Sub-Types of Waiting Rooms

Healthcare Partners Clinic Waiting Room, St. Paul, Minnesota

When we speak of “waiting rooms” and lounges, we typically think about waiting rooms in doctors’ offices or in reception areas of clinics or hospitals.

In reality, there are a variety of sub-types of spaces where people wait in a variety of healthcare settings and for different reasons.  Those specialized waiting spaces must address different needs beyond those of a main waiting room, which has been the focus of this blog thus far.

For instance, doctors and other staff wait in staff waiting lounges.  They need access to comfortable chairs, access to nature, computers, restrooms, and refreshments — reducing stressors in the environment and social support spaces — and perhaps there is less focus on positive distractions and control of the seating arrangements than in main patient waiting areas.

Gottlieb Memorial Hospital Physicians Lounge

Patients also wait in areas adjacent to treatment rooms prior to undergoing medical procedures and after medical procedures during recovery.  These spaces require more emphasis on, positive distractions and reduced environmental stressors and less on social support spaces.

During lengthy medical procedures, family and friends wait in nearby lounges, which need to address all of the needs of a main waiting area, with an even greater emphasis on:  privacy, particularly comfortable furnishings, refreshments and restrooms.

Rainbow Babies Hospital Ronald McDonald Family Room, Cleveland, OH

Just prior to getting a diagnostic procedure, patients sometimes have short-term waits in special lounges where they may need to change into and wear special gowns.  Since these are short-term waiting spaces, the focus can be placed more on positive distractions, reduced environmental stressors and access to nature through imagery and less on social support space and control over the patient waiting environment.

Christine Guzzo Vickery neatly itemizes these categories of waiting rooms in her blogpost, “Clinic Design:  The Waiting Rooms”.  These sub-categorizations challenge designers to think beyond the generic and to customize the designs of these sub-waiting spaces to address the particular different needs of each environment.

Thinking about patients, family, friends and staff, and how they proceed through a medical facility, each space where they must enter, pause for a spell, and then move on from should look and feel different, emphasizing those elements most needed at each “stop” and de-emphasizing those that are less relevant from a healing design perspective.  From a design standpoint, the escalation and de-escalation of various aspects of the design elements, depending on the type of waiting room, offer all sorts of opportunities for creative and interesting aesthetic detours.

Nourish Newborns

Nourish Newborns.   As promised, here is a closer look at the winners of the 2011 Nurture Collegiate Healthcare Design Competition.  The winning project, “Nourish Newborns: A Place for the Comprehensive Care of Neonates and the Family Alike”, was submitted by a team of students from the University of Kansas.  The project is exciting, because it focuses on addressing the challenges of designing waiting spaces for families that implements Ulrich’s Five Tenets of Healing Design, which are detailed in my February 26, 2011 blogpost.  Congratulations to this team!  Take a look at this thoughtful presentation, especially the Conceptual Waiting Floor Plan and renderings of terraces, alcoves and reading nooks.

The Center for Health Design Receives Grant from ASID Foundation to Develop Patient Room Checklist | The Center for Health Design

The Center for Health Design Receives Grant from ASID Foundation to Develop Patient Room Checklist | The Center for Health Design.

Michael Graves furniture for Capital Health

Welcome to the new year!

Furniture selection and furniture arrangement in waiting areas will become a new focus in upcoming posts.  And making waiting areas FUN will be another important topic (an idea that came from a subscriber to this blog).  Evidence-based design will continue to provide some underlying structure when thinking about these topics — What does the evidence say about the effectiveness and comfort of different kinds of furniture and furniture arrangements?  What is the purpose of furnishings in waiting spaces?  What makes waiting areas actually feel fun for those using those areas?

In 2012 I also look forward to moving beyond the waiting area lounges and to exploring other spaces in health care settings, including patient rooms in acute care and other  types of facilities.  Michael Graves has designed some pieces for use in hospital patient rooms that do not look like they necessarily belong in hospitals, which is a good thing.  He designed this patient room suite for Stryker.  I thank Denise DeCoster Architect for leading me to this brief video, which merely whets the appetite for more.  May 2012 bring us more enlightenment about aesthetics, about our connection to the natural world, about caring for others, and about how design affects all of our lives.

 

Healthcare Seating – Lounge Spaces

Healthcare lounge seating in waiting areas can be contemporary, as seen in this post in the “Healthcare Trends” newsletter of “Designer Pages”.

University of Kansas Students Win Honorable Mention for Design of How to Reduce Perceived Waiting Time – Nuture’s Inaugural 2011 Collegiate Healthcare Design Competition

Now that fall is here, and schools are back in session, it’s apropos that Nurture by Steelcase just announced the winners of its inaugural collegiate healthcare design competition.  Daniel Gonzales, Graham Sinclair, Niyanta Gopal, Rhett Morgan and Sharmin Kader of the University of Kansas students won honorable mention for tackling the issue of how to re-design the waiting experience to reduce patients’ perceived waiting time.  This inaugural competition sponsored by Nurture by Steelcase asked graduate students to reconceptualize “waiting” in various healthcare environments.

The winning students, who were also from the University of Kansas (Lauren Gloriod, Sara Mae Martens, Rhaynelina Estevez, Lindsay Slavin and Alex Jones), focused on neonatal intensive care units (NICUs).  From their research, they found that families contributed positively to infants’ medical outcomes.  So, they decided to figure out how to design spaces to accommodate families in NICUs more effectively.  I was thrilled to see that their solution implements at least one of Professor Ulrich’s Five Tenets of Healing Design (as discussed in my February 2011 post), including designing for positive distractions.  It divides the waiting space into three areas. One space functions as a space for privacy and quiet, while another provides information for families.  A third space offers families a variety of positive distractions.  It is exciting to see that students are thinking about these concepts.  They will be the future designers of healthcare environments that we will all be using.

