Design Strategies for Optimal Well-Being in Health Care Environments

Improving the patient, visitor, and caregiver experience through innovative and flexible design solutions
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Sponsored by AD Systems, Metl-Span, and The Sherwin-Williams Company
By Robyn M. Feller
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How Sliding Door Systems Affect Acoustics, Privacy, Space, and Accessibility

Sliding exam doors provide a host of benefits for health-care settings. Some high-quality sliding door products are purpose built for outpatient health-care projects, providing a range of locking and latching, acoustic, and other functional solutions to suit the needs of medical office building (MOB)/outpatient/free-standing ER and patient restroom settings.

Successful door systems should be highly configurable and can be standalone doors or interior storefronts with sliding doors. Manufacturers should offer design support to ensure the sliding doors meet individual project requirements. Let’s look at some of the benefits and features of these door systems.

Sliding doors vs. swing doors: The use of sliding doors can dramatically improve the efficient use of space in outpatient health-care settings or inpatient restrooms. A swing door requires that a significant amount of space be dedicated to the swing of the door and the approach clearances. Particularly in areas where large door openings are desired (typical of bathrooms or other areas in medical construction), the door swing is very obtrusive. When sliding doors are used, the layout of individual rooms is dramatically improved or a clinic can accommodate more exam rooms and usable space without wasting valuable space on door swings.

Photo of sliding doors in a hospital hallway.

Photo courtesy of Dekker Perich Sabatini Architects

Sliding door systems can be used to improve the efficient use of space in many types of health-care settings.

Space and design considerations: Sliding doors can also be an excellent solution for achieving a unique design concept in patient room corridors. For instance, for the 18-clinic rollout of the MultiCare Indigo Urgent Care Clinics in the Seattle-Tacoma, Washington, area, the architectural design firm on the project, BCRA Design, at the suggestion of the GC, Anderson Construction, chose a sliding door system in order to meet its goal of avoiding uninspired corridor walls and instead create a dynamic focal point that was visible from the lobby and other areas of the clinic. Furthermore, the sliding door system achieves the fundamental principles of universal design, a feature BCRA considered when deciding on its door approach. Laura Jacobson, an architect with BCRA, explains, “In order to achieve this impactful look and still be compliant for a health-care setting, we needed a system with an integral relite that was still able to put the door plane flush with the wall to link branded signage elements from the door to the wall.” Additionally, the door system had the advantage of heavy-duty construction and STC-rated assemblies.

Photo of sliding doors at the Indigo James Center.

© Aaron Locke/BCRA

At the Indigo James Center, part of the MultiCare Indigo Urgent Care Clinics in Tacoma, Washington, a sliding door system helps to create an impactful design effect, while maintaining compliance for a health-care setting.

Maintaining acoustical and visual privacy: Acoustical privacy issues are often a concern with sliding doors in general, but some newer doors have been designed to achieve high levels of acoustical separation that are required in health-care spaces. Other standard features include a frame system that wraps the wall construction to prevent damage from high traffic in and out of spaces and closes gaps that present issues for visual and acoustical privacy, soft closers that prevent slams and wear and tear on the doors, and a top-hung assembly with a concealed bottom guide so that no exposed floor track is required, making it an especially optimal choice from an accessibility and cleaning standpoint.

Balancing acoustics and accessibility: According to Tysen Gannon, sales and marketing manager at AD Systems, a manufacturer of sliding door solutions, finding the proper balance of acoustics and accessibility can be a challenge. Gannon states, “The goal is to comply with FGI (FGI refers to the Facility Guidelines Institute, publisher of the Guidelines for Design and Construction of Hospitals and Outpatient Facilities) and ADA guidelines so that patients can expect speech privacy from a door with good perimeter seals and ideally a dropdown bottom seal but not have the door sealed so tightly that it won’t allow for ease of operation. It takes good design, engineering, and a lot of experience working on medical projects to make products that are up to the tough standards of those environments and the high expectations of medical facility managers.”

