September 2022
Tool

Overview

Two goals are often at the center of current care models for behavioral and mental health: safety and healing. Most recently, the design of in-patient rooms for behavioral and mental health has focused on safety for both patients and staff through checklists for ligature-resistance. While safety is always a driver, we shouldn’t lose a strong emphasis on healing for this specialized care.

Each organization will need to balance priorities and evaluate risk to establish an appropriate solution to meet specific performance standards and address anticipated patient acuity. Generally, the evidence base for design of behavioral and mental health in-patient rooms focuses on deinstitutionalized design aesthetic that provides a sense of being both welcoming and safe.

In these diagrams, strategies that are focused solely on safety are indicated as such with an S

Click on one of the dots or the thumbnails below to learn more

  • Landscaping

    Desirable Outcome
    Layout (Overall); Space Configuration
    Design Strategies
    • Room for mindfulness activities (e.g., yoga, meditation, etc.) citation
    Desirable Outcome
    Caregiver health/support/respite
    Design Strategies
    • View to nature/natural landscapes citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    • View to nature/natural landscapes citation
    • Outdoor spaces and views of nature citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    • Outdoor spaces and views of nature citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    Desirable Outcome
    Improved patient healthy behaviors
    Design Strategies
    • Room for mindfulness activities (e.g., yoga, meditation, etc.) citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • View to nature/natural landscapes citation
    Desirable Outcome
    Safety; air quality
    Design Strategies
  • Handrail

    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Improved access/wayfinding
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid handrails citation
    • Anti-ligature items (e.g., safe sliding doors, continuous grab bars) and eliminate ligature points (e.g., standard doors, showerheads, bathroom fixtures, etc.) S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
  • Layout (Overall); Space Configuration