Healthcare Design Magazine and Nuture by Steelcase Blog will present these University of Kansas students’ entries in their November 2011 and January 2012 publications.  This blog will also share their entries in the coming months.  Congratulations to the winners and to those receiving honorable mention!

Does Color Really Matter?

Colors have so many social and cultural meanings that most of us are probably unaware that those meanings subconsciously bias us as designers when we talk about color in health care environments.  Designers talk about “cool”, receding colors such as blues that are “ideal” in health care settings, because they are “calming”.  Or, they’ll say that reds are “active” colors that are best left to pediatric play areas, for instance.  Yellows and oranges are “warm” and “cheering”.  These hues begin to sound as though they actually have inherent personalities!

Is there any science behind these statements?  Does any evidence underlie some of the commonly read ideas about color in design, especially as it relates to ideas about whether or not color has an impact on human behaviors, medical outcomes or healing in health care settings?  Perhaps this received wisdom has been repeated so often that designers take it as a given without really questioning its validity or examining the cultural and social lenses through which we view these ideas about color and about its presumed psychological and behavioral effects.

In 2004 the Coalition for Health Environments Research sponsored and funded a survey of all literature that addressed color in health care environments, reviewing over 3000 citations on the subject.  The goal was to separate common myths from truths and develop theories that could be helpful to designers, architects, health care practitioners, caregivers and patients.  The study’s primary results, quoted below, were, to say the least, humbling.

“The results of the critical review of the pertinent literature produced no reliable explanatory theories that may help to predict how color influences people in healthcare settings.

Regrettably, much of the knowledge about the use of color in healthcare environments comes from guidelines that are based on highly biased observations and pseudo-scientific assertions. It is this unsubstantiated literature that serves color consultants to capriciously set trends for the healthcare market.” (Abstract, Color in Health Care Environments, Coalition for Health Environments Research (CHER), Ruth Brent Tofle, Ph.D., Benyamin Schwarz, Ph.D, So-Yeon Yoon, MA, Andrea Max-Royale, M.E.Des, July 2004)

The study’s six conclusions were that:

1. There is no cause and effect between certain colors and medical outcomes.
2. Results do not substantiate the view that specifying certain colors for health care environments has a bearing on the emotional or mental state or behavior of individuals. “Spaces do not become ‘active’, ‘relaxing’, or ‘contemplative’ only because of their specific color.”
3. Although moods are associated with certain colors, this is not because the colors themselves inherently produce these moods.  Instead, the moods evoked by certain colors are a function both of how different cultures teach color-mood associations and of the psychology and physiology of people.
4. Devising universal guidelines to the use of color in health care environments is misguided, because of the diversity of groups and sub-cultures using these environments and the complexity of difference in “meanings and communication”.  In other words, a designer could specify a color based on some arbitrary universal guideline that could completely mystify the user for whom it was intended, or worse, that the user completely misinterprets with unpredictable — negative — results.
5. Understanding color in health care environments inevitably is challenging due to the multiplicity of meanings, settings and situations.  A human being’s aesthetic cognition of objective color is filtered through their culture and modified by their physical condition and the situation in which they find themselves.   So, other environmental factors, such as odors, clutter, lighting, noise, can influence their cognition of color.  If they’re not aware of where they are, anxious, under the influence of medication or experience a psychological disorder, their emotional and mental state will also influence how they experience — or don’t experience color.

Perhaps these results are not surprising.  To a designer, however, they are somewhat disheartening, because designers use color so much in their work, and color does enhance all sorts of environments.  What this study is saying, however, is that while the enhancement of a physical interior environment by the artful use of color in wall paint, fabrics, art work, floor coverings and other materials is a positive endeavor in designing health care environments, it is ill-advised to set universal guidelines, which are not based on real evidence.

Pallas cubicle curtain fabric, Provence in Butternut

A color in and of itself does not change someone’s mood.  To the extent that it does influence a person’s mood, it is more because of who the person is, their own psychology and culture and perhaps, because of other aspects of the environment that are wholly unrelated to color.  A 2010 University of Minnesota study by Kwon Jhain, Ph.D. entitled “Cultural meaning of color in healthcare environments: A symbolic interaction approach” addresses just this matter:  how health care color concepts depend on the person’s cultural background and personal experiences.  It is challenging to tease out the color-mood cause and effect when there are so many other conditions of the designed environment that can influence mood and behavior.

Fortunately, the study does not suggest that we give up and not move forward in studying color in health care environments, including waiting rooms.  “Clearly, the research of color in healthcare environments is an important endeavor. Yet, the subject matter is complex and multifaceted. Furthermore, mastering this knowledge for the application of research findings in healthcare settings requires caution and sensitive creativity is paramount.”

This is what evidence-based design does best.  It breaks through myths to get at the truths that we sometimes don’t want to acknowledge.  I’m not against bringing color to waiting rooms and other health care settings.  But, it’s heartening to know that there are no “rules” and thus no rules to break.  This is freeing to a designer and to anyone thinking about using color, which is a marvelous tool, in all sorts of waiting areas.

So while the study sponsored by CHER may be definitive, there is no harm in taking in and having fun with the color ideas promoted in Formica’s HEALTHCARE “Trend Report” from 12/09 — always with a grain of salt, of course, and always understanding that commercial trends are simply that.  No more, no less.