Health care more than any other building type has a more significant influence on its building occupants. I can't think of another building type where the health and well-being of the occupants or the success or failure of treatment can be as impacted as a health care facility. I'm John Torrick, and I'm Danny Sullivan. And you're listening to Speaking of Design, bringing you the stories of the engineers and architects who are transforming the world one project
at a time. Today, we'll look at what makes the ideal patient room for people being treated for behavioral and mental illnesses. That topic is a shared passion by a team of architects, Putting our heads together for the right reasons to ultimately try to make environment safer and more pleasant and more comfortable and supportive for patients and families. It's amazing to see how far that can go. That's Tammy Thompson, president and founder of the Institute for
Patient Centered Design. Tammy's career started in architecture where she took a personal interest in health care design. I always tell people I'm a patient first. I live with a chronic illness, sickle cell disease, and that left me in and out of the hospital in my college days. So at the same time that I was being trained on architecture, I was also getting a lot of experience as a patient. And so this really led me into a career in health care design.
With her interest in the patient perspective, Tammy founded the institute in 2010. The nonprofit works with health care providers, medical staff, and design teams to bring the patient's voice to health care design. In 02/2012, the institute was invited to partner with the health care design conference patient room to explore design ideas at the conference. We were tasked with developing our very first patient experience
simulation lab. So this was essentially a full scale high fidelity mock up of a patient room, and it allowed us to really explore design ideas. The best way we thought to do that instead of proposing our own solution was to put that call out to the industry. So in 02/2012, we released an article in Health Care Design
Magazine. It was essentially a call for proposals for the patient empowered room, and we were looking for a space that would empower the inpatient as much as possible to have as much control over their environment. And that was a huge success. That led to the institute sponsoring design competitions for neonatal intensive care unit and a cancer care center, both focused on the needs of patients and their families.
In 2015, the competition turned designers' attention to a different type of facility, an inpatient room designed for behavioral health. Behavioral health encompasses people experiencing mental illnesses, substance abuse disorders, and other addictions. That topic is extremely personal for Kim McMurray, Tammy's colleague and vice president of design at the institute. My passion in this profession is personal. I had an aunt that had a mental handicap her entire life.
And so the Department of Mental Health for the state of Alabama has been a part of my entire life. Sadly, Kim felt the impact of another type of behavioral health crisis when someone close to her family was in a serious car wreck. During her long period of recovery, she became addicted to opioids. Eventually, the pain became too much to bear, and she committed suicide.
That really touched us, and it really was a turning point and really made a passion for me to be out there and recognize the needs for this group of people and patient population and staff that work in it and the families. Having been a family, and you virtually feel like you don't know where to go and what to do. Kim said she's motivated to honor what her family members have gone through
in her work. In addition to her role at the institute, Kim is an architect and principal with behavioral health facility consulting. She works with designers and health care providers of all sizes to consider the needs of behavioral health patients and staff in the nuances of facility design. In many ways, her role at DHFC is similar to the role the institute plays, aiming to mentor designers and health care professionals across the industry.
Recognizing the need for a bridging between the patients, the patients' needs, the family needs, and the designers. That was really the origin of what our focus was as an institute is to help close that gap and help train and mentor and teach the designers from the patient perspective. The design competition simulations are a major interactive component of that. Tammy said the institute seeks designs built on a foundation of scientific
research. We generally will provide a template that gives them a guideline so that we know we are comparing apples to apples. Because we work in collaboration with the Center for Health Design, we also try to encourage, as part of the design submission, an evidence based design process. And one of our pages in the submission packet will allow design submissions to actually spell out how their process is evidence
based design. Participants are also encouraged to incorporate the institute's 10 principles for patient centered design. A few examples include respecting privacy, encouraging patient and family participation, promoting safety and security, and creating a comfortable environment. When the call for an inpatient behavioral health room design went out to the industry in 02/2015, '12 teams submitted original designs.
