Design That Cares E-Book

Janet R. Carpman

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: J-B AHA Press
• Sprache: Englisch

Seitenzahl: 881

Veröffentlichungsjahr: 2016

Beschreibung

Design That Cares: Planning Health Facilities for Patients and Visitors, 3rd Edition is the award-winning, essential textbook and guide for understanding and achieving customer-focused, evidence-based health care design excellence. This updated third edition includes new information about how all aspects of health facility design - site planning, architecture, interiors, product design, graphic design, and others - can meet the needs and reflect the preferences of customers: patients, family and visitors, as well as staff. The book takes readers on a journey through a typical health facility and discusses, in detail, at each stop along the way, how design can demonstrate care both for and about patients and visitors. Design that Cares provides the definitive roadmap to improving customer experience by design.

Leseprobe

CONTENTS

Cover

Title Page

Copyright

Dedication

Acknowledgments

Foreword

Authors' Introduction to the Third Edition

About the Authors

Chapter 1: Introduction

Projections and the Direction of Healthcare

Healthcare: Changing Within

Design as a Component of High-Quality Healthcare

Designing for Patients and Visitors

The Facility Design Process

Summary

Discussion Questions

References

Chapter 2: A Look at Current Healthcare-Facility Design Research

Design Research in Relation to Current Trends in Healthcare

Conducting High-Quality Healthcare-Facility Design Research

Research Claims

Integrating Design Research into the Design Process

Objectives for Future Healthcare-Facility Design Research

Summary

Discussion Questions

References

Chapter 3: Arrival and Exterior Wayfinding

Traveling to a Healthcare Facility

Exterior Wayfinding

Main Entrance Drop-Off Area

Parking

Transition between Parking and the Building Entrance Area

The Main Entrance Area

First Destinations

Summary

Discussion Questions

Design Review Questions

References

Chapter 4: Interior Wayfinding and the Circulation System

Finding One's Way through a Health Facility

Corridor Functions and Amenities

Traveling from Floor to Floor

Summary

Design Review Questions

References

Chapter 5: Reception and Waiting Areas

Entering a Reception and Waiting Area

Reception Areas

Waiting Areas

Summary

Design Review Questions

References

Chapter 6: Diagnostic and Treatment Areas

Accommodating Patients' Needs in Diagnostic and Treatment Areas

Summary

Design Review Questions

References

Chapter 7: Inpatient Rooms and Baths

Acute Care Inpatient Rooms

Inpatient Lounges

Accommodating Visitors

Intensive Care Units

Summary

Design Review Questions

References

Chapter 8: Access to Nature

The Importance of Nature in Healthcare Facilities

Valuing Access to Nature in Healthcare Facilities

Designing Outdoor Spaces for Healthcare Facilities

Bringing the Outdoors In

Summary

Discussion Questions

Design Review Questions

References

Chapter 9: Users with Disabilities

Statistics Regarding Users with Disabilities

Federal Legislation on Disability Rights

Universal Design

Design Considerations for Patients and Visitors with Mobility Disabilities

Design Considerations for Patients and Visitors with Hearing Disabilities

Design Considerations for Patients and Visitors Who Are Blind or Have Low-Vision

Design Considerations for Older Patients and Visitors

Design Considerations for Obese Patients

Summary

Design Review Questions

References

Chapter 10: Special Places and Services

Special Places

Special Services

Summary

Discussion Questions

Design Review Questions

References

Chapter 11: User Participation in Healthcare-Facility Design

What Is User Participation in Design?

