Designing hospitals that promote staff well-being

Even before Covid-19, rates of behavioral illnesses were on the rise. In the third year of the pandemic, mental health has accelerated to become a crisis, with healthcare workers in particular facing high levels of stress and burnout. Although mask mandates have been lifted and restrictions eased in many areas, caregivers are still treating infected patients, while coping with the fallout of the past two years. This confluence of factors has led to an increase in mental health problems among health care workers, many of whom report experience record rates of anxiety and depression compared to the general population.

Previously, the design of clinical spaces for wellness was primarily patient-centric. From now on, taking care of patients is a table stake; caring for the people who serve them is crucial to creating and maintaining a successful hospital system.

Designing buildings for the well-being of carers is not only necessary to stem the mental health crisis within the profession. It is also essential to reinforce the financial fallout that ensues with high turnover, avoiding additional pressure on a system already taxed by financial losses due to delayed treatment during the pandemic.

During Covid, hospitals have seen increased turnover rates between employees, costing morale and the bottom line. According Becker Hospital Reviewin 2020, RN turnover rate increased 2.8 percentage points to 18.7% industry-wide. Every percentage point change translates to approximately $270,000 lost or saved per hospital.

These numbers have prompted hospitals to rethink their approach to the physical environment and incorporate research-based design strategies that improve the well-being of patients and staff guiding their recovery. Below, we outline three lessons for designing hospitals and clinics based on the current projects NBBJ is working on with Massachusetts General Hospital, Atrium Health, Loma Linda University Medical Center, and Montage Health.

Lesson 1: Employee mental health can be part of a building’s identity.

Massachusetts General Hospital (MGH) in Boston is currently building a 482-bed expansion called Cambridge Street that focuses on staff and patient satisfaction, operational efficiency and environmental stewardship. Several years ago, NBBJ also oversaw the creation of MGH’s 150-bed Lunder building. Both installations offer key insights into how seemingly simple design interventions can have a significant impact on the mental well-being of staff members.

It is important to note that what we recommend are not amenities, although some may call them that. Rather than focusing on the “nice-to-have” perks found in the tech company’s headquarters, many of the spaces in the MGH facility are “must-haves” given that lives are at stake: cages of light-flooded staircases, deliberately quiet patient floors and safer spaces. working conditions, for example.

The Lunder Building provides abundant access to daylight through a glazed stairwell used only by staff, who have adopted the hallway as their de facto meeting space (dubbed the “staircase conference room”). Staff also use this stairwell as a place to “be alone together” and report finding comfort in watching employees walk through the stairwell as they use the space to reflect and decompress.

The building further expands staff exposure to daylight — that impacts work-related stress and job satisfaction and affects clinician burnout — by corridors allowing staff to access the rooms from an exterior wall. Since less noise can reduce caregiver stress and also helping patients recover from illness, the Lunder building uses a variety of sound-absorbing materials and techniques to make patient floors 35% quieter than typical healthcare buildings. Other features designed to minimize noise include sliding doors, distribution of work areas for clinical staff on the floor rather than in one place, and elevators and visitor waiting areas located away from patient rooms.

Finally, personnel safety is perhaps the most critical “convenience” of all. For example, overuse – in the form of repetitive routine physical tasks such as bending, stretching and standing – accounts for 45.6% of all injuries suffered by nurses, according to a 2018 study. article published by the United States Bureau of Labor Statistics. These injuries can lead to musculoskeletal conditions such as sprains and strains which accounted for 8,730 days lost from work among private sector nurses in 2016. Features such as motorized overhead patient lifts or glass doors height that provide better situational awareness can help reduce injuries.

Designing buildings this way makes a difference. For example, post-occupancy data from the new inpatient units and NBBJ staff work areas designed for Atrium Health indicate that the vast majority of employees feel safer and more comfortable at work. In the same post-occupancy evaluation, employees cited “the collaborative nature of the research floor”, “increased interaction with colleagues” and “improved team collaboration” as positive aspects of the new building, further illustrating that opportunities for collaboration and interaction are improving. employee satisfaction.

Lesson 2: Design features can reduce stress in key workspaces.

Many hospitals are embracing support spaces that allow people to choose how they spend their precious break time. These spaces, both “off-stage” (where staff can congregate or be alone) and “on-stage” (where caregivers see patients), allow staff to spend less time navigating a building and more time to unwind.

Loma Linda University Medical Center Expansion in Southern California boasts an open-core design. It features wide hallways, access to daylight, and the distribution of patient rooms and supplies along the wings, allowing staff to better connect with each other and with patients. In open-core hospitals, major support functions such as staff lockers, break rooms, and conference rooms reside in a centralized hub that connects to patient wings along the exterior. This arrangement reduces the need for staff to move between patient rooms and supply rooms, the type of inefficient and repetitive physical tasks that can lead to burnout.

In addition to open-core designs, collaborative clinician rooms – such as the MGH’s new Cambridge Street project examination rooms, which are sized to allow for multidisciplinary consultations – reflect the evolving nature of medicine. Collaborative clinician spaces reduce the burden on caregivers and their teams while providing patients with a new, more efficient way to navigate their medical journey.

In the future, these recharging spaces could take different forms, recognizing that everyone refuels in a different way. For instance, because the availability of private spaces It has been shown to reduce caregiver stress. Some hospitals are exploring restorative areas with nap areas for their staff that would be located close to the patient unit for ease of use.

Lesson 3: Good design is ultimately good for business.

Health systems such as Montage Health on the Monterey Peninsula are taking advantage of their less densely populated location by integrating nature into the design of their buildings. For instance, Ohana Assembly Center the garden-like environment and private patios for staff are designed to reduce levels of arousal fatigue – the psychological exhaustion that results from sustained stimulation without a break. Arousal fatigue is one of the main factors contributing to burnout in behavioral health care providers, who have an annual turnover rate of 40%.

Other organizations are exploring solutions such as satellite food lockers, mobile ordering apps, and meal programs that offer discounts on nutritious food options. These types of design interventions are investments in staff longevity; they help reduce stress and encourage positive lifestyle choices, thereby promoting the mental and physical well-being of those tasked with helping others recover.

Behavioral health issues existed before the pandemic and will persist after it is over. Therefore, as healthcare systems grapple with the lingering effects of the pandemic, it is more important than ever that they shift to a more caregiver-centric mindset. Only by creating spaces and implementing solutions that support both staff wellness and patient healing can they effectively retain and recruit staff and reduce the financial impact of burnout and turnover. Designing buildings to improve employee well-being will help keep them satisfied and productive.

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