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Ligature-resistant tactics (e.g., eliminate grab bars, fixture pipes, door hinges, etc.) S citation
    • The design should reflect the organization’s goals (e.g., population, rehabilitation, funding, risk tolerance, etc.) citation
    • Maximize therapeutic design potential by involving diverse groups of stakeholders citation
    • Organization’s risk tolerance effects design (e.g., safest possible setting, home-like ambience, upgraded finishes, etc.) citation
    • Weigh the benefits of uniform features against differing patient requirements citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Well-organized, orderly spaces citation
    • Symbolic meaning and messages reinforce treatment goals and expectations citation
    • Maximize therapeutic design potential by involving diverse groups of stakeholders citation
    • Provide opportunities for social interaction citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Ligature-resistant tactics (e.g., eliminate grab bars, fixture pipes, door hinges, etc.) S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Improved access/wayfinding
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Space needed for additional staff when required to accompany a patient citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Caregiver health/support/respite
    Design Strategies
    • Maximize daylight and nature within shared and private spaces citation
    • Staff zones support performing routines in a professional and respectful manner citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Clear/consistent line of sight throughout the entire room (e.g., no blind corners or hiding places; first means of egress, etc.) citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Staff-patient consulting areas citation
    Desirable Outcome
    Communication; staff to staff
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Well-organized, orderly spaces citation
    • Weigh the benefits of uniform features against differing patient requirements citation
    • Indoor therapy (PT, OT, music, etc.) citation
    • Staff zones support performing routines in a professional and respectful manner citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Space needed for additional staff when required to accompany a patient citation
    • Ligature-resistant tactics (e.g., eliminate grab bars, fixture pipes, door hinges, etc.) S citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Staff zones support performing routines in a professional and respectful manner citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Symbolic meaning and messages reinforce treatment goals and expectations citation
    • Staff zones support performing routines in a professional and respectful manner citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Personal bathrooms dependent on patient acuity (shared bathrooms may be appropriate for higher acuity patients) citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Reasonable accommodations for service animal citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Well-organized, orderly spaces citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Separate and secure women and vulnerable patient bedrooms from men and provide view from nursing station citation
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    Minimize undue strain during recovery
    Design Strategies
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Well-organized, orderly spaces citation
    • Access to options for acoustics citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Weigh the benefits of uniform features against differing patient requirements citation
    • Staff zones support performing routines in a professional and respectful manner citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Personal bathrooms dependent on patient acuity (shared bathrooms may be appropriate for higher acuity patients) citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Reasonable accommodations for service animal citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Well-maintained high-quality features and environment citation
    • Well-organized, orderly spaces citation
    • Opportunities to personalize the room citation
    • Symbolic meaning and messages reinforce treatment goals and expectations citation
    • Staff zones support performing routines in a professional and respectful manner citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Personal bathrooms dependent on patient acuity (shared bathrooms may be appropriate for higher acuity patients) citation
    • Reasonable accommodations for service animal citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Maximize therapeutic design potential by involving diverse groups of stakeholders citation
    • Separate and secure women and vulnerable patient bedrooms from men and provide view from nursing station citation
    • Maximize daylight and nature within shared and private spaces citation
    • Staff zones support performing routines in a professional and respectful manner citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Reasonable accommodations for service animal citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Improved patient engagement
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Maximize therapeutic design potential by involving diverse groups of stakeholders citation
    Desirable Outcome
    Improved family presence and engagement in patient care
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    Desirable Outcome
    Enhanced privacy
    Design Strategies
    • Personal bathrooms dependent on patient acuity (shared bathrooms may be appropriate for higher acuity patients) citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    Desirable Outcome
    Improved patient healthy behaviors
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • No access to roofs or high places, open stairs, screen porches or elevator shafts citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Well-maintained high-quality features and environment citation
    • Room for mindfulness activities (e.g., yoga, meditation, etc.) citation
    • Indoor therapy (PT, OT, music, etc.) citation
    Desirable Outcome
    Improved sleep quality
    Design Strategies
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Reduced risk of contamination
    Design Strategies
    • Personal bathrooms dependent on patient acuity (shared bathrooms may be appropriate for higher acuity patients) citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • No access to roofs or high places, open stairs, screen porches or elevator shafts citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Location of room should limit or provide no access to uncontrolled exits S citation
    • Features supportive of social interaction, onlooker observation and physical retreat citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • No access to roofs or high places, open stairs, screen porches or elevator shafts citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Private and/or large shared rooms based on patient acuity/diagnoses and model of care citation
    • Space needed for additional staff when required to accompany a patient citation
    • Location of room should limit or provide no access to uncontrolled exits S citation
    • Features supportive of social interaction, onlooker observation and physical retreat citation
    • Clear/consistent line of sight throughout the entire room (e.g., no blind corners or hiding places; first means of egress, etc.) citation
    • Consider outboard toilet for staff visibility citation
    • Ligature-resistant tactics (e.g., eliminate grab bars, fixture pipes, door hinges, etc.) S citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • No drop ceilings citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • The design should reflect the organization’s goals (e.g., population, rehabilitation, funding, risk tolerance, etc.) citation
    • Maximize therapeutic design potential by involving diverse groups of stakeholders citation
    • Organization’s risk tolerance effects design (e.g., safety first, residential ambience, hospitality finishes, etc.) citation
    • Weigh the benefits of uniform features against differing patient requirements citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Well-maintained high-quality features and environment citation
  • Layout-Caregiver/ Clinical Staff Zone

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Caregiver health/ support/respite
    Design Strategies
    • Staff zones support performing routines in a professional and respectful manner citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Clearly define staff zones (e.g., charting, hand-washing, storage, sitters, etc.) citation
    • Promote surveillance and first means of egress from charting and observation spaces citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • Staff-patient consulting areas citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Staff zones support performing routines in a professional and respectful manner citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Maximum of two adult patients per bedroom depending upon preference and population characteristics citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Staff zones support performing routines in a professional and respectful manner citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Staff zones support performing routines in a professional and respectful manner citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Staff zones support performing routines in a professional and respectful manner citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Staff zones support performing routines in a professional and respectful manner citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Staff zones support performing routines in a professional and respectful manner citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved patient engagement
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Clearly define staff zones (e.g., charting, hand-washing, storage, sitters, etc.) citation
    • Maximum of two adult patients per bedroom depending upon preference and population characteristics citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
  • Layout-Patient Zone

