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Hospital design promotes better healing
Sharp Memorial Hospital in San Diego, Calif.
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Tess Vigeland: We've all heard it: The most dangerous place to be if you're sick is the hospital. Every year thousands of patients are admitted for one problem and end up with another. According to the Centers for Disease Control, so-called hospital-acquired infections cost more than $30 billion every year. And it all adds up to more health care costs. Not to mention the added pain and suffering for patients.
As part of our ongoing coverage of health reform, "The Cure," Marketplace's Caitlan Carroll looks at how one hospital is tackling the problem by design.
CAITLAN CARROLL: I sink into an oversized chair with velvety pillows and contemplate the Japanese garden outside. Sunlight pours in through big windows. And as the sound of piano music starts up, I shake myself and think, "Wait, I'm in a hospital."
DAN GROSS: The two comments we often hear is it feels like Nordstrom's, or we feel like we're at the W Hotel.
Dan Gross is executive vice president of Sharp Healthcare. I meet up with him in the lobby for my tour of the swanky Sharp Memorial. Its a $200-million hospital in San Diego. And it's built with the principals of what's known as "evidence-based design."
GROSS: There's a lot of research today and a lot of conversation around how the design of a hospital really promotes comfort, healing and produces better quality outcomes for patients.
Better outcomes as in fewer medical errors, infections and injuries. That saves hospitals, patients and insurers a lot of money.
Gross points to a row of elevators to explain how the building design works.
GROSS: When we started designing our public transportation and our elevator system, we stole from the Disney concept of on-stage and off-stage work.
There are a separate set of elevators for the public to keep germs away from patients with weak immune systems. Nurses have private areas "off stage" where they can prepare medications uninterrupted, so there are fewer distractions and fewer mistakes.
As we get in the elevator to see the rooms, Gross tells me that patients are more relaxed, too.
GROSS: They're resting and sleeping more than they ever have before and the request for pain medications are decreasing.
Most hospitals are about as calm and relaxing as a busy airport.
But at Sharp the only noise you might hear is Dan Gross hushing some nurses as we get off the elevator.
GROSS: Shhhh. Good morning, ladies.
At Sharp, loud speakers are rarely used. There are no big carts rumbling down the hallways.
Nurse Carol DeVito says she had something to do with that. Staff members like her weighed in on the design changes.
CAROL DEVITO: Actually I said these are non-negotiable. Two things, very simple, one was a linen hamper in every room, and the second thing was that I asked that we have some kind of cabinet or cart.
That way there is less need to move things. It's quieter and germs can't hitchhike on equipment as it rolls from room to room.
GROSS: Here we are in one of our patient care rooms...
Dan Gross shows me the pull-out-couch for family members who want to spend the night. All the rooms are private. Heart surgeon Sam Baradarian says having a second patient in the room was distracting.
SAM BARADARIAN: There was just a lot of noise. There was a lot of interruptions.
Now the families can focus on the treatment plan. This can help patients get out of the hospital more quickly and stay well when they go home. So they spend less to get better.
BARADARIAN: It's just nice having a private room so you can speak candidly to the patients.
The single rooms, the extra nursing stations and additional medical gear can add millions of dollars to initial construction.
Blair Sadler is a senior fellow at the Institute for Healthcare Improvement. He says the investment pays off.
BLAIR SADLER: Well if something costs an additional million dollars once and reduces operating costs by half-a-million dollars year after year after year, the payback becomes pretty obvious.
Even small things like decorations can make a big difference.
Derek Parker is a hospital architect and a co-founder of the Center for Health Design. He worked on Packard Children's Hospital at Stanford.
DEREK PARKER: The artwork there, which is really museum quality, I discovered later it really isn't so much for the children as it is for the parents who wander the halls at night when the children are sleeping.
At Sharp, families have a comfortable place to get coffee, put their feet up and gaze out at the garden. Even the beds play lullabies to help patients forget for a moment that they're in a hospital. If that helps patients relax, heal and get out of the hospital faster, that's music to everyone's ears.
In San Diego, I'm Caitlan Carroll for Marketplace.
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What is good in the hospital premises are the structure and the building construction, the room arrangement, the requisites things which gives an overall better feeling of healing. Since medical costs have risen up due to the excessive changes in the reforms in the health sector the problems generally are occurring on the expenses in covering up these bills for the victims. The better the conditions may have a good effect on the correction of the body and living conditions too, but these arrangements could increase the bills or decrease it.
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I believe that most hospitals have embraced at least the basic concepts of comfort, safety and a warm environment for patients, visitors and staff. Many hospitals must do this within a constrained budget and cannot accomplish the full "swanky" presentation -- and other hospitals choose not to. The local demographics and hospital brand need to be carefully considered.
The story on Sharp Memorial Hospital is as impacting as the story of McAllen TX, the supposedly country's most expensive healthcare market, ofcourse in a good way though. If the statistics are proving to be true, hospitals such as Sharp Memorial can be one of the avenues to reduce healthcare costs while creating some jobs. I hope folks in Washington are listening...
@Martha Burke: The point is that hospitals are trying to be oriented towards human need: the need for control, the need for individual comfort, the need for social interaction and supports, and the need to connect with the natural world. These strategies all reduce stress which in turn, reduces pain and infection. People get well faster, and it's been shown to save costs in the final accounting.
My mother's recent stay at Sharp Memorial was her final hospital stay. We have not received the bill yet, but know what cost cutting measures helped reduce it, and they had nothing to do with the facility. They were the an Advanced Medical Directive that directed her discharge to home hospice care. It took a family meeting with hospital staff to convince them their desire to keep her for a month was contrary to her directive.
The hospitals in Sweden and France are not decorated lavishly with Zen decor and their clinical outcomes ie; hospital infection rates/mortality rates are superior to the United States. Another plus, they provide all citizens with healthcare.
I am unable to take the virtual tour of a patient room and have a question regarding the patient room ceiling light fixtures. Mission Hospital, in Mission Viejo Ca, recently added a new acute care tower with patient room lighting designed with the same goal in mind as Sharp. The recessed fluorescent ceiling lights over the beds have a holographic image, i.e with depth, of blue sky with clouds or overhanging trees, giving the illusion of a skylight. As one who has spent many hours/days counting the holes in the ceiling tiles in several hospitals, this design looks very soothing and comforting. Is this design included at Sharp?
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