Developing a User Participation Process

Techniques for Information-Gathering

Summary

Discussion Questions

References

Index

End User License Agreement

Guide

Cover

Table of Contents

Begin Reading

Chapter 1

Pages

iii

iv

xiii

xiv

xv

xvi

xvii

xviii

xix

xx

xxi

xxii

xxiii

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67

68

69

70

71

72

73

74

75

76

77

78

79

80

81

82

83

84

85

86

87

88

89

90

91

92

93

94

95

96

97

98

99

100

101

102

103

104

105

106

107

108

109

110

111

112

113

114

115

116

117

118

119

120

121

122

123

124

125

126

127

128

129

130

131

132

133

134

135

136

137

138

139

140

141

142

143

144

145

146

147

148

149

150

151

152

153

154

155

156

157

158

159

160

161

162

163

164

165

166

167

168

169

170

171

172

173

174

175

176

177

178

179

180

181

182

183

184

185

186

187

188

189

190

191

192

193

194

195

196

197

198

199

200

201

202

203

204

205

206

207

208

209

210

211

212

213

214

215

216

217

218

219

220

221

222

223

224

225

226

227

228

229

230

231

232

233

234

235

236

237

238

239

240

241

242

243

244

245

246

247

248

249

250

251

252

253

254

255

256

257

258

259

260

261

262

263

264

265

266

267

268

269

270

271

272

273

274

275

276

277

278

279

280

281

282

283

284

285

286

287

288

289

290

291

292

293

294

295

296

297

298

299

300

301

302

303

304

305

306

307

308

309

310

311

312

313

314

315

316

317

318

319

320

321

322

323

324

325

326

327

328

329

330

331

332

333

334

335

336

337

338

339

340

341

342

343

344

345

346

347

348

349

350

351

352

353

354

355

356

357

358

359

360

361

362

363

364

365

366

367

368

369

370

371

372

373

374

375

376

377

378

379

380

381

382

383

384

385

386

387

388

389

390

391

392

393

394

395

396

397

398

399

400

401

402

403

404

405

406

407

408

409

410

411

412

413

414

415

416

417

418

419

420

421

422

423

424

425

426

427

428

429

430

431

432

433

434

435

436

437

438

439

440

441

442

443

444

445

446

447

448

449

450

451

452

453

454

455

456

457

458

459

460

461

462

463

464

465

466

467

468

469

Design that Cares

Planning Health Facilities for Patients and Visitors

Third Edition

Janet R. Carpman

Myron A. Grant

with assistance from Elizabeth M. Kirchen

Copyright © 2016 by Jossey-Bass. All rights reserved.

Published by Jossey-Bass

A Wiley Brand

One Montgomery Street, Suite 1000, San Francisco, CA 94104–4594—www.josseybass.com

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax [phone], or on the Web at www.copyright.com. Requests to the publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, 201-748-6011, fax [phone], or online at www.wiley.com/go/permissions.

Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages. Readers should be aware that Internet Web sites offered as citations and/or sources for further information may have changed or disappeared between the time this was written and when it is read.

Jossey-Bass books and products are available through most bookstores. To contact Jossey-Bass directly call our Customer Care Department within the U.S. at 800-956-7739, outside the U.S. at 317-572-3986, or fax [phone].

Wiley publishes in a variety of print and electronic formats and by print-on-demand. Some material included with standard print versions of this book may not be included in e-books or in print-on-demand. If this book refers to media such as a CD or DVD that is not included in the version you purchased, you may download this material at http://booksupport.wiley.com. For more information about Wiley products, visit www.wiley.com.

Library of Congress Cataloging-in-Publication Data

Carpman, Janet Reizenstein, author.

Design that cares : planning health facilities for patients and visitors / Janet R. Carpman, Myron A. Grant, with assistance from Elizabeth M. Kirchen. – Third edition.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-7879-8811-1 (pbk.) — 9781118221631 (pdf) — ISBN 9781118235409 (epub)

I. Grant, Myron A., author. II. Kirchen, Elizabeth M., author. III. Title.

[DNLM: 1. Facility Design and Construction. 2. Health Facility Planning. 3. Human Engineering. WX 140]

RA967

725'.51–dc23

2015036499

Cover design by Wiley

Cover image: © 2016 Carpman Grant Associates, Wayfinding Consultants. Photo credit: Courtesy of Saint Joseph Mercy Ann Arbor.

Photos and illustrations by Myron A. Grant. Photo on page 313 by istockphoto.com.

