Wellness-Based Design Strategies in Healthcare  

Photo: Kyle J Caldwell; courtesy of Bison Innovative Products

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” −World Health Organization Constitution.

HEALTHCARE IS HOLISTIC

There is a renewed emphasis in healthcare design that seeks “the patients’ point of view, considering not only their physical, but also their social and psychological needs; this has prompted interventions aimed at enhancing the physical, sensory, and psychological comfort, improving wayfinding systems, and increasing the clarity of the meanings communicated by space design.”1 Yet a holistic approach to healthcare design is not an invention of the twenty-first century. In 1839, the Lexicon Medicum mentioned the “healing powers of nature,” arguing that many illnesses could be cured without the help of medicines, simply by focusing on air, sustenance, comfort, physical movement, and positive feelings.2

What is new today is cutting-edge research’s confirmation of holistic, whole-person design strategies. Design derived from data is also known as Evidence-Based Design (EBD). EBD is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes. For healthcare, this movement began notably in 1980 with Roger S. Ulrich’s work.

Photo: Fotoworks/Benny Chan; courtesy Rockfon

Patient-centered care must necessarily involve person-centered design. Methods, materials, and products for healthcare should empower the whole person.

Photo: ©Kyle Jeffers; courtesy of PABCO Gypsum

Considering the whole person in healthcare design comprehends mental and emotional reactions to the built world.

According to The Center for Health Design, EBD follows eight steps within its process:³

• Define evidence-based goals and objectives.
• Find sources for relevant evidence.
• Critically interpret relevant evidence.
• Create and innovate evidence-based design concepts.
• Develop a hypothesis.
• Collect baseline performance measures.
• Monitor implementation of design and construction.
• Measure post-occupancy performance results.

Data demonstrate that to obtain the best outcomes, the experience of healthcare for both patients and staff should be based not only on physical treatment but also on mental and emotional well-being.

EBD equips architects and design professionals to develop a healthcare design that plays a tangible role in the restoration of their patients’ health.⁴ To accomplish this, it is important to specify materials that intentionally support wellness for patients, visitors, and staff in modern healthcare facilities.

EBD Notes for Healthcare

While safety is obviously the right place for the healthcare design community to start when planning, it is clearly not the place to stop.⁵ Cutting-edge holistic care spaces require a new way of thinking and an approach that considers human needs in their entirety, rather than in a strictly therapeutic sense only6 “Normative” approaches have been criticized as oversimplifying the complexity of whole-patient care.⁷ However, emerging evidence suggests that certain design features facilitate key benefits in healthcare.⁸

• A homelike, deinstitutionalized environment that supports patient autonomy and control over their own environment.
• A well-maintained and well-organized environment.
• Noise control (acoustic comfort).
• Support for privacy.
• Access to daylight and views of nature.
• Physical access to the outdoors.
• Support for feelings of personal safety/security.
• Support for social interaction.
• Positive distraction.

Photo courtesy Inpro

Considered holistically, materials and products can perform unique design functions. Art enables wayfinding in new settings and personalizes the healthcare space.

Photo courtesy The Chicago Faucet Company

Solving water delivery system challenges in healthcare with the right products alleviates concerns about healthcare-associated infections as well as factors like patient access.

Photo courtesy PABCO Gypsum

Pursuing holistic healthcare design goes beyond surface-level decisions. Careful attention to selections made in all material categories—even those unseen, like gypsum panels—will facilitate many benefits, including better acoustics and prevention of mold.

Products That Power Holistic Outcomes

With a map of goals provided by EBD, the design professional can make more confident decisions when planning and specifying healthcare spaces. Informed tools, such as the WELL Building Standard from the International Well Building Institute (IWBI), or the Living Building Challenge from the International Living Future Institute (ILFI), provide considerable additional guidance. Also, new products and materials, backed by independent certifications, are equipping specifiers in securing the desired design outcome.

Just as a successful design encompasses multiple attributes to promote wellness, so too advanced products can offer compounding benefits for a project. Stone wool ceiling panels are highly sound absorptive and use high-performance materials that do not require biocides, antimicrobials, or fire retardants to meet performance specifications. Their design creates better acoustic privacy while meeting stringent safety codes. Additionally, stone wool ceiling panels are Low VOC to protect Indoor Air Quality (IAQ) and boast natural and durable materials that can be recycled at the end of their life.

