Improve care? Save money? Can standards do both?

Hospital professionals are always looking to improve the care they deliver and do so more efficiently. Many think standards are the answer, especially in patient room design. But a question quickly arises: Which approach—same-handed or mirror-image design—is better for patient safety and staff efficiency?

Why the debate? Mirror-image rooms like the one below share plumbing chases and medical gas and electrical lines. That’s efficient from an architectural point of view.

On the other hand, same-handed rooms like the one below don’t share chases and lines. That adds about $3,000 to $5,000 to the cost of each patient room.

Even with this added cost, an increasing number of hospitals are choosing same-handed design. They’re doing because they believe that standardized same-handed design contributes to better process and workflow. Trouble is, there’s very little evidence to support this belief.

So the debate goes on. We think it’s a healthy debate because it focuses attention on the important role design plays in patient-room settings. It’s generating new research into the merits of same-handed versus mirror-image design, too.

This is all good, but in all the research and all the talk, let’s not lose sight of the people who deliver care. Too much standardizing in the name of efficiency—prescribing, for example, their approach (either left or right) to patients—may backfire if we don’t involve them in the discussion.

Photos 2 & 3 credit: HKS Architects

Mobilegs: Building a Better Crutch With Problem-Solving Design

Photo via Popular Science

Think about crutches. Most of us don’t until we experience the difficulty and discomfort of using them. Crutches can damage nerves, arteries, and tissue, and it’s easy to slip and cause more pain or more injury.

Here’s a better way. It’s called Mobilegs, from Mobi, a Minneapolis-based designer of mobility products. Mobi, born out of Studio Weber + Associates, seeks to transform our perception and function of mobility devices like crutches, making them more comfortable, better-designed, and more customizable.

Mobilegs is so innovative, it was named Best of What’s New for Health for 2010 by Popular Science magazine, which reads, “Mobilegs takes the design to the 21st century with modern materials and careful attention to ergonomic factors (which should come as no surprise given that their inventor helped design the Aeron chair).”

That inventor is Jeff Weber, of Studio + Weber, who also designed Herman Miller’s Embody chair, Caper chair, and Envelop desk. “I work to humanize the relationship between people, products, and the world around us,” Jeff says. He was inspired by a 2005 foot injury that made him all too aware of the crutch problem. “The traditional crutch was not designed to accommodate the mechanics of the human body. Mobilegs does just that.”

Helen DeVos Children’s Hospital: The Art of Healing Kids

As a company committed to improving healthcare environments through better design, Herman Miller is pleased to tell you about how one man’s idea turned into a wonderful addition to the new Helen DeVos Children’s Hospital in Grand Rapids, Michigan.

It’s all about art. Kids’ art.

The idea, which originated with Dr. Bob Connors, head of the hospital, was to fill the facility with art created for and by children. And when the doors opened in January, more than 600 original creations, by nearly 9,000 West Michigan-area children, decorated the 14-floor facility.

“It was truly a community effort,” said Scott LaFontsee of LaFontsee Galleries/Underground Studios, who helped coordinate the huge effort that involved schools and other organizations as well as local artists who volunteered to help.

“When kids come to this place, they know it’s a children’s place,” said Dr. Connors, who was extremely pleased with the outcome.

Photo credit: Emily Zoladz, The Grand Rapids Press

Herman Miller Healthcare Researcher Supports Evidence-Based Design Accreditation

Healthcare design is a growing part of our business, and our research in this area has helped us develop a portfolio of problem-solving products and enabled us to partner with healthcare organizations interested in building and designing efficient spaces for staff and patients.

Much of our research includes evidence-based design, which is why I decided to pursue Evidence-Based Design Accreditation and Certification (EDAC) from The Center for Health Design. Evidence-based design is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes. It’s still in its infancy and not without skeptics. Yet, it’s a rapidly growing field and it’s making important contributions to the design of healthcare environments.

The accreditation program provides participants with an understanding of how to incorporate findings such as the restorative effect of nature into healthcare building design decisions. For example, views of nature reduce a patient’s use of pain medication and reduce stress. We also know that private patient rooms reduce the spread of infection and improve communication between caregivers and patients and family.

Overall, I’m looking forward to putting this accreditation to work and becoming part of a community that focuses on the education and assessment of an evidence-based design process.