We define behavioral health as essentially the health and wellness of the mental state. We actually use design for mental and behavioral health together because we realized that those definitions have different meanings to different people. But what we were trying to do was to look at an inpatient facility that was in place to provide care for mental illness, for substance abuse, and for traumatic experiences that affect the mental well-being.
The institute assembled a panel of jurors with expertise in behavioral health design to review the entries and narrow the list to three finalists. Kim McMurray and her colleague, Jim Hunt, who founded Behavioral Health Facility Consulting, were among the jurors. Basically, we're looking at five points, therapeutic environment, patient safety, staff safety, sustainability,
and overall patient centered care. Early in Jim's career as an architect, he was on the design team for a replacement hospital at the Menninger Clinic, a psychiatric hospital in Topeka, Kansas. At the completion of the project, Jim became the director of facilities management for the hospital. That gave him a unique insight into both perspectives of behavioral health design. I often say that every architect should have to live day in, day out with their projects
for twenty years. They might find a few things they'd do differently. So that experience gave me a great deal of insight into the day to day operations, what works and what doesn't work in this kind of facility, and it kinda got me started down this path. Jim said hospitals treating mental illnesses and addiction function quite differently than a general hospital. In general hospitals, patients spend the vast majority of their time in their rooms. They eat their meals in
their rooms. They see visitors in their rooms. They get treatment in their rooms. The doctors visit them in their rooms. In a psychiatric hospital, inpatient psychiatric hospital, none of those things happen in the patient room, and they need to move with the patients out in common spaces. They see their doctors. They eat. They do all these things out of their rooms. Every time they're really in the rooms is for sleeping and changing clothes. So the rooms need to be different.
A lot of things that are always done in general hospitals don't really add to the therapy environment that we want for for behavioral health. Jim read from the institute's call for entries, describing what participants behavioral health designs should achieve.
A patient centered behavioral health environment is one which patients receiving treatment for mental disorders are allowed to retain their personal dignity, comfort, and control of as many aspects of their environment as possible while limiting opportunities for patients to harm themselves or others. This environment should be welcoming, relaxing, comforting, and help patients to be open to the
treatment that will be provided to them. The scope of the competition covered patient rooms and bathrooms with patient and staff safety as a major driver. The data at the time was showing that the vast majority of attempts of self harm were taking place in patient rooms and bathrooms. And so that's where we need to focus our attention. It's inherently difficult to balance between creating a welcoming therapeutic environment and promoting safety. But those are the types of challenges the
competition is designed to explore. That's kind of the the beauty of the whole thing is that this collaboration between hospitals, design firms, and manufacturing to get in there and dig and really work to develop new products that both look good and are comfortable and user friendly, and they're safe. And so we don't have to choose anymore. We can we can have both. Tammy Thompson, the president of the institute, said jurors saw some consistent themes among the
competition's entries. The common things that we saw in the design submissions for 02/2015 for behavioral health included personalizing some element of the room and really customizing it to fit the needs of the patient. Another thing was safety, obviously, and easy and quick visibility into a space, a very clean open space that prevented, any hidden corners or crevices. The designs can also help inform product development in the industry.
We also saw that there was a great bit of creativity in terms of furniture design and development, which really led us to the conclusion that at this point, there really were not enough options available in terms of furniture for modern behavioral health design. As a juror, Kim McMurray noted that most entries also recognized the need to consider the design of shared spaces
outside the patient room. Everybody picked up on therapeutic and restorative environment, and they all had various different ways of expressing that. Daylight and nature was a common element that was introduced. Most of them focused not only on the patient room itself, but they also talked about how the open main area would come into play with that. Recognizing that in a behavioral health unit, the patient spends most of their awake hours out into a day program, a common shared
area. So that really stood out to me. After the jurors narrowed the field to three, the finalists presented their submissions virtually at the conference. Attendees got to experience each room and vote on a winner. The winning entry was titled One Haven.