Likewise, new wide-reach faucet designs address patient, staff, and safety concerns. Staff efficiency is increased so that healthcare workers can more easily perform tasks like filling containers or washing medical instruments. For patients, easier access to water promotes better hand hygiene, potentially reducing healthcare-associated infections. Universal Design wide-reach faucets accommodate users of various heights and physical abilities, aligning with ADA requirements and preserving access. The improved ergonomics also encourage more efficient water use, as users can more easily position their hands under the stream, enhancing water conservation.

The ability of materials to empower wellness continues even when out of sight. The use of constrained layer damping (CLD) gypsum panels in wellness-based designs can help support the safety, health, healing, and well-being of patients and caregivers. CLD gypsum panels may be used to meet fire and sound codes in lieu of traditional drywall. Partitions constructed using CLD panels can reduce costs, time, and waste by eliminating the need for additional material to increase noise control performance with improved Sound Transmission Class (STC) ratings. CLD panels with steel cores can be used in extreme impact areas, used as anchor points for equipment, or by adding additional shear resistance.

On the walls themselves, incorporating natural elements and art can enhance health, well-being, and productivity through biophilic principles. Commercial products, from wayfinding signage to elevator interiors, from wall art and wall protection to roller shades, can all play host to art and nature. Different art styles and movements, with their distinctive features and historical importance, can be integrated into interiors to positively influence mental and emotional health. Effectively integrating art into functional products creates items that go beyond the durability of a space to also meet aesthetic needs.

Outside, modular deck systems give designers the flexibility to create unique and beautiful rooftop environments and outdoor spaces. More than fifty published studies highlight natural daylight and views of nature as key factors that contribute to faster patient recovery, lower medication reliance, reduced stress for staff and families, and enhanced emotional well-being. Providing a healing garden or outdoor area extends the healthcare space and provides a place for social connectivity as well as connectivity to the natural world. Modular decks allow architects to include a mix of pavers and surface materials including wood, stone, structural porcelain, crushed rock, grating, artificial turf, and concrete, as well as planter cubes and benches to fashion unique, custom looks. Versatile, adjustable pedestal deck systems can be utilized over any structural surface - on bare structural decks, rooftop decks, roof membranes, green roofs, terraces, compacted grade, pavement, pool surrounds, or water features.

By adopting the patient and care worker’s points of view, design input is now considering not only physical but also social and psychological needs. This shift in viewpoint has prompted innovations aimed at enhancing physical, sensory, and psychological comfort, improving wayfinding systems, and increasing the clarity of the meanings communicated by space design.⁹

Photo: ©Michael O’Callahan; courtesy of Rockon.

When designing healthcare spaces, architects and designers take on a significant role in people’s health and wellbeing, by creating spaces that pay attention to wellness within design.

Photo courtesy The Chicago Faucet Company

Standards aim to improve accessibility, hygiene, and functionality in healthcare settings. For example, standards recommending wide-reach faucets aim to create more user-friendly and hygienic environments in healthcare facilities, contributing to better patient care and staff performance.

WELLNESS BENCHMARKS: CERTIFICATIONS AND STANDARDS THAT EMPOWER DECISION MAKING

A building’s materials collaborate to create a united product portfolio, designed to take on the biggest challenges. The challenges the built environment faces are especially prominent in healthcare. Each product should offer carefully designed, innovative solutions that promote occupant comfort, safety, and wellness. Third-party certifications and programs enable design professionals to make discerning selections with confidence, helping to guide a project to realize its full potential.

When making decisions for the health of a building and its occupants, look for products with demonstrable transparency and supported with life-cycle assessment documentation. Product transparency means that all relevant product information is fully and freely available to the public. These disclosures and accountability markers help designers, specifiers, and end-users make informed purchasing decisions about which materials should be placed in buildings. There are multiple independent reporting tools that disclose the precise material makeup of products.

The Health Product Declaration (HPD) Open Standard is a process for the accurate, reliable, and consistent reporting of product contents and associated health information. A published Health Product Declaration discloses the ingredients in the material or system, up to 100 parts per million. A published Health Product Declaration (HPD) allows a project team to specify products with confidence.

