Jackie Gonzalez receives post-cancer care at the University of Miami’s Sylvester Comprehensive Cancer Center after her pancreatic cancer went into remission.
When she was taken on a recent site visit for a new facility, she noticed a long hallway and suggested the designers put in some benches so a patient who needed to rest could stop along the way.
Gonzalez is part of a volunteer group made up of current and former University of Miami Health System (UHealth) patients and their families. Increasingly, healthcare systems are paying attention to how a facility’s design affects patient recovery, seeking input from healthcare architects as well as those who experience and deliver care, such as physicians and nurses.
“I’m really passionate about it,” said Gonzalez, who joined UHealth’s Patient and Family Advisory Board in 2021. “I’m a nurse by training, but I’m very clear when I’m here — I’m like patient here.”
She told WLRN that she and her peers were asked to test furniture and look at designs. “When we meet, they’ll show us the design and what they’re trying to achieve,” she said. “And then they’ll ask, ‘Do you think this will help achieve that?'”
On another site visit, she and her group looked at the check-in desk, which they felt was too high for some facility visitors.
“We looked at it from the perspective of an adult in a wheelchair maybe, or if you’re a kid, you’re going to be bouncing up and down,” Gonzalez said. “It didn’t allow contact with registrars that you want to have that feeling of being heard or understood.” So they made that change.
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WLRN recently went on a tour of a UHealth facility under construction in Doral with Soudabeh Eskandari. As a senior project manager at UHealth Design and Construction, Eskandari listens to the council’s input as a senior project manager at UHealth Design and Construction.
Eskandari is a cervical cancer survivor herself, and as a former patient, she knows that the smaller details go a long way.
“I didn’t know where to put my bag. I always hung it on my chair,” she said of her experience receiving cancer care in South Florida. So she made sure the infusion rooms in the Cancer Care Unit had a walk-in closet and a place for caregivers to sit with their loved ones in the same room.
“The carers sit there in comfortable furniture – a round table and that table has a charger so they can charge their phone or put their laptop down and work.”
Veronika Zaragovia
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WLRN
Instead of harsh fluorescent lighting, this glass building will let in plenty of natural light.
“By bringing in that light, we can help reduce stress and also help patients improve their mood and speed up the recovery process,” Eskandari said.
A 2022 study found that certain lighting can even affect the rate of falls in long-term care residents.
“Changing light bulbs in nursing homes can significantly affect fall rates,” said Dr. Diana Anderson, a geriatrician and professor of medicine at Boston University. “Of course, falls are things we don’t want to happen. It causes a lot of economic burden, injury burden and utilization burden on the hospital system.”
Anderson, who is also a healthcare architect at global solutions firm Jacobs, coined a term for her experience at the intersection of medicine and architecture: dohitect.
“It’s a term that I created and marketed, registered as something of a brand, that I think really helps illustrate the fact that these two professions can be integrated,” she said. She strongly believes that their integration can significantly help patients. Too much is at stake with the volume of people receiving care in a facility like a hospital over the years.
“It’s a pretty strong statement to say that the building you’re in is as powerful for your health as a pill you might take or a surgical procedure you might have in the hospital,” Anderson said. “But there is evidence to suggest that this is the case.”
She points to research including how close a patient’s room is to a nursing station, color patterns and even floor lines to help dementia patients.
Staff welfare also matters
The healthcare model in the US depends a lot on patient satisfaction because it is a payer model. Anderson urges health systems to look after the design of staff spaces.
“What we often see in design now is what we call this onstage-offstage model, where patients will often get the glitzy lobby with the art and window and sculpture or fountain, and the staff will get a lounge in the back of the building without any windows, with barren walls,” she said.
Staff wellbeing can affect the care and work they do. Until a design is made for all people inside the walls of the facility, capital will still lag behind.
“What I think is really good is that doctors, nurses and other clinical professionals really want to think about design,” Anderson said. “I have people call me and say, ‘I really, really want a certificate or diploma program because I think it can impact the way I deliver care in the operating room, in the clinical space.’
The delivery of health care is not without complex problems. The experts who decide many of them already work in a hospital, and she believes that if more of them gain experience in design, it will lead to even better results.
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