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Acuity-adaptable rooms to accommodate medical and behavioral comorbidities to reduce transfers and errors citation
    • Customize design to fit patent’s needs citation
    • Private bedrooms citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Well-organized, maintained, and orderly spaces citation
    • Continuous “chaise longue” sloped angle surface between top of 18-inch bench and a 27-inch desk citation
    • Doorless storage cubbies for clothing and personal items citation
    • Movable furniture that increases control without sacrificing safety citation
    • Therapeutic furniture that patients can rock slightly (e.g., ottoman) citation
    • Safe features in patient toilets (e.g., solid-surface countertops, integral sinks, ligature-resistant faucets, recessed cabinet pulls, and securely locked doors that enclose under-counter pipes) S citation
    • Access to daylight citation
    • Patient control citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Bedroom personalization with patient’s items (e.g., photos, gifts, bedding, etc.) citation
    • Maximize the number of single-occupancy patient rooms and bathrooms citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Space for additional staff when required to accompany a patient citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Easy and quick visibility without hidden corners or clutter citation
    Desirable Outcome
    Caregiver health/ support/respite
    Design Strategies
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Curved angles and concealed, pull-out equipment and furniture citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Communication; staff to staff
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Well-organized, maintained, and orderly spaces citation
    • Clearance of 6 feet in toilet room for inclusive accommodation of all patient populations and staff assistance citation
    • Private toilet accessible from patient room without transitioning through a corridor citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Space for additional staff when required to accompany a patient citation
    • ADA-compliant bedroom and bathroom citation
    • Ligature-free furniture and fixtures S citation
    • Bi-directional swinging doors citation
    • Sliding doors should have stainless-steel recessed pull and concealed track citation
    • Continuous “chaise longue” sloped angle surface between top of 18-inch bench and a 27-inch desk citation
    • Doorless storage cubbies for clothing and personal items citation
    • Movable furniture that increases control without sacrificing safety citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Light fixtures with substantial lenses securely anchored in place and frames secured with tamper-resistant screws citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Easy and quick visibility without hidden corners or clutter citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in furniture that maximizes safety and minimizes institutional aesthetics citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Single-patient rooms and toilets for those with medical and behavioral comorbidities citation
    • Curved surfaces (e.g., walls, casework, counters, etc.) to minimize dust and debris citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Well-organized, maintained, and orderly spaces citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Bed positioned for direct view out window citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Maximize daylight and nature within shared and private spaces citation
    • Places for withdrawal and reflection citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Well-organized, maintained, and orderly spaces citation
    • Continuous “chaise longue” sloped angle surface between top of 18-inch bench and a 27-inch desk citation
    • Doorless storage cubbies for clothing and personal items citation
    • Movable furniture that increases control without sacrificing safety citation
    • Therapeutic furniture that patients can rock slightly (e.g., ottoman) citation
    • Patient control citation
    • Affordances for autonomy/spontaneity citation
    • Places for withdrawal and reflection citation
    • Bedroom personalization with patient’s items (e.g., photos, gifts, bedding, etc.) citation
    • Maximize the number of single-occupancy patient rooms and bathrooms citation
    • Built-in furniture that maximizes safety and minimizes institutional aesthetics citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Acuity-adaptable rooms to accommodate medical and behavioral comorbidities to reduce transfers and errors citation
    • Access to daylight citation
    • Patient control citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Well-organized, maintained, and orderly spaces citation
    • Single-patient rooms and toilets for those with medical and behavioral comorbidities citation
    • Curved surfaces (e.g., walls, casework, counters, etc.) to minimize dust and debris citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Bed positioned for direct view out window citation
    • Customize design to fit patent’s needs citation
    • Maximize daylight and nature within shared and private spaces citation
    • Patient control citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Bedroom personalization with patient’s items (e.g., photos, gifts, bedding, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Maximize the number of single-occupancy patient rooms and bathrooms citation
    • Areas for reflection or spiritual practices citation
    Desirable Outcome
    Improved patient engagement
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Private bedrooms or non-dormitory style occupancy citation
    Desirable Outcome
    Improved family presence and engagement in patient care
    Design Strategies
    • Places for withdrawal and reflection citation
    • Maximize the number of single-occupancy patient rooms and bathrooms citation
    Desirable Outcome
    Improved patient healthy behaviors
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Room for mindfulness activities (e.g., yoga, meditation, etc.) citation
    Desirable Outcome
    Improved sleep quality
    Design Strategies
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Safety; medication safety
    Design Strategies
    • Acuity-adaptable rooms to accommodate medical and behavioral comorbidities to reduce transfers and errors citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Features supportive of social interaction, onlooker observation and physical retreat citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Space for additional staff when required to accompany a patient citation
    • Features supportive of social interaction, onlooker observation and physical retreat citation
    • Curved angles and concealed, pull-out equipment and furniture citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Ligature-free or resistant transitions between patient rooms and bathrooms S citation
    • ADA-compliant bedroom and bathroom citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Private toilet accessible from patient room without transitioning through a corridor citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Acuity-adaptable rooms to accommodate medical and behavioral comorbidities to reduce transfers and errors citation
    • Safely accommodate visitors with secure storage outside patient room and first egress access from inside patient room citation
    • Easy and quick visibility without hidden corners or clutter citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in furniture that maximizes safety and minimizes institutional aesthetics citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
  • Layout-Family Zone

