for the design of facilities and personnel to provide timely. Although this is not always appropriate in mental health institutions. However, if these design features include the optional choice of lighting, way finding libraries, architectural resources, improved food menus, private rooms for patients and

optional areas to reside in. Some studies in psychiatric services, well equipped and nursing homes found that the choice of moving seats in the dining areas improve social interaction and improved eating disorders. When patients feel a bit of control over their recovery program and construction features focus more confidence in the quality of care and reduce tensions.

As with all therapeutic design, which allows the doctor to use its resources for healing instead of patient populations 'manage'.

Reduce or eliminate environmental stress

Noise level measurements indicate that the hospital can be very noisy places that have negative effects on patient outcomes. The continuous background noise produced by the medical team and staff voices often exceeds the level of a busy restaurant. The noise peak periods (change change equipment alarms, pagers, telephones, bed rails, cars, and some medical equipment such as portable X-ray machines are comparable to walking beside a busy road when a motorcycle or large truck passes.

Several studies have focused on children in IAS us, saying that high levels of noise, for example, decreased oxygen saturation (increased need for supportive therapy with oxygen), increased blood pressure, increased heart rate and breathing, and worsen sleep. Research in adults and children show that noise is a major cause of the loss of sleep and waking.

Sleep impairment addition, there is strong evidence that the noise increases stress in adult patients, for example, which increases blood pressure and heart rate. Environmental surfaces in hospitals are often hard and sound-reflecting, without lining making noise to travel corridors and patient rooms. Sounds tend to echo, overlap, and stay longer.

It has been found that interventions that reduce noise to improve sleep and reduce stress for patients. Among them, environmental interventions or design, such as changing the acoustic ceiling tiles are more effective organizational interventions such as the establishment of "rush hour".