Building upon the HPD, The Healthy Hospitals Initiative (HHI) encourages healthcare systems to measure the impact on improved patient, worker, and community health by reducing energy and waste, choosing safer and less toxic products, and purchasing and serving healthier foods. Practice Greenhealth acts as a guide for HHI in products that meet Initiative criteria. The Greenhealth Approved program was launched in late 2019 and provides centralized data submissions for suppliers wishing to vet products for healthcare organizations wishing to purchase more sustainable products.

For comprehensive project certification, The WELL Building Standard is an evidence-based system for measuring, certifying, and monitoring the performance of building features that impact health and wellbeing. The standard is divided into 10 concepts: Air, Water, Nourishment, Light, Movement, Thermal Comfort, Sound, Materials, Mind, and Community.

U.S Green Building Council’s (USGBC) Leadership in Energy and Environmental Design (LEED) Building Design and Construction: Healthcare provides a rating system meant for hospitals that operate 24 hours a day, seven days a week and provide inpatient medical treatment, including acute and long-term care. A more rigorous focus on water efficiency, access to nature, and daylighting addresses the links between sustainability and the health of the patient.

Living FutureSM Living Building Challenge provides a framework for designing, constructing, and improving the symbiotic relationships between people and all aspects of the built and natural environments. The seven Petals of the Challenge facilitate restoration and regenerative principles across a design.

Additional excellent resources for healthcare product selection guidelines include applicable Facility Guidelines Institute (FGI) guidelines, Green Globes Assessment Protocol for Commercial Buildings, and the National Institutes of Health (NIH) – Design Requirements Manual.

Photo courtesy Inpro

Choosing products and materials with independent certifications enables confident decision-making for demanding healthcare spaces.

The Designer’s Charge

Architects and designers have a significant role to play in people’s health and well-being by creating spaces that pay attention to wellness within design. This means verifying the selection of the best and healthiest materials; it also means combining these materials together in ways that create a holistic design, enabling wellness.

Stress factors for patients in healthcare environments are often related to the inability to control their surroundings, especially in terms of physical and organizational spaces and timings of the place of care.¹⁰ Other stress factors include the lack of visual and auditory privacy, the presence of unfamiliar and often disturbing sounds, artificial lighting with a low comfort level, and intense environmental smells.

A place perceived as welcoming, understandable, aesthetically attractive, and relaxing promotes the development of a greater sense of trust and activates positive feedback to the information and the stimulations coming from outside.¹¹ When design teams leverage a universal approach to support improved well-being for all populations, healthcare becomes accessible to all.

WELLNESS AESTHETICS: USING ART AND NATURE TO NURTURE

Central to a holistic design approach in healthcare is the concept of biophilia. Biophilic design is a design philosophy that encourages the use of natural systems and processes in the design of the built environment.¹² As EBD continues to demonstrate, hospital design plays a tangible role in the restoration of patients. There is a growing movement towards creating these restorative environments by reconnecting humans to nature.¹³ “Biophilic design is more complex and richer than the mere application of vegetation in buildings; it broadens the variety through encompassing different types of nature from physical, sensory, metaphorical, morphological, material to spiritual.¹⁴

Biophilic Design for the Interior

Incorporating biophilia into a project’s interior design allows people to maintain their biological connection to nature, even indoors. Humans have an innate affinity for the life-supporting aspects of the natural world. Understanding this inherent attraction to the natural world has spurred innovation in the architectural community. Working through digital imagery or prints on an architectural product, art that features biophilia can play an impactful role.

Biophilia in medical facilities improves occupant mood, helps promote efficiency and satisfaction in healthcare, and can decrease time spent in recovery for patients. By incorporating permanent biophilic features into the built environment, designers can ensure that everyone reaps the benefits from contact with nature. In an environment where direct exposure may not be possible, such as an aseptic medical environment, images of nature can provide a connection to the natural world for both patients and medical professionals.¹⁵

Biophilic elements can also enable wayfinding. Healthcare campuses present a unique set of navigational challenges. Often, these environments have developed over time and encompass multiple buildings. This makes navigation among the buildings complex. In addition, patients and families who visit healthcare campuses are often under stress. Wayfinding systems can help reduce their stress by providing easy-to-follow signage and legible directions to their destinations, according to the Society for Experiential Graphic Design. Using biophilia, and coordinating themes, imagery, and colors, minimizes reliance on text-based messaging and instead places the burden on more easily interpreted non-text cues such as colors and symbols.¹⁶ Designed sounds are used for wayfinding too.