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Visiting areas in the room should be visible and easily accessible by staff citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Visiting areas in the room should support family participation citation
    Desirable Outcome
    Improved patient engagement
    Design Strategies
    • Visiting areas in the room should support family participation citation
    Desirable Outcome
    Improved family presence and engagement in patient care
    Design Strategies
    • Provide lockers where families can lock up belongings prior to entering patient areas citation
    • Dedicated family zone located near door for first egress citation
    • Design visiting areas for privacy citation
    Desirable Outcome
    Enhanced privacy
    Design Strategies
    • Design visiting areas for privacy citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Provide lockers where families can lock up belongings prior to entering patient areas citation
    • Dedicated family zone located near door for first egress citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
  • Privacy Curtain/ Screen/Barrier

    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Features supportive of social interaction, onlooker observation and physical retreat citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid materials that are breakable, toxic, flame retardant, or can cause suffocation S citation
    • Features supportive of social interaction, onlooker observation and physical retreat citation
  • Sound-Masking Equipment

    Desirable Outcome
    Improved access/ wayfinding
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • High performance sound-absorbing ceiling citation
    • High performance sound-absorbing floor citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • High performance sound-absorbing ceiling citation
    • High performance sound-absorbing floor citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • White noise generator with patient-controlled volume to curb unwanted noise citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • High performance sound-absorbing ceiling citation
    • High performance sound-absorbing floor citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Enhanced privacy
    Design Strategies
    • High performance sound-absorbing ceiling citation
    • High performance sound-absorbing floor citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • High performance sound-absorbing ceiling citation
    • High performance sound-absorbing floor citation
    • White noise generator with patient-controlled volume to curb unwanted noise citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid materials that are breakable, toxic, flame retardant, or can cause suffocation S citation
  • Flooring

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Secured, homelike, non-breakable artwork, marker board, etc. citation
    • Wood grain pattern sheet vinyl flooring and molding profile rubber base citation
    • Durable secured non-glare flooring material citation
    • Attractive aesthetic space citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved access/ wayfinding
    Design Strategies
    • Differentiate areas through color, lighting, carpeting, wall graphics, and furnishings citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • High performance sound-absorbing floor citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • High performance sound-absorbing floor citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • High performance sound-absorbing floor citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Attractive aesthetic space citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Enhanced privacy
    Design Strategies
    • High performance sound-absorbing floor citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • High performance sound-absorbing floor citation
    • Avoid highly reverberant spaces citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid highly polished floors or other reflecting surfaces because of glare citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Anchored furnishings and accessories without openings or sharp edges citation
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Avoid highly polished floors or other reflecting surfaces because of glare citation
    • Secured, homelike, non-breakable artwork, marker board, etc. citation
    • Slip resistant 2” x 2” [50.8 mm x 50.8 mm] ceramic tile for bathroom floor and slope-to-drain shower, but not for the walls citation
    • Shower and bathroom floor drains for slab depressions of 2” [50.8 mm] or less; slope length of bathroom floor to shower drain for depressions 4” [101.6 mm] or greater citation
    • Durable secured non-glare flooring material citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Slip resistant 2” x 2” [50.8 mm x 50.8 mm] ceramic tile for bathroom floor and slope-to-drain shower, but not for the walls citation
    • Durable secured non-glare flooring material citation
  • Walls