We really were able to come up with a thesis statement to, design the ideal patient room that would empower the patient and give them a sense of autonomy and control over their environment throughout the healing process while still providing a safe and secure environment for patients, staff, and visitors. That's Brian Giebink, an architect and behavioral health planner at HDR. In The United States, Mental Health and behavioral health are usually considered the same
under one umbrella of behavioral health care. We know there are differences. Mental health deals with issues in the mind, such as schizophrenia or bipolar disorder, psychosis, things like that. Behavioral health is really fit looking at, behavior and substance use disorders. But we as a as a culture have somehow decided that behavioral health care is less stigmatizing than mental health care, yet most other countries in the world still
refer to it as mental health care. Brian said the design competition offered the opportunity to design specifically for patients in more of a perfect world scenario. We really approached the design of the room as an opportunity for us to step back and step away from the behavioral health work that we have been doing and really remove some of the restrictions that we often see, whether it's budget or specific owner requirements or even building orientation.
We were able to kind of remove those criteria and really think about what is the ideal patient room. What does the patient really need if we remove these restrictions? Before getting into the design, the team certainly did their homework. They analyzed studies of behavioral health settings in peer reviewed journals, consulted experts within the field, and even interviewed a family of a past behavioral health patient.
We designed a room around a tremendous amount of research and evidence that we've collected through this process. And we came up with six or seven themes kept coming up over and over, things like artwork and access to daylight and providing control over the environment and sound and lighting. All of these things, we realized, start to really play a role in the patient experience and in the healing process. It makes sense.
Even though so many of those details seem small and may sound secondary, they all contribute to making the environment feel more like the outside world and hopefully more
like a home. In mental health care facilities or in behavioral health care facilities, it's really important that we provide a very comfortable environment, a very normalized environment, one that's not institutionalized, one that feels very inviting and also an environment that's empowering for patients because it's important that when patients are receiving mental health care, they don't feel like they're in prison, they don't feel like they're being controlled.
There are all of these ideas around patient control and choice that may sound like a small thing to us, but for somebody who feels like they're in a very confined environment, who doesn't have the freedom to come and go as they please, Those very small things can really go a long way into improving that patient experience. Take artwork, for example. That's a pretty subjective choice, but it's something you're gonna look at every day if you live in the facility.
We provided a digital artwork display so patients could not only look at artwork, but they were able to select the type of artwork they were looking at, which is really important. We wanna make sure that patients feel that they have control. If they don't like the piece of artwork they're looking at, then let's let them change that artwork. Because what we would normally see is either a room with no artwork in it or a room with
permanent artwork. But what somebody likes may not be what another person likes, and you're just providing another sense of control by allowing them to use this digital artwork display. We also incorporate concepts of allowing them to select the type of music they're listening to or if they're listening to music at all. Designing space and furniture that can be used in different ways added another element of choice for patients.
We provided a built in shelf that wraps around the perimeter of the room. It could be used as a shelf. It could be used as a seat. It's long enough that patients are able to lounge against it. It has a little sloped portion on it so patients can sort of comfortably lounge and relax on it. After being voted the winner at the health care design conference, Brian's team continued to collaborate with jurors who were selected for their expertise in behavioral health.
They included Jim Hunt and Mardell Shepley, an author and chair of the Department of Design and Environmental Analysis at Cornell University. The next step, to build a low fidelity mock up of the room for the Patient Centered Design Innovation Summit, a signature event for the Institute for Patient Centered Design. The event brings together designers, students, health care professionals, and researchers to take a deep dive into a health care topic.
