CREJ - Healthcare Properties - July 2020
The following is a question-and-answer session with Kelli Falardo and Val Williams of Page’s Denver office about what underpins pediatric behavioral health design. Mental health, behavioral health and brain health are essential to overall health. Children with mental or behavioral health problems require special care and sensitivity, as do their families. The environment in which this care is delivered plays an important role in supporting the child and his family through diagnosis and treatment. It also can positively influence users’ attitude and beliefs about mental and behavioral problems and their prognosis, priming patients for success and helping their families provide essential support. The demands from users and stakeholders on pediatric behavioral and mental health facilities are numerous. The COVID-19 pandemic intensifies these demands, requiring additional infection prevention and safety measures as well as increased physiological screening on patient units. Our interdisciplinary teams include nurses, clinical experts, doctors, administrators and guest advocates, so that we understand their perspective and incorporate their requirements from the beginning. Our work on behavioral and mental health facilities benefits from our expertise on nonclinical projects including data centers and mission-critical buildings, research labs, commercial office buildings and interiors, schools and child care centers, as well as hospitality environments. Our diverse design teams draw on this varied expertise to synthesize competing goals into welcoming, functional, sustainable and affordable health care facilities. How do designs of pediatric hospitals or outpatient facilities differ from those for adult patients? The primary differences are scale and form factor. In pediatric environments, we want to incorporate moments of play and whimsy. We carefully consider color, textures, the play of light and environmental graphics to create interiors that are comfortable and provide positive distractions. We also consider how to support children with special needs or different abilities, so that they feel welcome and supported. Pediatric facilities are unique in that children are accompanied by members of their family. What design elements support families while their children are being treated? We anticipate that some families will spend many hours at the facility while their child is in treatment. Siblings need space to play, relax, do homework. Adults may want to catch up on work. We create flexible living spaces within the facility that support a wide program and are adaptable over time. We also incorporate Smart TVs that disseminate information regarding new research, treatment options, support groups, or coping techniques to reassure and empower family members. What design details help promote healing? Our designs include opportunities for the patient to personalize their private space so that it is comfortable, inviting and reflects their personality. Patients can select the lighting levels, change the color of accent lighting and play their own music. Choice gives the patient a sense of autonomy that reduces stress. We also consider the impact that public spaces have on patients. Some need the stimulation of a group setting. Others require more privacy and separation. We make sure that public spaces can adapt to these operational changes. Providing a range of public spaces in behavioral health inadvertently facilitates social distancing. Behavioral health patients – even smaller ones – sometimes need extensive personal space due to their conditions. Allowing for these spatial needs in the resident milieu can reduce the potential for spreading germs, which happens frequently in pediatric settings (such as schools). How do you approach the functional requirements of physicians and staff? Caregiver burnout is a serious concern, especially in pediatric behavioral and mental health, so our designs incorporate areas of respite for providers. Like patient rooms, these include controls for lighting levels and colors to help users relax and recharge in between patients. COVID-19 has created a need for more frequent and intense cleaning, which is an additional burden on unit staff. The right material selections can reduce or eliminate the need for frequent wipe downs by being inherently antiseptic or neutralizing pathogens that land on the surfaces. How do the projects ensure the safety and security of patients and staff? Buildings should strike a balance between dignity and safety, so that they encourage the patient’s healing and wellness. We approach this mandate by carefully planning the interiors, from layout, adjacencies and sightlines to safety finishes and breakaway features. The central aim is to create secure spaces for patients and providers that feel warm and inviting, not cold and institutional. What projects have you worked on that incorporate new trends in pediatric mental health care? Working with Health System in Denver, we thoroughly considered every small detail to create a homelike and soothing atmosphere for their young patients. Some of the key features of this project are “closet rooms,” self-regulated rooms, calming areas with carefully tuned color palettes, adjustable lights and biophilic design features, noted Williams. Health System in Grand Junction challenged us to empathize with patients and providers in a new way and consider scenarios that are not typical of most health care projects, added Falardo. The skills and approach we developed during this project are incredibly valuable across program types, she said.