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize Stigma
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid “institutional colors” (i.e., “institutional green”) citation
    • Minimize “safe” design features citation
    • Recessed, wall-mounted screens with nature scenes supplement window views citation
    • Secured, homelike, non-breakable artwork, marker board, etc. citation
    • Secure trim, headboards and soothing colors contribute to the residential feel citation
    • Painted gypsum board for walls with at least one soothing warm color accent wall or wood grain texture wainscot panels citation
    • Attractive aesthetic space citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved access/ wayfinding
    Design Strategies
    • Differentiate areas through color, lighting, carpeting, wall graphics, and furnishings citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Mirrors made of stainless steel, acrylic, unbreakable glass, or polycarbonate citation
    • Affix finishes, molding, and other interior details to limit contraband hiding spaces citation
    • Artwork installation prevents hazards (e.g., non-breakable frame/covering, secured with tamper-resistant fasteners) citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Nature art and prints citation
    • Discreet security features that reinforce safety without compromising experience citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Patient-based color selection (e.g., typically avoid monochromatic/blands and trendy/pastels, overstimulating bright colors, depressing blue-greens, and white/gray in seclusion rooms, etc.) citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Access to options for acoustics citation
    • Ligature-free bed with multiple locations and orientations along headwall(s) S citation
    • Patient selected artwork using wall-mounted screens with preselected images citation
    • Curb noise and promote auditory control (e.g., sound-absorbing plaster, patient-controlled white noise generator, etc.) citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Nature art and prints citation
    • Discreet security features that reinforce safety without compromising experience citation
    • Opportunities to personalize the room citation
    • Artwork installation prevents hazards (e.g., non-breakable frame/covering, secured with tamper-resistant fasteners) citation
    • Avoid “institutional colors” (i.e., “institutional green”) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Minimize “safe” design features citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Patient-based color selection (e.g., typically avoid monochromatic/blands and trendy/pastels, overstimulating bright colors, depressing blue-greens, and white/gray in seclusion rooms, etc.) citation
    • Attractive aesthetic space citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Marker Boards for care and team information should be securely attached citation
    Desirable Outcome
    Improved patient healthy behaviors
    Design Strategies
    • Art depicting realistic social engagement citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • Nature art and prints citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • Curb noise with durable sound-absorbing plaster wall and ceiling finish systems citation
    • Avoid highly reverberant spaces citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Durable gypsum board walls with metal studs extending to structure above and sound attenuation features (e.g., batt insulation and least penetrations.) citation
    • Good acoustical control citation
    • Curb noise and promote auditory control (e.g., sound-absorbing plaster, patient-controlled white noise generator, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid clothes hooks S citation
    • Avoid curtain rods S citation
    • Avoid handrails S citation
    • Ligature resistant shelves S citation
    • Ligature resistant towel racks S citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points citation
    • Avoid objects, fixtures, and furniture which might be used as weapons citation
    • Avoid clothes hooks S citation
    • Avoid curtain rods S citation
    • Avoid handrails S citation
    • Ligature resistant shelves S citation
    • Ligature resistant towel racks S citation
    • Avoid materials that are breakable, toxic, flame retardant, or can cause suffocation S citation
    • Mirrors made of stainless steel, acrylic, unbreakable glass, or polycarbonate citation
    • Affix finishes, molding, and other interior details to limit contraband hiding spaces citation
    • Artwork installation prevents hazards (e.g., non-breakable frame/covering, secured with tamper-resistant fasteners) citation
    • Alternative to wall-mounted alcohol-based hand rub (ABHR) dispensers citation
    • Alternative to non-recessed life safety devices (e.g., chimes, strobes, pull station, smoke detectors, sprinkler heads, fire extinguishers, hose cabinets, etc.) citation
    • Alternative to wall-mounted equipment (e.g., medical devices, television, etc.) citation
    • Wall mounted items should avoid glass, protruding edges, or exposed corners citation
    • Alternative to non-recessed monitoring, communication, and access equipment (e.g., speakers, cameras, phone, access card readers, wireless access points, etc.) citation
    • Cover plates and receptacles free from protruding edges, exposed corners, and screws that can be tampered with citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Signage should be secured to structure citation
    • Recessed, wall-mounted screens with nature scenes supplement window views citation
    • Curb noise with durable sound-absorbing plaster wall and ceiling finish systems citation
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Secured, homelike, non-breakable artwork, marker board, etc. citation
    • Marker Boards for care and team information should be securely attached citation
    • Wall-mounted ligature-resistant over-bed lighting with high strength acrylic lenses (not correctional type) securely fastened to the wall with tamper resistant screws S citation
    • Clothing or towel hooks should be designed to collapse when any weight above 4 lbs [1.81 kg] is applied citation
    • Paper towel dispensers in patient bathrooms should be recessed citation
    • Soap dispensers should be wall-mounted with sloped tops to prevent anchor points citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Ligature-free bed with multiple locations and orientations along headwall(s) S citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Affix finishes, molding, and other interior details to limit contraband hiding spaces citation
    • Durable gypsum board walls with metal studs extending to structure above and sound attenuation features (e.g., batt insulation and least penetrations.) citation
  • Ceiling