The use of images of nature in the built environment has been widely investigated in environmental psychology. Images of nature have been found to be as stress-reducing as actual views of nature in certain circumstances.¹⁷ Images of nature can even be more restorative than the view of real nature, depending on the content of the image and the view of nature.¹⁸ Art, then, can become a crucial component of any healthcare space by bringing in the natural world.

Photo courtesy Inpro

Transform interiors with printed wall protection, which provides design freedom for stunning and durable walls. PETG protection guarantees longevity, and clear sheet back-printing maintains graphic vibrancy without scratches, enabling design professionals to customize with images, branding, or statements.

Blending Biophilia and Art with Architectural Products

New digital imaging and printing techniques have enabled endless possibilities when it comes to adding art to architectural products, including wall coverings, panels, shades, and signage. Design professionals are no longer limited to solid colors or patterned wallpaper. Stock photography and curated artworks from artists can be showcased through architectural products. Any image can find a place on a project’s walls, signage, or even window treatments. Art is no longer something relegated to hang on the wall as an ornament, it can be transformed into something that is ultimately functional. Complete customization enables architects and designers to create unique, one-of-a-kind products that produce an unforgettable experience for building occupants. The colors, materials, textures, and impact-resistance levels of these products also offer designers and facility staff limitless options to enhance the aesthetics of a facility’s interior, while delivering much-needed protection to the edifice itself.

It’s a difficult balancing act to design beautiful interiors that can also stand the test of time in harsh environments, such as healthcare. Architects and design professionals can slow the inevitable wear and tear by thinking long-term and specifying products that not only preserve their design and artistic vision but also serve building owners in preserving a structure long after the ribbon is cut. This can mean, in high-use areas, selecting products that protect the planned interior from accruing damage in the first place.

Walls are one of the largest elements of the built interior. Thanks to innovations in technology, designers no longer have to compromise their visions by using drab institutional products, nor do they have to sacrifice durability for aesthetics. Adding design integrated into wall protection gives walls an additional purpose while expanding their longevity and enhancing protection against damage. Durable wall panels can be used in high-traffic spaces prone to damage and deterioration. Specifying printed wall protection provides a protective wallcovering that can be applied directly to the wall at virtually any size. When the graphic is back-printed onto clear sheet, like Polyethylene terephthalate glycol (PETG), the custom artwork, photography, or image remains vivid and will not get scratched over time.

In areas that do not need enhanced protection, printed wall art offers completely customizable design options, enabling the professional to choose impactful photography, logos, or colors to align with the brand and continue the design scheme. Printed signage allows art to be integrated in creative ways throughout the space. Printed cubicle curtains, window treatments, and shower curtains, made from fiberglass, polyester, vinyl, and acrylic, can help to block glare and unwanted heat while still allowing a degree of natural light. When combined with digital print capabilities, these fabrics create the perfect combination to add and display art within commercial buildings.

Photo: © Craig Dugan Photography; courtesy Inpro

Not only can art enhance the human experience, many architectural products also benefit the environmental profile of a space, with LEED and Greenguard Gold certifications, as well as HPDs.

Building Direct Connection to the Out of Doors

Modifying hospitals’ designs by humanizing spaces and reconnecting with nature offers therapeutic support that can positively impact the patient’s psychological and physical well-being; it can also measurably improve their ability to recover.¹⁹ International studies have confirmed that 95 percent of patients and families exposed to direct contact with nature reported lowered stress levels, more positive thoughts, and increased coping ability.²⁰ In addition, plants in rooms and rooftop gardens in hospitals improved patients’ psychological response to treatment, with lower levels of pain, anxiety, and fatigue.²¹

Stephen R. Kellert and Elizabeth F. Calabrese define Biophilic Design as “the deliberate attempt to translate an understanding of the inherent human affinity to affiliate with natural systems and processes—known as biophilia—into the design of the built environment.”²² There are many ways to incorporate biophilic elements into a building’s design – through a visual connection to the outdoors, incorporation of natural elements, or by directly expanding the boundaries of indoors to the outdoors. Rooftop and patio deck systems offer an exceptional opportunity to incorporate biophilic design elements and sustainability goals.