Healthcare’s Hierarchy of Needs

In 1943, Abraham Maslow introduced the world to what is prominently known as Maslow’s Hierarchy of Needs. These needs often are shown according to their level of importance within the shape of a pyramid, with the most fundamental levels of needs at the bottom.

Inspired by this idea, researchers from Herman Miller Healthcare developed the Caregiver Goal Prioritization Pyramid.

In fact, Doug Bazuin, a senior researcher with Herman Miller Healthcare and frequent contributor to Discover, recently had an article published by Hospitals & Health Networks about the Caregiver Goal Prioritization Pyramid. The article, called “The Pyramid of Caregiver Needs,” highlights the team’s research findings from nine hospital observations and 150 interviews.

Says Bazuin, “The pyramid reminds us to think through the multiple implications of any change or decision in a care giving process or environment. When we use the pyramid as an input into the design of a space or product, it can help to ensure we have considered all the variables and results in a better outcome for both the caregiver and the patient.”

The (Herman Miller) Doctor is In

In November, Herman Miller began offering basic medical services on site to its employees with a primary goal of reducing health care costs, but also to make it more convenient for people to get the appropriate care they may need.

“We know from our health insurance claims that a lot of people use urgent care or emergency room services for things that are not really emergencies simply because they don’t have a family doctor or anywhere to go for basic care,” says Mike Koppenol, Senior Manager, Employee Benefit Programs. “We thought if we offered some limited services at our three on-site clinics (previously used for work-related cases only) we could save money and also provide a better place to treat people for minor things such as sore throats, coughs, fevers, sprains, stitches, eye or ear injuries, that sort of thing.”

Using ER services for non-urgent care is not only very expensive—on average $450 versus $90 for a doctor’s office visit—it also ties up valuable resources that others may need.

Koppenol says the idea with the clinics, which are staffed by a physician, a physician’s assistant, and a nurse practitioner, isn’t to replace a primary care doctor, but to serve as more of a fill-in. “Employees need primary care physicians for annual physicals and for preventive care, and also so they have a medical ‘home’ to go to if something goes wrong. Our clinics can take care of the bumps and bruises that may come up in the meantime.”

Other large companies, from Toyota to Pepsi to Disney, are finding that on-site clinics are a great way to go; some studies show employers can save as much as 25 percent in employee health care fees in the first year alone, not to mention the savings in productivity when an employee doesn’t have to take 2-3 hours off for a doctor’s appointment.

Seven Questions for Gianfranco Zaccai, Industrial Designer

Gianfranco Zaccai brings to design a synergy of two cultures: the rational, practical, American approach he grew up in and the more emotional, traditional, Italian perspective that is his heritage.

While he may have relied on American practicality in his design of the Swiffer system for Proctor & Gamble, he clearly drew from broad experience and a depth of understanding in his work on Herman Miller’s Compass system.

He also is the co-founder of Continuum, an international design firm.

Here are seven questions (plus a half) for Gianfranco Zaccai:

1. What are you working on right now?

Well, I’m working on another project for Herman Miller. Like Compass, it’s in healthcare, which is a particularly compelling area to work in. When I first got out of design school, I began to focus on bringing a human touch to healthcare. That’s really vital.

There’s an overwhelming amount of technology in healthcare. Even doctors get overwhelmed by the evolution in certain disciplines. What gets lost is the human touch.

2. Which of your projects are you most proud of?

Years ago, I worked on another project for Herman Miller that never went to market, but it dealt with ways to allow people to stay at home as they aged or developed disabilities. We came up with a series of solutions for things like personal hygiene, for example. My own parents were aging at the time, so the development of the project came from observing them. When we were building prototypes, many people talked about how they needed something like it for their mothers—or for themselves. It never went into production, but those conversations indicated a need.

3. What inspires you? Where do you go for inspiration?

The way we approach any project is to get deeply into the context. So, with healthcare, we spend a lot of time in hospitals. We observe and talk to people—nurses, doctors, patients, cleaning staff. As a result, we are able to glean information that we’ve developed into a series of projects.

I also like to hike in the Italian Alps, especially the Dolomites. That’s a particularly wonderful place to be.