In 02/2017, the event was hosted by the Savannah College of Art and Design and funded in part by design grant from the National Endowment for the Arts. The focus that year was behavioral health, and Jim said the low fidelity mock up provided many benefits for their work. The low fidelity mock ups are a tremendous tool to use in design projects, and we're a tremendous tool for this to let people really get a feel for the spaces and what what worked and what didn't work and what we were trying to
present. A large percentage of the population, I'm convinced, really cannot relate to two dimensional drawings. My brother is one of he's much smarter than I am than everything else, but you could show him floor plans and elevations till you're blue in the face, and he doesn't have much clue as to what that's actually gonna look like when you walk into it. The low fidelity mock up is made out of cardboard, and it gave both professionals and students a chance to explore the space
and provide feedback to the design team. People could really get a feel for the space and how it was gonna work, and staff could could see when they entered the room and couldn't see. And so it's a great thing. And the other advantage of it is if somebody says, well, gee, this needs to be more over here or there. This needs to be bigger or smaller. You know, you freak and start doing that. That feedback was valuable, and it prepared the team to build
an even more real life simulation. It also introduced the One Haven design to someone who would help bring the concept to people it's designed to help. Some of them would say, I left Vietnam in the sixties, but it never left me. It's it's still in my head. It wakes me up at night. But now with mindfulness practice, I can I can put some of these thoughts of of war out of my head using mindfulness practice so now I can
get better sleep? That's Mary Therese Hankinson, former director of the Office of Patient Centered Care and Veteran Experience at the VA New Jersey Healthcare System. During her fourteen years in that position, VA New Jersey implemented a number of groundbreaking programs to improve care and quality of life for veterans. Many of their programs followed the model of Plain Tree, a nonprofit that works with health care providers to develop patient centered programs in a healing environment.
If you have patients who are in chronic pain and now they can find other strategies to manage their pain and really overcome their addiction, and four of them for which there's good evidence is using acupuncture, using mindfulness practice, using tai chi, as well as using yoga. So there's a good evidence we're using these modalities. Now when you use these modalities, you have to create spaces. So we created yoga rooms and and other quiet spaces for these activities to occur.
The VA New Jersey health care system even implemented gardening programs and culinary classes as forms of therapy. Mary Therese heard about the One Haven behavioral health design and was invited to the design summit in Savannah, where Brian and Jim's team presented the low fidelity mock up. The Institute for Patient Centered Design typically creates a high fidelity mock up of the winning design. With Mary Therese's interest and involvement, Tammy Thompson recognized an opportunity
for the behavioral health room. Tammy approached the VA in Washington about a site where they might install this high fidelity mock up based on One Haven design. And so we got word from VA central office that this was being offered in, and sites that were interested could apply to have the high fidelity mock up really installed
at their site. Because the intent then was to really have the experience of being in the room and then to get feedback from patients, staff, manufacturers who are going to to donate. The high fidelity mock up takes the cardboard version of the room a significant step further. The high fidelity mock up is when you take the conceptual design and you actually do a build out. So in the high fidelity mock up, our goal was to then build this room, and, of course, it's built within
a room. So we built it at the VA as a room within a room. There's furniture in there. You can lie on the furniture, lie on the bed, you can sit on the chair, you can sit on the shelf that's in the room. We're actually recreating the room and the physical space as you might experience it versus the cardboard mock up. Tammy said building the mock up at the VA offered a win win for the institute and the VA.
We saw great value in collaborating with the VA because they are essentially the largest provider of behavioral health in the country. And so we thought that this would make a huge impact on their facilities and that it would give us the opportunity to learn from the professionals and even the patient advisers there at the VA. Tammy said the institute always has the high fidelity mock up in mind
when they're planning a design competition. Generally, we'll reach out to sponsors of product first so that we are able to secure the products necessary to build the mock up that will follow the competition. And so we send those competition participants to their websites to learn more about the products that we're actually going
to use in the mock up. And that helps us that once we are able to select a a winner, we are then that much further because that winner has already selected the various products during the course of their submission. The space used to construct the room said a lot about the importance of the project to veterans in Lyons, New Jersey.