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize Stigma
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Attractive aesthetic space citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Limited-access ceilings for required utility servicing citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Affix finishes, molding, and other interior details to limit contraband hiding spaces citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • High performance sound-absorbing ceiling citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • High performance sound-absorbing ceiling citation
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Access to options for acoustics citation
    • Curb noise and promote auditory control (e.g., sound-absorbing plaster, patient-controlled white noise generator, etc.) citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • High performance sound-absorbing ceiling citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Attractive aesthetic space citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved patient engagement
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Enhanced privacy
    Design Strategies
    • High performance sound-absorbing ceiling citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • High performance sound-absorbing ceiling citation
    • Curb noise with durable sound-absorbing plaster wall and ceiling finish systems citation
    • Avoid highly reverberant spaces citation
    • Good acoustical control citation
    • Curb noise and promote auditory control (e.g., sound-absorbing plaster, patient-controlled white noise generator, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Ligature resistant fire sprinklers S citation
    • Ligature resistant ceiling lights S citation
    • No exposed pipes, sprinkler heads, light fixtures, vents, or ducts citation
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Ligature resistant fire sprinklers S citation
    • Ligature resistant ceiling lights S citation
    • No exposed pipes, sprinkler heads, light fixtures, vents, or ducts citation
    • Required safety/security features are concealed or as discreet as possible citation
    • High ceilings citation
    • Collapsible curtain rails citation
    • Monolithic ceiling surface to restrict ceiling space access S citation
    • Avoid materials that are breakable, toxic, flame retardant, or can cause suffocation S citation
    • Affix finishes, molding, and other interior details to limit contraband hiding spaces citation
    • Alternative to non-recessed life safety devices (e.g., chimes, strobes, pull station, smoke detectors, sprinkler heads, fire extinguishers, hose cabinets, etc.) citation
    • Alternative to non-recessed monitoring, communication, and access equipment (e.g., speakers, cameras, phone, access card readers, wireless access points, etc.) citation
    • Use alternative to suspended ceiling citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Use solid ceilings in patient rooms and bathrooms citation
    • No drop ceilings citation
    • Limited-access ceilings for required utility servicing citation
    • Use anti-ligature and vandal resistant lighting, ceiling systems and sprinklers S citation
    • Fire Alarm (e.g., strobes, horns, etc.) should be ceiling mounted or “hooded” S citation
    • Curb noise with durable sound-absorbing plaster wall and ceiling finish systems citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Ceiling-mounted patient lifts should not be installed in patient rooms S citation
    • Sprinklers should be vandal-resistant and not able to be used as an anchor point S citation
    • Gypsum board or other inaccessible and durable ceiling system with tamper resistant fixtures and features citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Affix finishes, molding, and other interior details to limit contraband hiding spaces citation
  • Windows