4. What work do you most admire by another artist or designer?

One guy I very much admire is Ettore Sottsass, founder of the Memphis collective. He was very pragmatic and was not afraid to step outside the bounds of what’s considered good design. His work was both rational and emotional at the same time.

I also admire Philippe Starck because he transforms everyday items into something you can experience in a different way. It’s very emotional design. I particularly like the flyswatter and the ghost chair.

And Renzo Piano, not only because he designs elegant buildings, but also because he incorporates elegant solutions, like bringing light into a gallery space, for example.

5. What would be your dream project?

To redesign the American healthcare system–the way healthcare is delivered, the way people collaborate, the way technology is integrated. We have a lot of Band-Aid solutions. Someone has to change the package.

And one-half: You’ve said that Compass is your favorite project. Why?

Compass deals with the sweet spot that I’m interested in—humanizing health care. If we’re successful, we will have created an environment in which providers can practice better healthcare and patients can feel that they’re well taken care of. Compass is a system that allows for efficient change, even if the hospital is 100 years old. It’s Utopian to think you can create the perfect environment for something when that something keeps changing.

6. What place in the world would you most like to visit?

Tibet, because of the mountains, but also because Asian art, architecture, and furniture is very appealing to me. I’ve been to other places in Asia, but not there.

7. What one thing do you want to accomplish before you die?

To make sure my children are headed in the right direction. Everyone has their own path to follow. I hope to do my part in preparing them to be good people and to achieve their dreams.

Photo via Syracuse University Magazine

Making Medications Safer by Design

When actor Dennis Quaid’s 12-day-old twins nearly died as a result of a medication mix-up a few years ago, it brought to light an on-going and serious problem for hospitals: dispensing the wrong medications to patients.

Herman Miller has been working closely with hospitals for many years to help health care professionals find ways to reduce what are known as “adverse drug events.” A new Herman Miller Solution Essay, “Making Medication Dispensing Safer for All,” discusses the common causes of drug errors — from interruptions to poorly designed med dispensing rooms — and offers advice on what hospitals can do to prevent or mitigate them.

One of the most interesting aspects of all this is the study of “human factors;” that is, human capabilities and/or limitations that may have an impact on any given situation, from the person’s age to his or her reaction to stress. The idea, of course, is to learn all we can about why people make mistakes in the first place, so we can design work environments that help prevent them from doing so. Or, as the U.S. Institute of Medicine once put it, “make it easy for people to do the right thing and hard for them to do the wrong thing.”

Check out the latest Solution Essay to learn more about how Herman Miller helped two hospitals improve their processes.

Kendall Students Share Healthcare Design Discoveries

This fall, Herman Miller’s Insight + Exploration team and Herman Miller Healthcare worked with senior interior design students at Kendall College of Art and Design. The students in Professor Lee Davis’ Studio V class completed the interior design of an adult healthcare clinic, which includes primary care and an infusion center. Herman Miller provided knowledge about the function of the space and a comprehensive product portfolio that allowed the students to focus on creating an innovative, healing environment for these two unique patient groups.

The students did their own research, learning from interactions with office managers, nurses, physicians, and close family members who experienced these types of spaces and treatments.

“Research is a huge part of healthcare design. Herman Miller’s healthcare knowledge was a great assistance in our learning,” said student Melissa M. Suchowolec.

When asked to identify a key learning, there was consensus that the complexities and rigorous requirements of healthcare design were eye opening. The thoughtfulness and attention to detail would make them better designers of any space, not just healthcare.

Experiencing the students excitement, seeing their innovative designs, and hearing how this project had influenced their design thinking made this is a great collaboration and a meaningful experience for me and the Herman Miller team.

Herman Miller Scholars Recall Highlights from Healthcare Design 2010

The recent Healthcare Design conference began on November 13, 2010, at the MGM Grand Hotel in Las Vegas, with much anticipation from the nine intern architects sponsored by Herman Miller. The scholars attended a variety of educational sessions and toured the large exhibit hall. So I decided to ask them what they remembered most.

Here’s what they had to say about it:

Josh Boltinhouse
Stevens & Wilkinson, Columbia, SC
One thing that I took away from the conference was the incredible anti-microbial properties of copper. Most anti-microbial products simply don’t allow bacteria to multiply on them, but copper actively kills bacteria.
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