'A Space To De-Escalate Stress': How A Proactive Approach To Design Benefits Hospitals And People

Hospitals and other healthcare facilities prioritize stress reduction for patients and employees, such as with building designs that are meant to promote healing.

But implementing a major design change in a busy medical space, no matter how well intentioned, can be its own source of stress if not managed well.

“The more I work with hospitals — and I love working with nurses and other healthcare providers — the more I see the stresses that are on them on a daily basis,” said Teresa Wilson, director of project management for Colliers Project Leaders USA, a division of Colliers Engineering & Design. “That is why looking at how you can design a space to de-escalate tensions and stress is really important.”

Wilson said there are many ways to use design to improve conditions for medical building users, such as by finding ways to provide more privacy for emergency room patients or reducing the distance people must travel from one department to another.

One recent project required Wilson and her team to add much-needed inpatient beds while minimizing the impacts in an active healthcare environment. Phasing the work to avoid disruptions was key to success, she said.

“Phasing and move management become critical, as does understanding hidden conditions in the building,” Wilson said. “Every time you open up a wall, you may find things you didn't count on seeing, so the work requires a lot of communication and the ability to react quickly.” 

An architect with more than 30 years’ experience in healthcare design and planning, Wilson said it is better to prepare thoroughly and communicate closely with stakeholders than to be in constant reaction mode as new challenges arise. 

She and her colleagues employ a patient-centric approach to design that emphasizes concepts like continuous improvement and the reduction of wasteful steps, whether they pertain to keeping a construction project on track or ensuring the best care for patients.

Lean principles such as the Last Planner System require the team to identify and eliminate bottlenecks or conflicts before they arise — rather than being reactive, which is much less time- and cost-efficient. Wilson said lean works best in a medical setting when it takes into account the perspectives of multiple stakeholders, including the people who work with or around patients on a hospital floor daily.

“It's a very methodical and team approach,” Wilson said. “You thoroughly document the space to understand what works and what doesn't. That can include interviewing a nurse or someone from housekeeping to learn how their roles support each other and how the designer can make the space easier for them to use or clean.”

To maximize successful outcomes, the team, which can include designers, construction specialists and project managers, must be involved in a construction or renovation project from the very beginning, she said. 

“I always want to have as many early meetings as possible about potential pain points in a project,” Wilson said. “In addition to hospital personnel, this can include meeting with the building inspector to explain what we want to do and find out whether it might create a problem. Preplanning is most critical for me.” 

As the owner's project manager, Wilson said she is often in a position to select members of the team who understand how to apply lean principles. This pays off when surprises arise, which recently happened when a hospital project was suddenly greenlighted and the design development plans needed to be completed in 11 weeks instead of the originally planned 12 to qualify the hospital floor for state licensing.

One less week might not sound like a big difference, but healthcare projects must account for thousands of moving parts that impact patients and staff alike. A team that communicates well and understands the end goal is best positioned to make it happen with minimal disruption, which is what Wilson said was the result in this case.

“It was a big, big task, but I had such confidence in the team and knew they could do it,” she said. “I worked very closely with the architect and the owner on a daily basis, and once a week we would meet with the entire team and say, ‘This is what we're thinking. Tell us where we need to adjust.’ The team was cohesive and they made it work.”

Wilson, who will speak at Bisnow’s Boston Healthcare and Campus Development event May 14, said this patient-centric approach to design and construction can benefit hospitals as they navigate trends such as serving an aging patient base while contending with a pending wave of retirements among nurses. A well-designed space can not only serve the immediate needs of the hospital population but also act as a recruiting tool for young healthcare professionals.

“Design is important, whether it concerns improvements to a hospital floor or the artwork that will be displayed,” she said. “Think of all the things that you do to de-stress in your normal life. We are providing a version of that for staff and patients.”

This article was produced in collaboration between Colliers Engineering & Design and Studio B. Bisnow news staff was not involved in the production of this content.

Studio B is Bisnow’s in-house content and design studio. To learn more about how Studio B can help your team, reach out to studio@bisnow.com.