Including access to the outdoors, decks, or patios, can connect guests to the surrounding environment using natural materials, such as wood and stone, and foster the incorporation of vegetation and greenery into an individual’s regular routine through the use of planter cubes and pots. Regular interactions with the outdoors are proven to have positive health benefits for everyone—staff and patients alike—such as lower blood pressure, reduced stress, expedited healing, and improved mood and focus. These areas can also provide occupants with the opportunity to release tension through recreation, sport, and physical activity, thereby improving users’ focus, health, and morale. For staff, offering natural spaces onsite increases productivity, with lower illness and absenteeism, better staff retention, and job performance.

New products are helping to remove barriers and facilitate the development of natural spaces within healthcare settings. Adjustable pedestal deck systems provide a unique alternative to traditional deck building methods that deliver tremendous design flexibility, coupled with ease of installation. Pedestal deck supports are designed to elevate a variety of substrates, including granite or concrete pavers, wood tiles, composite materials, fiberglass grating, or conventional wood decking systems. These systems are available in a range of heights and weight-bearing capacities to suit a variety of applications. The pedestal system is one of the most labor- and cost-efficient methods of creating a flat, level deck over a sloped sub-surface. They also open the opportunity to use underutilized outdoor spaces, turning an otherwise wasted space into a functional outdoor amenity.

Modular pedestal decks create distinctive opportunities to capture nature in design. Pop-Up Parks can be used to reclaim car-designated zones in urban areas. Pop-Up Parks vary in size from a one-car parking space of about 150 square feet to many spaces linked together, to a whole block or lane. Installations include pedestal supports with wood tile, stone, or concrete paver surfaces covering the existing pavement. Popular accessories include attachment hardware, planters, railing, and benches. Some manufacturers offer all the built elements required for a Pop-Up Park installation. This creates a smooth installation as well as offering a consistent warranty for the entire system.

Modular decking transforms balconies and rooftops swiftly into outdoor decks, affording living space with a direct visual and material connection to nature and a peaceful refuge to rejuvenate the body, mind, and soul. A deck’s sweeping views of the encircling landscape allow patients and staff to visually survey and contemplate the surrounding environment. These broad landscape views inspire an emotional attachment to the building’s natural surroundings and promote positive interactions between the building’s users and the neighboring ecosystem.

Photo credit: Kyle J Caldwell; courtesy of Bison Innovative Products

A growing body of evidence suggests that certain design features, including access to daylight and nature, facilitate key benefits in healthcare.

Photo courtesy of Bison Innovative Products

Versatile pedestals, pavers, and site furnishings offer the design flexibility to create unique and beautiful rooftop environments. Independently tested, modular deck systems allow rooftop decks to be installed quickly and easily.

Deck support systems are impervious to water, mold, and freeze-thaw cycles. Pedestal systems can support decks over occupied space, allowing cavity space for electrical systems, ductwork, and irrigation. Pedestals also elevate the deck surface to meet the threshold, delivering an even and level transition from one space to another. This allows easy access for patrons with different levels of mobility. Being a gravity system, the supports do not penetrate the substrate, and therefore protect roofing membranes and waterproofing and do not damage or harm the surface below.

Modular deck systems contribute to sustainable design goals and may help projects earn certification through LEED, SITES, WELL, and other green building design initiatives. Pedestal decks can help to reduce a building’s carbon footprint through a reduction in a roof’s ambient temperature, potential for green space, rainwater collection initiatives, and reduced need for roof replacement, avoiding additional construction materials. Where wood tiles are specified, verify the availability of FSC-certified species. Paver trays provide simple, lightweight, and durable support for porcelain, natural stone, and concrete pavers. Paver trays made from galvanized steel meet the testing requirements for non-combustible surface materials. The paver support trays are designed to enhance the impact and wind uplift resistance and provide additional strength to paver surface materials. Paver trays can be adhered to the desired surface pavers on site before or during installation. Planter cubes integrate with walkways in a modular pedestal deck system, making it easy to design a beautiful outdoor environment. Available with standard irrigation sleeves and drainage holes, cubes can host plant life in the summer and be repurposed for seating and storage in the winter.

THE UNSEEN VARIABLES: ACOUSTICS, IAQ, SAFETY, AND HEALTH

There is now a significant body of evidence that shows the physical environment is a critical component in any program to improve safety and comfort for patients and provide a safer working environment for staff.²³ The physical environment in which people work and patients receive their care is one of the essential elements to resolving preventable hospital-acquired conditions. EBD demonstrates that the physical environment in which patients are cared for and in which caregivers work has a measurable and quantifiable impact on them.