To the experienced eye of a careful observing nurse, the daily . . . changes which take place in patients . . . afford a still more important class of data from which to judge of the general adaptation of a hospital for the reception and treatment of the sick. One insensibly allies together restlessness, languor, feverishness, and general malaise with the closeness of wards, defective ventilation, defective structure, bad architectural and administrative arrangements, until it is impossible to resist the conviction that the sick are suffering from something quite other than the disease inscribed on their bed-ticket. . . A vast deal of the suffering, and some at least of the mortality, in these establishments is avoidable.

—Florence Nightingale, 1863*

Note

*

Notes on Hospitals,

Third Edition, London: Longman, Green, Longman, Roberts, and Green, 1863, pp. 6–7. The original of this book is in the Cornell University Library (Medical Library in NYC). There are no known copyright restrictions in the United States on the use of the text.

www.archive.org/details/cu31924012356485

Dedication

For our children:

David Carpman, Rachel Carpman, and Adrienne Grant

Acknowledgments

We are grateful to everyone who contributed to and assisted with the third edition of Design That Cares: Planning Health Facilities for Patients and Visitors.

Craig McAllister and David Hughes energetically mined the literature on health facility design and behavior.

Kimberly B. Phalen, PhD, contributed important theoretical and practical information on the benefits of exposure to nature and guidelines for outdoor environments used by patients and visitors.

Peter J. Baker, Anne Bauman, Dick Bauman, Carolyn Burnstein, Bob Collins, Pam Gibb, Diana Raimi, Donald Theyken, and Mary Ellen Weakley helped with photo shoots.

Valerie Fletcher, Christopher Hart, and Ruth Super of the Institute for Human Centered Design, and Kathy Gips of the New England ADA Center, Boston, provided detailed knowledge of design requirements for people with functional limitations and important information about related US legislation and guidelines.

Many colleagues generously forwarded copies of their own research papers. The Center for Health Design went above and beyond to send a whole boxful of useful reports.

Our thanks to the Saint Joseph Mercy Health System, which graciously provided photographic access to two of its Michigan hospital campuses: St. Joseph Mercy Ann Arbor and St. Joseph Mercy Chelsea.

Elizabeth (Betsy) Kirchen skillfully and cheerfully wrestled with the text and references, endlessly delving into a raft of issues and questions to come up with just the right wording. Her passion for the subject matter and attention to detail added immensely to the book's breadth and depth. Betsy also drafted the summaries and pedagogical questions used in each chapter.

We thank draft reviewers David Allison, Kirk Hamilton, Wayne Ruga, PhD, and James Shraiky, who provided thoughtful and constructive comments on the complete draft manuscript.

Our editors at Jossey-Bass, the late Andy Pasternack and Seth Schwartz, ably assisted by Melinda Noack, offered unflagging and sustained support throughout a lengthy writing period.

Finally, we recognize the late Jeptha Dalston, PhD, (then) CEO of the University of Michigan Medical Center, who not only encouraged us to write the first edition of Design That Cares, starting in 1984, but also provided financial support and his own brand of Texas-sized good cheer as we went about it. We think he'd be proud that this book continues to influence new generations of health facility decision-makers and students to carefully and caringly consider the needs of patients and visitors in health facility planning and design.

Janet R. Carpman, PhD

Myron A. Grant, MLA

March 2016

Foreword

In healthcare facilities, where decisions and actions can mean the difference between life and death, where stress levels are high and decision-making time is short, where people experience some of their happiest and saddest moments, and where most individuals feel as if they have lost control over what's happening to and around them, it is critically important to create environments that support patients, families, and staff, and contribute to the quality of care.

With the publication of the first edition of Design That Cares some 30 years ago, Jan Carpman, PhD, and Myron Grant, MLA, set out not only to elevate the role of the physical environment and its impact on outcomes for vulnerable patient populations, but also to provide an expansive and accessible tutorial for designers, nondesign professionals, and students who are—or will be—involved in making design decisions. This long-awaited third edition is cause for celebration. It offers a compendium of new research findings, references, design guidelines, and design review questions, as well as overviews and learning objectives. By inference, it shows how our field has grown and continues to grow.

