Can Hospitals Create Universal Comfort?

Posted on January 14, 2014

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Last fall, I listened to the Healthcare Design Conference (HCD.13) keynote speaker, Thomas Goetz talk about “hardware vs. software”. Among many salient points, he was the latest to build on the argument that healthcare’s focus on the infrastructure to deliver care has created a barrier to the emotional well-being of the patient, which is a real key to better healing.

Goetz made a comment about doctors liking their offices, but that an office is a frightening environment for those receiving care.  Having been sympathetic to similar ‘walk-in-their-shoes’ arguments about healthcare design, this one stuck with me.  I have been turning it over in my head for the past few months, pondering the next step.  I’ve been thinking, ‘if an office is no good, then what is?’

Intuitively, it seems we should simply take away the intimidation factor and make as many hospital interior environments ‘healing-centric’.  This makes sense.  So, when a doctor and patient need to talk privately in a non-threatening space, where do they go, other than the doctor’s office?  What is a more healing-centric alternative?

A consultation room?  These are designed to be completely neutral so they can be “flexible”.  They are spatially and architecturally vanilla:  a small table with four chairs, two loose ones or maybe a loveseat, and four white walls.  As a young architect, I once asked why they existed, and my project architect said “it’s the place where a lot of bad news is delivered.”  Perfect:  a room whose sole function is the modern equivalent of a gallows.  This is the last place I would want to talk to a doctor.  My heart would start racing immediately on the approach.

Let’s think creatively.  Most people consider their kitchen comfortable—how about we recreate the kitchen table feel?  Except let’s ditch the Viking range, 50 Shades of Gray palette, and solid surfacing—that’s way too modern and cold.  How about a beat-up Formica counter, some uneven wooden chairs, and picnic check window treatments?  We can run the dishwasher as a HIPAA sound mask.

Maybe the mall?  A lot of people find comfort walking around the mall, Muzak, surrounded by people but not too close for comfort.  Oh, better:  the library.  Everyone likes a library.  Let’s recreate a library in a hospital, except you can’t talk.  Or a restaurant—wait, we kind of have that at the cafeteria.  Or a garden?  But it can’t be too windy or raining.

Now some quick associations.  Police station:  comforting or intimidating?  HR Director:  comforting, intimidating?  White:  clean or sterile?  Brown:  homey or dirty?

My point:  just as beauty is in the eye of the beholder, comfort and emotionally-soothing space is in the heart of the patient.  And universal comfort—a space or environment that is comfortable and supports healing for every patient—is elusive, and quite possibly an ideal that cannot be had.  I think we need a Pebble Project for this and tap Planetree as well.

Every month or so I do a really deep clean on my kitchen and bathroom floors with Lysol, Original Scent.  I looks like cough syrup and I use it because Lysol is potent and kills all bacteria and viruses commonly found in a house.  I could eat off the floors.  Yes, my house smells like a Band-Aid for a few days, like a hospital.  I like it; my best friend can’t stand it.

Similarly, others may find a doctor’s office discomforting; I would argue a doctor’s office is one of the more human places in a hospital; it’s the closest relative to a space people work in or have in their house.  It’s the best of what’s available, which may be the issue for healing-centric spaces:  the bar is low right now and there is not enough choice.

Just as important, there is not much consensus on what appeals to everyone—other than quiet is good, and clinical spaces are definitely not comforting.  And there may not be.  Maybe we heal differently, which is not so strange an idea.

I remember an unfortunate hospital situation of my own where I received bad news.  The tech looked at her imaging equipment and answered my benign status inquiry with, “The doctor will be in to discuss.”  I knew something was up.  Those six uncertain minutes felt like a year, and who knows if a couch or hot chocolate or fresh air would have helped me stomach the news any better.

A place, or three, in a hospital where everyone feels at ease enough to handle the emotional side of healing might be hard to come by right now.  We know time heals; however, it’s the quality of that time that matters.  And design will need to deliver the spaces for that quality time.

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