Assuring safety is a must. Along with safety, hand-in-hand come the attributes of an enhanced indoor environment, including acoustics.

One of the most significant aspects of a healing environment is acoustic comfort. When considering a healthcare setting as a holistic whole, managing sound becomes extremely important. Noise affects patient safety and health and is an important part of the patient experience. The noise from equipment, patient intake and discharge areas, nurses’ stations, and common areas, plus the regulatory requirements for patient privacy, all point to the need for the mitigation of sound transmission as a critical aspect of design. Patients often complain about noise levels during their hospital stay, but there are many interventions, such as stone wool acoustic ceilings with high Noise Reduction Coefficient (NRC) ratings and high STC-rated partitions made using CLD gypsum panels, available to support a healthier and more comfortable environment.²⁵ EBD research indicates that proper sound control can increase patient sleep and recovery, increase patient and staff safety, improve patient privacy and dignity, and relieve caregiver stress while increasing job satisfaction.

Achieving optimized acoustics can be refined to three practices: first, selecting a ceiling system to optimize acoustic absorption, then, using walls, floor slabs, or plenum barriers to effectively optimize sound isolation between rooms. Finally, designs need to ensure that the background sound level is within the desired range. Soundscaping can also add positive and desired sounds to the care environment to aid privacy, wayfinding, positive distractions, and biophilia.

Photo: ©Michael O’Callahan; courtesy Rockfon

The material elements of a healthcare environment are just as critical to ensuring positive patient outcomes.

Photo: ©Kyle Jeffers; courtesy of PABCO Gypsum

When considering a healthcare setting as a holistic whole, managing sound becomes extremely important. Acoustic comfort is one of the most significant factors in healing environments.

New Options in Acoustic Control

The Facility Guideline Institute (FGI) provides recommendations for STC ratings and other acoustic criteria. STC ratings measure the effectiveness of walls in reducing sound transmission from one space to another. STC ratings for a specific space need to be determined before partitions are specified. Wall systems with an STC lower than 35 are considered poor sound barriers while those with an STC above 55 are considered very good. To meet these higher STC ratings, products such as gypsum board partitions require enhancements beyond what conventional products provide.

Constrained layer-damped (CLD) gypsum panels are an alternative product that provides excellent acoustic performance while integrating more easily into standard construction. CLD panels contain a viscoelastic polymer layer that allows the gypsum layers to independently shear, dissipating the acoustic energy of the sound wave. This results in less audible energy passing through the board, in essence, reducing the sound transfer between rooms. CLD panels achieve higher STC ratings at a lower installed cost than other sound reduction options such as resilient channels, sound isolation clips, and using multiple layers of gypsum. This also decreases the chance of improper installation that will negatively affect acoustic performance. STC performance with CLD panels also is not affected by headwall systems and mounted fixtures. Critically, CLD can achieve both tested STC performance and UL/ULC fire-rated walls in one design. Furthermore, specialized CLD panels can meet additional criteria, including high impact, mold-resistant, radio frequency (RF) shielding, and low-frequency control.

“CLD panels excel where it matters most, creating quiet environments conducive to healing and enhanced speech privacy in a simplified manner,” says Ben Shafer Sr. Acoustician, Research and Applications, PABCO Gypsum. In addition to designing for noise, architects need to address mold concerns. Breathing mold-contaminated air can cause severe health issues for hospital patients, personnel, and visitors. Because the campus buildings are equipped with HVAC units and plumbing running through plenums above ceilings, this may increase the risk of mold growth. Mold-resistant CLD panels are an option to treat areas above ceiling height and mitigate mold concerns.

CLD panels also save on installation time, reduce installation steps, and help control labor costs. Certain CLD panels also allow installers to easily score, snap, hang, and finish the drywall like standard gypsum wallboard. With no paper or metal in the center of the panel, the drywall delivers the desired acoustic performance with improved workability.

Photo courtesy of PABCO Gypsum

Specifying CLD panels not only secures better noise control, but these panels can also save on installation time and reduce installation steps.

Photo: © 2023 James Steinkamp Photography; courtesy Rockfon

Stone wool ceiling tiles designed for healthcare environments can meet ISO Class 4 standards for low particle emissions and exceed FGI guidelines. They can inhibit the growth of MRSA and are tested per ASTM D4828 for washability, ASTM D2486 for scrub resistance, and ASTM D1308 for chemical resistance. These tiles can also offer excellent sound absorption of up to NRC 0.90, promoting a healing environment.