Design That Cares grew out of Carpman and Grant's groundbreaking work at the University of Michigan Medical Center in the 1980s. Their Patient & Visitor Participation Project used empirical research to understand the design-related needs of patients and visitors, with the goal of providing timely, design-relevant findings and recommendations that would help make a multimillion-dollar replacement hospital an exemplar of human-centered design. Carpman and Grant were among the pioneers in what we now know as a worldwide movement for evidence-based health facility design that maximizes patient outcomes and positive customer experience. When my organization, the Center for Health Design, held its first national symposium in 1988, Carpman and Grant were presenters.

Building and renovating health facilities are enormous, complex undertakings. It takes a strong, interdisciplinary team to discuss, imagine, study, debate, and come to consensus on myriad issues over an extended period of time. As members of a hospital planning and design team for six years, Carpman and Grant witnessed scores of medical and health professionals doing their best to understand design issues and options during such a project, but often feeling frustrated and having little influence. With no background in reading architectural plans or in understanding aspects of design—such as scale—nurses, physicians, healthcare administrators, and others often go along with or approve design schemes because of social pressure and time limitations without fully comprehending the behavioral implications. The authors framed Design That Cares to include evidence-based findings and guidelines, and especially design review questions, in order to make explicit what decision-makers should ask about proposed design schemes or features, and what design-behavior relationships they should advocate.

At the Center for Health Design, we are strong advocates of design solutions that use an evidence-based design process. A large and growing body of research attests to the fact that physical environments affect patient stress, patient and staff safety, staff effectiveness, and quality of care provided in healthcare settings. Basing planning and design decisions on this research to achieve the best possible outcomes is what evidence-based design is all about. Design That Cares contributes to the state of the art by addressing complex issues, including wayfinding, physical comfort, control over social contact, universal design, access to nature, sound and music, and many others. This book is an indispensable resource for making informed design decisions that will affect patients, visitors, and staff over the lifespan of a health facility—often fifty years or more.

I am proud to join the writers of forewords to the first and second editions of Design That Cares: Jepha W. Dalston, PhD, former CEO, University of Michigan Medical Center, Ann Arbor and Hermann Hospital, Houston, representing the fields of hospital administration and medical care; and Margaret Gaskie, former senior editor, Architectural Record, representing the field of architectural design. My own career in healthcare design is at the nexus of these fields: combining my love of interior design and architecture and my compulsion to help make the (healthcare) world a better place. As they did, I salute Jan Carpman and Myron Grant and Design That Cares, third edition, for offering a new generation of present and future health facility design decision-makers jargon-free, compelling, evidence-based guidelines for creating caring environments for patients and families.

Debra Levin, EDAC

President and CEO

The Center for Health Design

Authors' Introduction to the Third Edition

The first edition of Design That Cares grew out of a quest for information about the design-related needs of patients and visitors. In 1980, when we were hired by the University of Michigan Medical Center to act as what would now be called “customer-experience advocates” during the long, complex, expensive process of designing a huge replacement hospital, there was almost no useful information available about health facility design and its effects on patients. The design needs of family members and visitors were barely on anyone's radar. In the absence of this information and with a commitment to evidence-based decision making, we began conducting our own research. With the existing hospital and its patients as our laboratory, and the fast-moving train of design decision making as our engine, we conducted nearly three dozen distinct studies focusing on patients' and visitors' needs and preferences for health facility design features. Six years later, when the new hospital was complete and we had done our best to use our data to influence scores of design decisions, it was time to publish the information. In the meantime, we had been on the ground floor of a new field. There was finally a nascent body of health facility design literature based on empirical research.

This book was always intended to be different from the vast majority of architecture books and journals. Design That Cares is not a compendium of completed projects. Though such publications are useful in order to show designers and design students what has been accomplished across the United States and around the world, they tend not to emphasize the reasons why design decisions were made or how each feature was intended to function. By their visual nature, they emphasize aesthetics over function. Good design, of course, reflects aesthetics, function, and a host of additional considerations and requirements, such as corporate culture, marketing, capital costs, codes and regulations, environmental impacts, operating costs, long-term maintenance, and other requirements.