What was interesting about the space that we did acquire was that there was a group of veterans from what's called Alliance Combat Veterans Group, and they're a group of veterans who are who have been involved in combat. And they heard about the project, and they were so eager to be a participant in the project that they had a room where they would meet, and the space was ideal. It met all those requirements in terms of being located in an area with it's adjacent to a parking lot. It's not
hard to get there. There's views of nature. They were just so passionate about the project, and they said, if we can give some feedback regarding spaces and design of those spaces where veterans are being treated for behavioral health, it's worth it for us to give up our room because it was an ideal space. Bringing the design to life took a larger team of manufacturers and suppliers, including OFS, a family owned contract furniture maker, and Accurate Lock and Hardware, among many others.
So for this room to occur, we had donations from 18 vendors, and we also had a lot of other expertise that was involved in terms of materials. There were furniture manufacturers that were really trying to design the furniture based on the HDR One Haven design. Brian Giebink, the lead architect, said everyone's passion for the cause enabled the project to be built without a budget. So we started developing construction documents for them to
construct this mock up. Now the whole mock up was built on volunteer time with volunteer materials. Everything was donated. Everything from the light fixtures to the the bathroom accessories, like the toilet paper holder, to the paint on the walls. Every single thing had to be a donation because there was no budget for this. Going through that process
helped improve the design. Through that process, we've learned a tremendous amount about how closely we need to pay attention to details when we're designing a room, but also the importance of designing a mock up because you start to notice things that you wouldn't catch on two dimensional drawing or even three-dimensional drawing. You really have to build it. If you're wondering why a patient room for behavioral health treatment is so specialized that it requires manufacturing
new products, Brian framed the larger picture. Behavioral health care is a totally different realm of health care because you're treating patients who are very vulnerable, who could be very dangerous to themselves or others. They could potentially be at risk for self harm. They could be at risk for flight. They could try to leave the facility at any time. So when we think about behavioral mental health care, the very first thing we think about is the safety and security
of patients, family, and staff members. An example of one challenge would be creating furniture that's flexible in how and where it's used, yet it can't be picked up, and it doesn't have accessible legs on its base. We worked with a furniture provider to design a the ottoman that could be moved around the room, and it had a weeble wobble base on the bottom so a patient could start to interact with it a little bit more and use it how they wanna use it.
It's a harsh reality, but one of the key safety considerations for furniture and hardware is that it's ligature resistant. By that, we mean something that somebody can't tie something around and use to harm themselves with. This kind of activity using its terms as hanging or strangulation. The ottoman was designed to be weighted and flushed with the ground. The bed also comes all the way to the floor and can be repositioned by sliding along the shelving unit attached to the wall.
Door design became another key element of One Haven. The door to the room swings both ways to prevent patients barricading themselves in the room. It also offers staff a view of the entire room from the doorway. And the bathroom features a unique sliding door that respects patient privacy without creating safety concerns. No. That's a good example. Door hardware, the design that HDR submitted had a sliding
door on the bathroom. Those sliding doors have been a no no for the whole forty years I've been doing this, and there just wasn't hardware that we could use that was safe to use in these environments. The hardware company developed a concealed track system without any anchor points or cavities exposed that could be used as ligature attachments. You know, it's something that we couldn't do before that and largely because of this design competition.
This is now available to the industry, and we can do it because having room to swing the patient bathroom door is always a problem and creates barricade issues. The One Haven team also worked with a lighting company to develop fixtures that feel less institutional, avoiding the fluorescent lighting appearance so it feels more like a home. Just that one simple change made a phenomenal difference in the character of the space because that's not something you normally
see in the hospital. And we're trying to make these things not look like hospitals, yet we still go back and need to see the same things that we've always used in hospitals and commercial buildings and institutional buildings. So lighting is a huge, huge area right now for behavioral health.
