By Barbara Tone, RN
Photo courtesy of Scott McDonald © Hedrich Blessing
June 10, 1999

The hospital room of 2001 will resemble that of 1901 about as much as e-mail resembles the early telegraph. From instrumentation reminiscent of a "Star Trek" set to "healing art," new technology is combining with old-fashioned common sense to create an environment conducive to a speedy and soothing recovery. And patient and family comfort have become the central concern for the hospital design of the future.

Market forces are one inspiration for the changes in hospital design. Increasing emphasis on outpatient care means hospitals need to compete more and more to attract inpatients. So planners build all-private-room facilities to attract the shrinking population of hospitalized patients.

Studies and surveys also contribute to trends in hospital design. A study at New York University Hospital found that patients recover more rapidly when family members stay with them. A survey done by The Center for Health Design of Walnut Creek, Calif., and The Picker Institute in Boston showed that the environment makes a difference to patients when choosing a hospital.

Peaceful places

Planners looked carefully at all these factors when designing Northwestern Memorial Hospital in Chicago, a 492-bed facility that opened May 1. The hospital has only private rooms and was built to provide a peaceful and comforting environment for the patient. "All of our rooms have huge windows, bringing in a lot of natural light," said Terra Suriano, MSN, RN, manager of infection control.

Northwestern Memorial also houses 1,800 pieces of "healing art," each selected for its soothing impact. "I see so many of the paintings during my rounds," said Suriano. "They are so catching that it almost grabs you into the picture, and it feels like you’re there." A piece of "healing art" hangs on the wall facing each patient.

Rainbow Babies and Children’s Hospital, part of the University Hospital Health System of Cleveland, sought input from patients and parents when planning the hospital, which opened in 1997. As a result, most medical equipment is housed behind sliding doors; each bed has a built-in video game, each bedside a VCR, and each room a refrigerator; and meals are served in decorated waxed bags rather than on the traditional tray.

Family ties

Each room at Rainbow Babies has a bed for the family, with its own curtain and night-light for reading. "If you look at the rooms, and the unit, they are truly focused on the patient and patient’s family," said Clarke. "We recognize the family as the constant in the child’s life, and our services revolve around the importance of that relationship."

Rainbow Babies has a family lounge on each floor so parents can take a break from the pressures of dealing with an ill child. The lounge has a washing machine, a TV, a refrigerator, a microwave, and soda and snack machines.

Families are important to adult patients too, and at Northwestern Memorial all patient rooms have a window seat that converts to a cot for family members, extra closet space, and wood shelving for flowers and cards. Patients’ bathrooms have drawers and counter space. Each room is equipped with a separate sink for hospital staff.

Quieting the call

Not all design innovations can be seen; some focus on reducing noise. New call systems, such as the one at Northwestern Memorial, have virtually eliminated overhead paging for nurses. When a patient calls for assistance, the message is relayed via a pager, spelling out the patient’s request. "It’s wonderful," said Suriano, "because when the nurse responds to the patient, she arrives with whatever they requested in hand, saving steps in the process."

The communication system at Rainbow Babies is straight out of a sci-fi movie. Each nurse wears a transmitter that is programmed at the beginning of the shift. When patients call, the transmitter locates their nurse and rings the nearest communications station. "It’s so much quieter without all that overhead paging," said Leslie Clarke, MS, MBA, RN, vice president of nursing and patient care services.

Future planning

"I feel like I’ve come full circle," said Joseph Balbona, CEO of RBB Architects Inc. in Los Angeles, consulting architects for the $600-million replacement hospital for UCLA Medical Center. Balbona worked on a hospital design project 25 years ago on a Pacific island that focused on accommodating the needs of family members who arrived in canoes to cook for and care for patients. He remembers thinking the approach was out of date at the time, but now he sees a return to similar concerns. "Here we are now, again making provisions for family to stay with the patients," Balbona said.

The hospitals of the near future are likely to improve on innovations of the recent past. The new UCLA facility, scheduled to open in 2004, will have day beds for families, a call bell system tied to the nurses’ cell phones, and perhaps the capability to display patient X-rays on their in-room TV screens. "The technology advances so rapidly that we are delaying purchase decisions as long as possible so we can open with all the latest equipment, " said Ellen Pollock, MSN, RN, assistant director of nursing at the existing facility.

The ICU beds in UCLA’s new hospital will be accessible from all four sides. The bed will sit in the middle of the room with a power column that hangs from the ceiling and will swing 360 degrees, allowing the patient to be turned toward the window.

The search continues for ways to decrease the stress of hospitalization. On June 15, Rainbow Babies and Children’s Hospital will unveil a hotel-like orientation video along with a bedside manual in each room, detailing hospital services and nearby places to eat. And in keeping with the "hotel" theme, UCLA will provide patients and families a hotel-style treat: room service on demand.