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Provide exterior window to access daylight citation
    • Patient control of light, views, and privacy using windows with integral blinds citation
    • Windows that open to 4-inches citation
    • Window mini-blinds should be behind security glazing without stainless steel screens, exposed cords, chains, or wands citation
    • Avoid using correctional-style view panels in patient room doors citation
    • Maximize daylight and nature within shared and private spaces citation
    • Large windows and niches that serve as shelves to store or display personal items citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved access/ wayfinding
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Unbreakable glass in windows citation
    Desirable Outcome
    Caregiver health/ support/respite
    Design Strategies
    • View to nature/natural landscapes citation
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Unbreakable glass in windows citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Clear/consistent line of sight throughout the entire room (e.g., no blind corners or hiding places; first means of egress, etc.) citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Multiple, Large, low windows with laminated safety glass citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Multiple, Large, low windows with laminated safety glass citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • View to nature/natural landscapes citation
    • Discreet security features that reinforce safety without compromising experience citation
    • Provide exterior window to access daylight citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Multiple, Large, low windows with laminated safety glass citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Maximize daylight and nature within shared and private spaces citation
    • Outdoor spaces and views of nature citation
    • Good daylight citation
    • Windows should have integral blinds and be operable to a maximum of 4” citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Windows with controlled operability (i.e., sash openings limited to 4” or less) citation
    • Window shades between glass that are cordless, remotely controlled or restricted S citation
    • Patient control of light, views, and privacy using windows with integral blinds citation
    • Windows that open to 4-inches citation
    • Large windows and niches that serve as shelves to store or display personal items citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Large, low windows citation
    • Fresh air, good ventilation, and neutral odors is recommended citation
    • Multiple, Large, low windows with laminated safety glass citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Maximize daylight and nature within shared and private spaces citation
    • Outdoor spaces and views of nature citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • View to nature/natural landscapes citation
    • Discreet security features that reinforce safety without compromising experience citation
    • Bed oriented for direct view through window with consideration for size, sill height, daylight control, privacy, etc. citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Large, low windows citation
    • Provide exterior window to access daylight citation
    • Positive distractions (e.g., outdoor views, art, television, information wall, etc.) citation
    • Maximize daylight and nature within shared and private spaces citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Large, low windows citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Ample natural daylight citation
    • Multiple, Large, low windows with laminated safety glass citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Enhanced privacy
    Design Strategies
    • Avoid using correctional-style view panels in patient room doors citation
    • Windows should have integral blinds and be operable to a maximum of 4” citation
    Desirable Outcome
    Improved sleep quality
    Design Strategies
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • View to nature/natural landscapes citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid curtain rods S citation
    • Unbreakable glass in windows citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    • Maximize daylight and nature within shared and private spaces citation
    Desirable Outcome
    Safety; air quality
    Design Strategies
    • Fresh air, good ventilation, and neutral odors is recommended citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid curtain rods S citation
    • Unbreakable glass in windows citation
    • Window shades between glass that are cordless, remotely controlled or restricted S citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid curtain rods citation
    • Unbreakable glass in windows citation
    • Window shades between glass that are cordless, remotely controlled or restricted S citation
    • Use an alternative to non-institutional window hardware and treatments S citation
    • Clear/consistent line of sight throughout the entire room (e.g., no blind corners or hiding places; first means of egress, etc.) citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Use windows that prevent elopement citation
    • Use secure window/glazing with limited-access patient operation citation
    • Patient control of light, views, and privacy using windows with integral blinds citation
    • Windows that open to 4-inches citation
    • Multiple, Large, low windows with laminated safety glass citation
    • Use shatterproof windows with breakaway curtain rods S citation
    • Shard/shatter proof windows and safe treatments (e.g., no curtains, drapes, or vertical blinds) citation
    • Window mini-blinds should be behind security glazing without stainless steel screens, exposed cords, chains, or wands citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Exterior windows should have integral blinds and laminated glass on interior face citation
    • Heavy gauge commercial strength windows with insulated double glazing and other safety features (e.g., custodial locks, integral blinds, laminated glass, 4” maximum opening, etc.) S citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Windows should have integral blinds and be operable to a maximum of 4” citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Unbreakable glass in windows citation
  • Doors