Although there are many facilities where they're doing their best to provide the highest physical and social environment, the majority of facilities, mostly through lack of funding, are facilities someone who is very healthy would not wanna be in. And I just feel like that's something that we need to call attention to. That's Mardell Shepley, chair of the department of design and environmental analysis
at Cornell University. With her background as a health care architect and design researcher, Mardell has authored or coauthored six books. The latest, titled Design for Mental and Behavioral Health, was published in 02/2017. My area of focus has been for a long time health care design and research. So I essentially am interested in environments where people are most
vulnerable. So the focus has been, things such as I've worked in neonatal intensive care for a long time and generally intensive care and very interested in mental behavioral health lately because it's received insufficient attention. Mardell's research led to being involved with the Institute for Patient Centered Design's neonatal intensive care unit mock up. She was a juror for the behavioral health design competition, then continued to advise the team through the
mock up phases. There's a science to collecting meaningful feedback to better inform design. Mardell's research background brought that element to the team. It is evolved and, they refer to it as research form design or oven space design. More and more firms, particularly in the health care area, embrace this as something that they incorporate in their practice.
And what I basically do in the books that I write, I try and serve as a conduit between people that are conducting research and people that are in practice so that they can understand one another. Working with the design team, Mardell developed a written survey to help measure how well One Haven captured the designer's intentions. Then that survey was then distributed at the site to staff and to residents.
We also went down and we had three focus groups, two with staff and one with residents to get their verbal feedback on what they'd experienced. So this is what they call this a multi methods approach. So we were trying to triangulate the results of this the responses to the written survey questionnaire and people's oral comments during the process of being in the focus group. More than 50 patients and staff participated in the survey, and 30 took part in the listening sessions.
Ever the dedicated researchers, Mardell and Mary Therese Hankinson stressed that the process was less formal than a research project with focus groups, even though we've used that term interchangeably in discussing the listening sessions. The VA actually labeled the work as a quality improvement project rather than official research because the VA employs a routine process of implementing patient centered initiatives using a structured process to solicit the voice
of veterans and staff. For the survey, Mardell used a Likert scale where participants could rate their agreement with a statement on a scale of one to seven. You make a statement about something, and they say I agree or disagree rather than asking each question differently like, do you think this is effective in one question? And then another one you say, how important is this to you? Sometimes that confuses the recipient. So we'd say two things. We try and create a sort of logical,
easy to follow discussion. We make sure the content is based on previous set goals, and we try and keep it at a level that's not in architectese. You try and you avoid using jargon that's inappropriate. Participants in the survey and listening sessions gave their input around four major themes. Whether the room communicates respect for patients, whether it provides adequate access to daylight, whether it provides adequate acoustical control, and whether it empowers patients and patient control.
Mary Therese Hankinson, who was then working at the VA New Jersey healthcare system, described the first walk through. We all invited participants. So those manufacturers who had manufactured accessories for the bathroom, they had manufactured a new type of door, all to really need safety standards for behavioral health. We invited them to do a walk through. So we had numerous people, patients, staff, these vendors who had donated their products, walk through this high
fidelity mock up. And we had written forms, and they would provide feedback. And then on to part two. And then we had as part two, we had listening sessions, and that's where staff and patients who work in behavioral health have the opportunity to really give feedback on the room based on their experience of either working in behavioral health or their experience being a patient in behavioral health. In general, staff rated the room slightly higher than patients.
But some of the feedback that we got wasn't surprising in terms of of balancing safety and privacy, and that's always a a big concern in in behavioral health. The other theme and feedback that we received from patients and staff is really the importance of having hominess in the environment or deinstitutionalization and having and that type of feel of of hominess in the environment. Other themes tied back into some of the
original intentions of the design. The other feedback we received from patients and staff was their appreciation in the room for the ability to for patients to have some empowerment and control. So having lighting control and access to daylight were really things that resonated with both patients and staff. But having this empowerment and control is not surprising because when you're hospitalized, you really lose disabilities for any level of control, experiencing your home like environment.