Photo: Fotoworks/Benny Chan; courtesy Rockfon

Stone wool tiles perform for areas requiring high cleanliness, offering sealed edges to prevent particle ingress and maintain clean room standards. Stone wool tiles can also provide high light reflectance of up to 83 percent, contributing to brighter spaces and energy savings.

Addressing IAQ and Acoustics with Ceiling Tiles

Few specifications are as important as those for hospitals and healthcare facilities. Like walls, the ceiling system also plays an important part in the overall healthiness of the building, as well as that of the patients and staff. Attention should certainly be given to selecting ceiling systems with high sound absorption to cut down on noise. However, specifying the right ceiling system can additionally save energy on lighting and cooling, help prevent mold and infections with its cleanability, offer recycled and recyclable materials, and provide a full palette of colors to help create a warm and inviting setting.

Acoustic absorption is important. FGI requires it in all normally occupied spaces. When ceilings with a high Noise Reduction Coefficient (NRC) replace ceilings with less acoustic absorption, people perform much better. “Evidence-based design includes installing high-performance sound-absorbing ceiling tiles as a priority design recommendation based on the evidence available and the impact on safety, quality, and cost,” says Gary Madaras, PhD, Rockon Acoustics Specialist. “When ceiling panels with a high Noise Reduction Coefficient (NRC) are installed, patient and staff stress is reduced, patient sleep deprivation is reduced, and satisfaction is increased.”

Stone wool ceiling solutions offer optimal acoustic, and infection control, as well as aesthetic benefits that impact the vitally important functionality, safety, and atmosphere of medical facilities.

As healthcare providers work to protect their patients and the wider population from the spread of disease, deliver effective care, and encourage healing, they rely on their built environment to provide a safe, clean, and comfortable space. Much of the solution to indoor air quality (IAQ) issues, and overall indoor environmental quality (IEQ), lies in the materials used for building and renovating. Besides acoustic comfort, stone wool ceiling solutions bring additional benefits to the table. Stone wool is a durable material that holds up to infection control and cleaning measures. The surface is easy to clean and disinfect without affecting appearance or performance. Stone wool is a non-chemically treated material to lessen the chemical load on patients trying to heal. It is also an inorganic material that naturally resists mold. Additionally, stone wool ceilings enhance natural lighting and provide proven natural light attributes. Light is vital to human functioning and important for both psychological and physiological conditions. Dodge Data & Analytics identifies access to daylight as a key feature for healthier buildings.

Photo courtesy The Chicago Faucet Company

Stagnation prevention is crucial in showers for the safety of patients. Comprehensive draining solutions exist that remedy this hazard by automatically draining water in the water column pipe and the hose for handheld sprays.

Photo courtesy The Chicago Faucet Company

Levels of customization ensure that faucets are optimized for the needs of both patients and staff in various healthcare settings. By leveraging Bluetooth connectivity and mobile monitoring capabilities, hospitals can create a safer, more efficient, and more responsive environment for both patients and healthcare workers.

Improving Outcomes with Safety

Specifying plumbing fixtures merely on design appeal without looking at improved outcomes for healthcare is not fully serving clients. What should be promoted is the application of design that improves healthcare performance, patient satisfaction, staff productivity, and safety.

Minimizing Healthcare-Acquired Infections (HAI) is a key concern for hospitals, senior care centers, and behavioral centers. Specifying the optimal plumbing systems and fittings is crucial to minimizing infections. This includes selecting hygienic showers and faucets that are specially designed to eliminate water stagnation and minimize infections.

The Centers for Disease Control and Prevention recommends that healthcare facilities included in the scope of ASHRAE Standard 188 (Section 5.2) develop and implement comprehensive Water Management Plans (WMPs).²⁶ WELL V2 also requires projects to proactively test drinking water and to manage recirculating hot water systems against Legionella colonization by having a WMP. Implementing a WMP can help reduce the risk of Legionella growth and transmission. WMPs identify potentially hazardous conditions and outline steps to minimize the health impact of waterborne pathogens on patients and staff. The standard includes special requirements for healthcare facilities, recognizing their unique risks and needs.