Installing an acoustical sliding door opens up the opportunity for health-care facilities and medical office spaces to realize a range of benefits. Developed to prevent a high level of sound from filtering through, acoustical sliding doors help these facility owners protect their work settings and provide patients and employees with a positive environment. The following advantages offered by acoustic doors make them an increasingly popular choice for numerous architects and their clients.

  • Provides confidentiality: Patient confidentiality is a serious matter that is expected to be upheld in all doctor offices, medical clinics, and hospital institutions. Along with the Health Insurance Portability and Accountability Act (HIPAA) making it the responsibility of health-care providers to comply with strict regulations regarding privacy came a change in the way many establishments were designed and constructed. There have been many changes to facility design centered around addressing HIPAA concerns as well as more efficient delivery of care—and the use of sliding doors is of course affected by both. Along with designing full-height walls and being mindful of the routing of HVAC ducts, doors are a critical element of ensuring privacy of exam rooms, as they are responsible for sealing the hole in the wall that allows access. Sliding doors have traditionally been lower performing acoustically than swing doors because the tracks set them either within the wall cavity or part of the walls with spaces all around, but new sliding door designs feature much more solid construction than the typical “pocket door,” and acoustic gaskets and drop seal features bring their performance in line with the gasketed swing doors that would be used in the same occupancies.
  • Helps maintain focus: Most medical offices are busy places, with constant action going on amongst coworkers and patients. In today’s on-stage/off-stage patient clinics, doctors and nurses are often working in open-plan environments in the “back-of-house” area. Frequently, the acoustical performance is only considered from the corridor side, but it is equally important for the provider side. This assures not only that patient confidentiality is maintained when doctors need to carry on conversations in the back of house, but also that workers in the open-plan environment are not distracted by what is happening in the surrounding exam rooms or adjacent areas. It can be easy to lose focus and difficult to concentrate on the tasks at hand when employees are consistently getting distracted and interrupted by everything that is happening around them so it is critically important that heath-care workers have workspaces conducive to concentration and productivity in order to deliver the best possible care to many patients.
  • Offers a comfortable environment: Having the ability to get some peace and quiet when necessary does wonders for a patient’s recovery time and the happiness of employees. Nonstop noise is a general characteristic of medical establishments. This makes it hard for patients to get the rest and relaxation they need to get better in a timely manner. For staff, it cultivates a more stressful and overwhelming environment. To maximize comfort and eliminate disturbing sounds, an acoustical sliding door can be the answer.

Installing an acoustical sliding door will give health-care facilities all these noise-canceling benefits, while allowing them to maintain a high level of aesthetic appeal and save a significant amount of space as well. However, not all acoustic door systems are created equal so it’s essential to select products from a reliable supplier to ensure optimal performance. Look for a product comprised of high-quality materials, advanced engineering features, with numerous options for finishes and hardware, and that complies with ADA requirements. (See the sidebar on ADA Compliance in the online portion of this course.)

 

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Originally published in Architectural Record
Originally published in December 2016

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Design Strategies for Optimal Well-Being in Health Care Environments
Buyer's Guide
AD Systems Sliding Door
AD Systems offers complete sliding door and office-front assemblies ideally suited to health-care and corporate environments. This unique product provides excellent acoustical mitigation, reliability, and a wide range of customizable design options and hardware features thanks to its innovative frame design and tested performance. For more information, please visit www.specADsystems.com.
FRP CleanSeam
The FRP CleanSeam insulated metal panel is designed to create a virtually seamless joint between the wall and ceiling to prevent mold and mildew growth. The two-part welded seal system creates a permanent bond. FRP CleanSeam is the ideal solution to clean rooms, pharmaceutical, and health-care facilities.
Metl-Span
metlspan.com
Paint Shield®
Paint Shield® is the first EPA-registered microbicidal paint and represents a game-changing advancement in coatings technology. Paint Shield kills greater than 99.9 percent of Staph (Staphylococcus aureus), MRSA (Methicillin-resistant Staphylococcus aureus), E. coli (Escherichia coli), VRE (Vancomycin-resistant Enterococcus faecalis), and Enterobacter aerogenes within two hours of exposure on a painted surface.
The Sherwin-Williams Company
www.swpaintshield.com