So, yes, state safety and privacy were really key things that emerged from patients and staff, but that the design would provide an atmosphere that was home like or use the word hominess, and that how much they wanted the room to really provide some level of empowerment and control for patients. With many topics, the feedback was mixed, and that makes sense given that patients will bring different perspectives to their treatment. This is designed not only as a private room,
but it also had an adjoining bathroom. And so there was a lot of discussion about that. In the literature, there's mixed reviews on that. In a VA population, some of the feedback we got with the veteran said, you know what? Sometimes it's nice to not be alone, but to have a roommate because of this camaraderie that occurs in the military, you would have someone to talk to. And others feel as if they'd rather a private room to decompress.
However, there's always mixed reviews about this, but the safety issue becomes one that if it's a private room, then the staff has to ensure safety. Kim McMurray, who we met earlier in both her role with the institute and behavioral health facility consulting, said she thought the bathroom design went a long way toward improving that balance. I think the sliding door was a very positive, impact.
The bathroom door is one of the highest risk areas in terms of attempting to arm themselves, and it's the most problematic of how to handle it in terms of privacy. So I think the slider door application really starts to handle that extremely well. Mary Therese said the flexibility of how the space in the room can be used was a popular element of the design. Some of the things that the staff really liked about the design, One Haven, was the long countertop that's in the room that could also be
used as seating. And it's a sloped countertop, so it could also double as a chaise lounge. So people saw that as a very unique and positive feature, which hadn't been apparent in other rooms that in behavioral health. It also could double as an area for someone to, you know, to put things on top of that shelf or seating. It had a lot of multiple attributes that people found to be positive for that design. Kim McMurray also recalled a patient's reflection about the same space. One patient
very resonated with me. She sat down there. She leaned back, and she said, wow. I can do my journaling and my reflecting and my exercises right here. This is great. And then another one turned over and said, then I could sit here and do my journaling. So I think just that whole bench offers variation of choice of how to use it, time of day. So that's a very nice element that's also quite safe for the patients. But Mary Tree said there were also surprises
in the feedback. The biggest surprise for me was the ottoman. So the ottoman was in the room is a very unique piece of furniture. It's not like having a chair. It was specifically designed by the manufacturer for behavioral health environment. And the interesting feature of the ottoman is that it rocks.
Now rocking is considered very therapeutic. There's information being written about how it's therapeutic for treatment behavioral health and patients would talk about how locking movement can help decrease anxiety and how it's very therapeutic. So the big surprise to me, I thought that the people would find this to be terrific because it was furniture that met the standards of safety, but also included this therapeutic intervention, which is the benefits of rocking for which
there's information in the literature. But there's a lot of criticism about the ottoman, which totally surprised me, and it was one of those innovations that we all saw as very unique. Some people said, well, what about somebody rocking and falling off it? And all these other things. And it's just interesting that the people saw it as not as as beneficial as
many of us saw it. Mardell Shepley recently completed a paper about the evaluation of both the room design and the concept of using a high fidelity mock up to conduct research. She said the mock up proved to be a reasonable tool, but that the evaluation showed it needs to be as realistic as possible. In spite of all the effort that went into the design and gathering evidence about its effectiveness, Mardell returned to a point Jim Hunt also
made about behavioral health. The design has an impact, but it's still secondary to the people. Despite the fact that we think the physical environment is very effective and has a huge impact, which we do, the social environment is more effective. We'll always agree that we need people that care, that are talented at dealing with your issues. That becomes more important than situations where people are,
sorry to put this another way. If you're in an environment where there are kind, intelligent people supporting you, and the environment's not that good, that's probably going to be a better experience than if you're in a beautiful environment that has people that are not attending to you. Evidence based design is becoming more and more of the norm. And knowing how buildings affect the lives of people who occupy them, Brian Gebink is happy to be part of that
movement. We're starting to see a lot more of that in behavioral health care where research and evidence are becoming sort of like the they're in the driver's seat. That's really the most important thing. If the research doesn't support a design decision, then why are we doing it? If research says that we shouldn't use green wallpaper, then why are we doing it? And if you're not consulting the literature that's out there and all of the research that's been done, then you're not doing
anything. You're not advancing design. What we're doing is we're continuing to experiment, but we're not advancing it. So what we need to do and what we're starting to see as a trend is more evidence based design. But then once the facility is built, we're actually going back, and we are learning from that. And we create a new research study out of this new built environment.
