In terms of the modernization of commercial facilities, healthcare facilities have experienced the most dramatic changes in architecture and interior design in recent years. With the emergence of HMOs and PPOs, hospitals have transformed, incorporating more residential and hospitality interior elements. More often, hospitals are treating patients like clients. The Rehab Hospital at WakeMed, Raleigh, NC, went a step beyond the current trend of humanizing healthcare interior elements in its facility and instead created an inspirational, highly functioning, original space for its patients and staff.
In response to increased competition among hospitals for patients, healthcare facilities have adapted to compete with one another. “I have been doing healthcare design for 15 years and the facilities continue to get better and better in terms of aesthetics and patient comfort,” says Susan Ford, FreemanWhite’s director of interior design. FreemanWhite, with its team of architects, interior designers, and engineers headquartered in Charlotte, NC, has extensive healthcare design experience.
Hospital administrators have become much more informed about high-quality design and functionality in their facilities. Cold, clinical boxes have been replaced by warm, welcoming spaces over the years. “When I began in 1979, most healthcare design was fixated on the building’s front entry and exterior façade, while the rest of the building simply fell into place,” says William Bethune, principal, FreemanWhite.
Now, according to Bethune, healthcare organizations are shunning rote, cookie cutter interior design and layout. Instead, many healthcare facilities managers are viewing their spaces differently and are striving to make their facilities attractive and efficient. “Building owners in the hospitals we work with have gotten more sophisticated with what they want,” adds Bethune.
The Rehab Hospital at WakeMed is a 43,290-square-foot facility, which serves inpatients as well as outpatients. Over the last 13 years, the hospital had increased its number of beds for inpatients significantly, from 45 beds to 68. The rehab hospital also has a waiting list for outpatients. Before the modernization, the hospital was a standard rehabilitation facility with patient rooms, exercise and therapy space, and a small dining room.
Because of the facility’s growth, it seemed cramped, awkwardly laid out, and limited with regard to space for occupational and physical therapy. The two-story building desperately needed a modernization to serve its patients and support its staff better. “We never felt we were doing an adequate job of keeping up with therapeutic spaces in terms of size as we grew the number of inpatient beds,” says Deborah Friberg, senior vice president of nursing and executive director, The Rehab Hospital at WakeMed, Raleigh. The contractor for the WakeMed modernization was T.A. Loving, Goldsboro, NC, and the structural engineer was Laurene & Rickher of Charlotte.
The hospital serves as the only inpatient rehab facility in the area as well as a regional referral center. Many of their patients journey from 50 to 60 miles away for outpatient treatment. “[During the modernization,] we had the opportunity to [ask] what is the ideal support space and therapeutic space that we need to make sure our patients have the best possible experience,” says Friberg. The healthcare facility serves children and adults with a variety of conditions, including orthopedic complications, post fractures, joint replacement, neurological disease or injury, strokes, multiple sclerosis, Parkinson’s disease, and spinal cord injuries. The average inpatient stay is 13 to 14 days, with outpatient treatment usually lasting several months.
To better serve its patients, the building owner, WakeMed, collaborated with its design team, FreemanWhite, to create real-life settings where patients can practice life skills, such as cooking and shopping; become reintegrated into society; and recapture their independence. “That was our goal – not to simulate environments and pretend they are real, but to create real environments that can simulate other real environments,” explains Friberg. Many rehab facilities use simulated environments – a few shelves to emulate a grocery story, a lift to imitate a car – as practice areas for patients.
In the past, the rehab hospital staff would take patients out into the city of Raleigh in buses to practice vital life skills. In addition to being disruptive, the hospital administration did not believe Raleigh was an accurate representation of the small towns in which many of their patients currently reside. The hospital staff also had to transport inpatients off-site for hydrotherapy and some other physical therapy. A small adjacent outdoor area was used by WakeMed so that patients could relearn tasks; however, this space was inadequate because it was exposed to the elements.
The rehab hospital staff and patients also had significant input in the modernization. “Rehab is a very team-oriented care process, so we had teams of staff assigned to each one of the desired spaces,” says Friberg. Small groups of nurses, therapists, doctors, and patients formed committees to shape specific areas of the modernization. Adds Ford, “You will get a much better space when you have collaboration from experts. It is their facility; they are going to be living there. It is important for the owner to be an active participant.”
The facilities management department, hospital staff, and design team took field trips to several facilities – from hospitals to health clubs to wellness centers – taking pictures and notes, and working together closely to create the ideal site. “There was nothing quite like what they wanted to do,” says Bethune.