We wanted Design That Cares to consider design from another vantage point: emphasizing function (designing for the needs of patients and visitors) and encouraging creativity on the part of planners and designers. There are endless possibilities for how designs can look while at the same time satisfying functional criteria.

We are delighted that our hunch about the usefulness of this approach has proved to be on target for more than 30 years. As we began writing the third edition, we were gratified to see that the situation we faced in 1980, of having virtually no useful evidence-based information, is long past. There is now an active, productive, prolific community of researchers, designers, and others exploring numerous issues pertaining to patients, visitors, and health facility design. Research has expanded from an exploration of preferences to measures of a variety of physiological effects. The once-radical notion—that health facilities affect patients and visitors and should be designed with their needs in mind—is now an accepted paradigm.

However, paradigms are not enough. We offer this edition of Design That Cares to current and future design decision-makers with the hope that its nuanced, evidence-based guidelines will inspire the creation and long-term functioning of health facilities that care for and about their most vulnerable users.

An instructor's supplement is available at www.wiley.com/go/Carpman3e. Comments about this book are invited and can be sent to [email protected].

Janet R. Carpman, PhD

Myron A. Grant, MLA

March 2016

About the Authors

Janet R. Carpman, PhD, and Myron A. Grant, MLA, are consultants, designers, and design researchers who believe that environments should respond to the needs and preferences of the people who use them. In the early 1980s, they created and directed the Patient & Visitor Participation Project at the University of Michigan Medical Center, a groundbreaking, six-year-long design research and advocacy effort for a $285 million tertiary care hospital. They went on to establish Carpman Grant Associates, Wayfinding Consultants in 1986, which helps clients create places that are easy to navigate and, as a result, optimize customer experience (www.wayfinding.com). Carpman and Grant have involved thousands of users in hundreds of projects for medical centers, museums, colleges and universities, and other public facilities. In addition to writing three editions of Design That Cares: Planning Health Facilities for Patients and Visitors, they are also authors of the award-winning book Directional Sense: How to Find Your Way Around, a guide for directionally challenged people. (www.directionalsense.com).

Janet R. Carpman holds degrees from the University of Michigan (PhD, Sociology and Architecture), Harvard University (Master of City Planning) and the University of Rochester (BA, Sociology).

Myron A. Grant holds two degrees from the University of Michigan (Master of Landscape Architecture and Bachelor of Fine Arts).

Chapter 1Introduction

Learning Objectives

Understand how ongoing demographic and lifestyle changes in the United States affect demand for and expectations about healthcare.

Become familiar with some ways in which economic forces and developments in medical practice are transforming the healthcare field and giving rise to an era of healthcare competition.

Realize how the delivery of high-quality healthcare, in terms of both medical outcomes and human experience, requires attention to supportive health-facility design.

Grasp the nature and purpose of each phase of the design process, from predesign programming to design, construction, concurrent planning, design review, activation, and post-occupancy evaluation (also known as “Facility Performance Evaluation”).

In the coming decades, healthcare will continue to be an issue of major concern in the United States as it is worldwide. The uncertainties are many. The capacity of the medical professions to treat illness and injury is continually growing, as are the costs associated with such treatment. New legal mandates and constraints upon healthcare delivery are regularly brought into play. The character of society—demographics, experiences, and expectations—is, as always, in transition. Our very understanding of health itself, its sources and conditions, is expanding and evolving.

The healthcare systems of tomorrow will look different from those of the past. Those of us involved in planning and designing healthcare facilities have many issues and questions to consider. No matter how diligent and well informed we are, we cannot know with certainty the nature and rate of future change. Yet some of today's decisions must be based on projections about medicine and society in the year 2030 or 2050. The better we understand the issues involved, the better prepared we will be to meet tomorrow's healthcare demands and contribute to the development of effective, efficient, caring healthcare delivery systems, in the United States and abroad.

Projections and the Direction of Healthcare

Health is an indicator of overall quality of life. The growing popularity of exercise, proper nutrition, and stress-reducing activities shows that many people have a strong interest in health. Individuals in first-world countries, including the United States, are becoming more knowledgeable about their own health and are taking more responsibility for it (Panther, 1984; Spreckelmeyer, 1984).