With the subject as personal and emotional as people being treated for behavioral health, using data becomes even more important. It's really important to use all of that information rather than using your intuition or your instincts because what our instincts tell us is correct for somebody who is neurotypical, somebody who we would consider normal in society, maybe totally different for somebody in a mental health care facility.
So we kinda have to throw our intuitions out the window and really rely on research and evidence to support all of the design decisions that we make. Tammy Thompson said collecting feedback from patients and staff and sharing the findings with designers and health care providers will be one of the lasting impacts of the design competition. I think that's what we're most proud of.
In any mock up, what we can hope for is that people will walk away with new inspiration and an understanding based on the evidence of, what design features work and what design features are desirable.
And this really exceeded our expectations there because not only did they walk away with that understanding, but we were able to develop several collaborative projects that allowed vendors to produce new products that ultimately will be for the benefit of our entire design community and the patients that we serve. That's quite a feat, especially for an organization that's being led by volunteers.
We are just amazed at how our work really has wings and is able to take off in so many different directions and inspire so many people. And I think that's the most satisfying part of this nonprofit work that we're doing. Obviously, you know, we're led by volunteers, and we spend a lot of time outside of our day jobs working on these types of projects. And so it's really satisfying to see the impact that these simulation labs can have.
The VA is looking at opportunities to incorporate findings from the mock up into new design guidelines. Many other health care providers follow the VA's direction in developing their own guidelines. And Mary Therese Hankinson said she expects the impact to continue to expand as more people learn about One Haven. It's already made an impact. I mentioned that there were 18 vendors who had donated these materials. So we're talking about lighting manufacturers, furniture manufacturers.
We're talking about people who manufacture accessories for the bathroom. So it's already started to create this, and Center for Health Design calls it a pebble project, which is you throw a pebble in the pond and then it starts to spread
and it creates waves and movement. And I think that this project has really done that because not only do you have awareness by the community of behavioral health staff as well as patients, but publication to spread what we learned and manufacturers who actually got feedback about their products. On a personal level, Jim Hunt hopes this work will inspire environments that help behavioral health patients to reinforce their humanity.
It's just the simplest little things that are easy to get lost in the millions of decisions you're making in designing money so somebody's putting it together, that we've got to keep those little things in mind because those are the things that really make a difference and really speak to giving these patients an environment that doesn't dehumanize them. It doesn't say you're not good enough to be able to do this on your own. We have to do it for you.
That's not helpful, and it's not gonna encourage them to get better and enable them to get better. So we have to look for all those things that we're doing that unintentionally give that message and get rid of them. With nearly fifty years in the field, Jim sees no end to the progress. We're getting better at it. We're getting better and better. And what I would love to know and I'll never live to see it, fifty years from now, 02/1970,
what will these facilities be looked like? And will the designers then be talking about what we're doing today and in terms about how horrible these things were and how we got to replace them and so forth because what they're doing now is so much better. I really hope so. I hope that this thing keeps moving in that direction and will continue to improve the environments for these staffs and patients.
We're doing a whole lot better than our predecessors did, and I hope that our successors keep it going. I don't see a reason why not. For more information on this podcast, visit hdrinc.com/speakingofdesign. There, you'll find more information about the One Haven design and links to the Institute for Patient Centered Design and behavioral health facility consultants. If you like what you heard, be sure to rate us or leave feedback on iTunes, Stitcher, or wherever you get your podcasts.