Healthcare facilities must develop a comprehensive water management program for all water systems, from potable systems to hydrotherapy equipment and even decorative fountains. Based on these assessments, appropriate control measures must be implemented, such as:

• Temperature management
• Disinfection protocols
• Flushing regimens
• Point-of-use filtration where necessary

Photo: ©Kyle Jeffers; courtesy of PABCO Gypsum

“Holistic medicine is not an alternative but the very basis of the art of healing.” −George Vithoulkas

Architects and designers should be aware that there are plumbing fittings that can facilitate their water management plans because they have been engineered specifically for healthcare. For example, showers in public facilities and healthcare settings must eliminate water stagnation to minimize bacteria growth leading to infections. Shower system technologies can simplify the process by automatically eliminating the sitting water in the pipe column, valve, and shower spray hose, instead of relying on manual removal by maintenance staff or nurse aides. It is important that specifiers understand that several types of comprehensive draining technologies are available, wherein the system automatically drains water from the shower system. Water residing in the pipe column, thermostatic/pressure balancing valve or pressure balancing valve, and hose is quickly drained upon shut-off. For showers that have both a showerhead and a hand spray, the Auto-Drain diverter assures that any water in both the showerhead and a hand spray drains after each use, without requiring any manual intervention. A diverter assures that any water residing in the pipe column and hose is quickly drained upon shut-off. For showerhead-only showers, draining the thermostatic or pressure balancing valve with an intuitive drain ensures the removal of the water from the pipe upon shutting off the water flow. For showers that have both a showerhead and a hand spray, a diverter should be specified to ensure that both are drained.

Also keeping in mind the Well V2 Building Standards for public bathrooms include contactless faucets and soap dispensers so users can exit the bathroom hands free. Faucets must be:

• Sensor-activated operation to minimize contact and promote hygiene.
• Equipped with a programmable line-purge system.
• If mixing is used, hot- and cold-water lines are mixed at the point of use.
• The faucet design prevents the water column from flowing directly into the drain or a sink drain stopper is installed.
• Water does not splash outside the sink when the faucet is fully open.

Specifying touchless faucets in hospitals plays a critical role in infection control by minimizing the risk of waterborne pathogens that can lead to hospital-acquired infections (HAIs). Touchless faucets with Bluetooth connectivity enable mobile programming and adjustments through an app, making it easier for facility managers to maintain a hygienic water system. These advanced faucets can automatically implement hygiene flush protocols, reducing stagnant water and bacterial growth by regularly flushing out contaminants. In times of remediation, they also allow for flushing that can clear water lines more effectively. Furthermore, facility managers can track usage patterns, helping to ensure handwashing compliance and supporting infection prevention efforts throughout the facility.

In addition to Bluetooth connectivity, specific design features in touchless faucets add layers of protection. For example, a touch-free design limits surface contact and bacterial transfer, while copper tubing helps inhibit bacterial growth naturally. Features like antimicrobial laminar flow outlets reduce the risk of bacteria, mold, and mildew, providing added protection at the faucet outlet. Studies have shown copper is effective against a wide range of pathogens, including Legionella, Staphylococcus aureus, and E. coli, enhancing faucet hygiene. Low-volume solenoid valves also help by minimizing water stagnation in the faucet, while non-aerated laminar flow limits microbial spread. Together, these attributes support healthier environments for patients and staff in healthcare settings.

Utilizing wide-reach faucets is another strategy to improve accessibility, hygiene, and functionality in healthcare settings. The Facility Guidelines Institute (FGI) has updated its guidelines for healthcare facilities to include recommendations for wide-reach faucets. For wide reach, the spout reach of faucets should be at least 6 inches (15.24 centimeters) to accommodate the size of two adult hands and to avoid pooling of water at the sink backsplash. This design also allows users with limited mobility to access the water stream more easily without having to lean forward excessively. Wide-reach faucets available in both manual and touchless models, also enable increased functionality.

A Final Note

Though holistic design is a complex concept, striving to consider the whole patient and their physical, mental, social, and spiritual well-being, it creates a comprehensive model of caring. It also guides the creation of buildings and spaces, which can lead to better outcomes for patients and healthcare systems.

END NOTES

¹Totaforti, S. Applying the benefits of biophilic theory to hospital design. City Territ Archit 5, 1 (2018). https://doi.org/10.1186/s40410-018-0077-5. Accessed October 2, 2024.
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Amanda Voss, MPP, is an author, editor, and policy analyst. Writing for multiple publications, she has also served as the managing editor for Energy Design Update.