{"id":3283,"date":"2021-04-13T13:56:23","date_gmt":"2021-04-13T13:56:23","guid":{"rendered":"https:\/\/hx.design\/staging\/5366\/?p=3283"},"modified":"2021-06-07T18:54:15","modified_gmt":"2021-06-07T18:54:15","slug":"design-approach","status":"publish","type":"post","link":"https:\/\/hx.design\/staging\/5366\/design-approach\/","title":{"rendered":"Design Approach"},"content":{"rendered":"<p>I was recently asked to spell out my priorities when working with clinicians and architects to establish the plan of a new facility.\u00a0 I enjoyed answering the question so much, I decided to write it all down and share it with the readers of our website.\u00a0 So, here it is.\u00a0 Enjoy:<\/p>\n<p>In my mind, the planning of a psychiatric unit, units or hospital must start with a deep understanding of how the treatment program works.\u00a0 Every place is different. \u00a0It is essential to understand how they work and how they would like to work before you ever put a pen to paper.\u00a0 Our preference is to start with a detailed conversation with the program leaders and follow that up with a day embedded in their existing facility so we can watch and observe a \u201cday in the life\u201d.<\/p>\n<p>The second thing we want to do is have a detailed conversation about the client\u2019s clinical beliefs on key planning issues that vary from facility to facility:\u00a0 open vs. closed nurse stations; private vs double rooms; en-suite vs corridor accessed toilet facilities; centralized or decentralized therapy\/ social space.\u00a0 This is the WHY phase.\u00a0 I wrote another blog on that so feel free to check it out for more detail.<\/p>\n<p>In this initial data gathering phase we are trying to figure out if the client already has a well thought out <u>idealized<\/u> operational plan.\u00a0 In many cases, we find that clients have developed programs around the limitations of their existing facilities.\u00a0 By introducing design thinking exercises, our job is to help them imagine a better way to do things.\u00a0 It is absolutely critical that this process happen early.\u00a0 In my experience, clinical leaders\u2019 minds get opened up during the process and they start to more effectively imagine this wonderful future.\u00a0 Unfortunately, those thoughts often coincide with design deadlines and result in last minute changes.\u00a0 We want to get it right the first time, so taking the time to design the operational program first is the key to reducing the design team\u2019s stress level along the way.<\/p>\n<p>Once we have established the program we are designing for, our next step is to explore plan options around some key experiential factors:<\/p>\n<ol>\n<li>Efficiency.\u00a0 Yes, I know.\u00a0 That sounds boring, but efficiency in planning is a key driver for staff productivity which is a key driver for economic viability.\u00a0 A program that is not economically viable will not help patients no matter how beautiful the building.<\/li>\n<li>Social Dynamics. We have posted some other blogs on this, so I will not belabor the point, but the plan needs to consider all the options for providing viable social and treatment space to provide patients with as much choice and control as they can be allowed.\u00a0 Carefully designing for social dynamics is a key driver for reducing environmental agitation.<\/li>\n<li>Acoustics.\u00a0 Speaking of environmental agitation, very few things are as impactful on levels of agitation as acoustics.\u00a0 You might think that is a design detail and not a planning move, but I strongly disagree.\u00a0 Because the nature of a BH space limits your sound absorbing options, the layout of rooms must consider all the factors that impact acoustics such as non-parallel walls, variations in ceilings and connected spaces.<\/li>\n<li>Daylight and views. Some projects offer more possibilities in this area than others, but that only means that we must plan from the start to get the most bang for whatever buck is available.\u00a0 It seems like circadian rhythms is one of the hottest topics in the design profession today and it also seems like a lot of designers are struggling to understand the dizzying array of lighting options.\u00a0 I know this:\u00a0 The impact of real, natural sunlight is unquestioned in its positive impact on all humans.\u00a0 Giving patients and staff access to this bit of magic is a critical planning element that simplifies so many other decisions down the road.<\/li>\n<li>Sight Lines.\u00a0 This is often misunderstood as simply estimating the sight lines from the nurse station, but I refer you back to my earlier comments in this blog.\u00a0 Some programs do not use the nurse station as an observation point.\u00a0 I once had a clinical director explain that there are no nurse stations on their units.\u00a0 All observation takes place on the milieu and staff are dedicated to that job.\u00a0 She did want glass around the charting rooms so that staff doing heads down work could identify issues quickly when they arise, but under no circumstances did she want us designing them as \u201cobservation points\u201d.\u00a0 If we take the time to understand how the client will observe the patients, we can design an environment that is best suited to that operational paradigm.<\/li>\n<\/ol>\n<p>There are other critical issues like safety and security that are generally design detail questions but understanding where they will lead can have a planning impact.\u00a0 For example, if you allow a smoke barrier (or any other rated wall) to bisect the unit, safety will impact the plan.\u00a0 That simple planning move creates a rated door that the staff will want held open.\u00a0 That means it cannot have a surface mount or even concealed closer which would represent a ligature point when the door is open.\u00a0 There are other closer options, but many of them have significant maintenance issues.\u00a0 \u00a0Rather than search for a technical solution to a design flaw, the planning process must anticipate these issues and prevent them wherever possible<\/p>\n<p>Planning a psychiatric treatment unit is a complex endeavor.\u00a0 To do it right requires a detailed conceptual understanding of the idealized operational program; a thorough understanding of the psychology of space and the keys to a therapeutic environment; and the experience to understand how the little details that will come along later will manifest in the planning decisions.\u00a0 That is why hX brings both operational and design experience.\u00a0 We use our talents to supplement talented architectural teams so the whole process delivers an outstanding result for the client.\u00a0 In the end, our clients treat some of our most vulnerable neighbors.\u00a0 We owe them nothing less than our best.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>I was recently asked to spell out my priorities when working with clinicians and architects to establish the plan of a new facility.\u00a0 I enjoyed answering the question so much, I decided to write it all down and share it with the readers of our website.\u00a0 So, here it is.\u00a0 Enjoy: In my mind, the [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":3288,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[1],"tags":[],"class_list":["post-3283","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-none"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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