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Minimize “safe” design features citation
    • Warm light gray paint with cool blue accent wall, woodgrain built-in’s and doors, solid surfaces, stainless steel fixtures and hardware citation
    • Sliding bathroom doors (not pocket) with a wall-inset top sliding track and a receiving wall on the patient room side citation
    • Stained wood doors are strongly recommended over hollow metal doors for their aesthetic appeal citation
    • Avoid using correctional-style view panels in patient room doors citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Non-protruding wing doorknobs that do not allow patient to maintain grasp to prohibit staff from entering the room citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Retrofit inward-opening doors with Wicket door-within-a-door systems citation
    • Doors should open out to facilitate emergency access citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • All lockable patient doors allow emergency access citation
    • Eliminate doors entirely if patient privacy can be maintained citation
    • Eliminate doors with hold-open devices and self-closers citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Doors open in both directions citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Communication; staff to staff
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Doors should swing out to prevent barricading or blocking room access citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Bi-directional swinging doors citation
    • Sliding doors should have stainless-steel recessed pull and concealed track citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Doors should swing out to prevent barricading or blocking room access citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Minimize “safe” design features citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced privacy
    Design Strategies
    • Solid core wood door citation
    • Avoid using correctional-style view panels in patient room doors citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Non-protruding wing doorknobs that do not allow patient to maintain grasp to prohibit staff from entering the room citation
    • Ligature resistant door hinges (e.g., continuous “piano” style that extend from top to bottom) S citation
    • Doors open in both directions citation
    • Door closing devices, if used, should be on the public-facing side of the door citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Non-protruding wing doorknobs that do not allow patient to maintain grasp to prohibit staff from entering the room citation
    • Ligature resistant door hinges (e.g., continuous “piano” style that extend from top to bottom) S citation
    • Doors open in both directions citation
    • All lockable patient doors allow emergency access citation
    • Ligature resisent bathroom door S citation
    • Eliminate doors entirely if patient privacy can be maintained citation
    • Eliminate doors with hold-open devices and self-closers citation
    • Door closing devices, if used, should be on the public-facing side of the door citation
    • Alternative to non-institutional door closure, hardware and hinges citation
    • Cut top of doors (e.g., avoid anchor point when closed against frame) citation
    • Anti-ligature items and elimination of ligature points (e.g., patient-safe sliding doors, continuous grab bars, standard doors, bathroom fixtures, etc.) S citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Use ligature-resistant door hardware (e.g., hinges, handles and locks) S citation
    • Retrofit inward-opening doors with Wicket door-within-a-door systems citation
    • Doors should open out to facilitate emergency access citation
    • Anti-ligature bathroom doors that lower to 45-degree angle with pressure on top S citation
    • Continuous tamper-resistant door hinges citation
    • Exit door locks meets OBC/LSC criteria citation
    • Bi-directional swinging doors citation
    • Sliding doors should have stainless-steel recessed pull and concealed track citation
    • Warm light gray paint with cool blue accent wall, woodgrain built-in’s and doors, solid surfaces, stainless steel fixtures and hardware citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Avoid door swing conflicts (e.g., inward-swinging door from corridor and an outward-swinging bathroom door) citation
    • Doors should swing out to prevent barricading or blocking room access citation
    • Ligature-resistant doors and hardware (e.g., closed-door clearances, continuous geared hinges, knobs, levers, pulls, deadbolts, classroom-function lock sets, tapered door tops, etc.) S citation
    • Bathroom doors with pressure sensitive alarm at door head, continuous hinge and anti-ligature lever with magnetic latch S citation
    • Bedroom doors should have anti-ligature hardware and continuous out-swinging hinges to prevent barricading S citation
    • Bathroom doors with continuous hinges open outward with door-top pressure sensitive alarms or sloped top and anchor-point resistant hardware citation
    • Sliding bathroom doors (not pocket) with a wall-inset top sliding track and a receiving wall on the patient room side citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Solid core wood door citation
    • Interior doors should be 1¾” [44 mm] thick, solid-core, flush-panel wood doors in hollow metal frames citation
  • HVAC

    Desirable Outcome
    Improved access/ wayfinding
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Temperature controls allow for heating and cooling per patient preference citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Temperature controls allow for heating and cooling per patient preference citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Patient lighting and temperature control citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Fresh air, good ventilation, and neutral odors is recommended citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Temperature controls allow for heating and cooling per patient preference citation
    • Patient lighting and temperature control citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Temperature controls allow for heating and cooling per patient preference citation
    • High-quality air filtration systems citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • Avoid ligature points S citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Safety; air quality
    Design Strategies
    • High-quality air filtration systems citation
    • Fresh air, good ventilation, and neutral odors is recommended citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Serviceable components of HVAC terminal devices and covers, thermostats, vents, and grilles should be located outside room S citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid ligature points S citation
    • Serviceable components of HVAC terminal devices and covers, thermostats, vents, and grilles should be located outside room citation
    • Secure in-room HVAC units, diffusers, and grilles citation
    • Restrict size of HVAC in-room unit, diffuser, and grill holes or slots citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • HVAC covers with limited-access citation
    • Locked or tamper-resistant mechanical units with secured air grilles that have perforated openings no larger than 3⁄16” in diameter citation
    • Mechanical supply and return diffusers should have small perforations behind the louvers and be located in the ceiling citation
  • Electrical

    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Ligature resistant ceiling lights S citation
    • AFCI (Arc Fault Circuit Interrupter) & GFCI (Ground Fault Circuit Interrupter) outlets specified whenever possible citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Ligature resistant ceiling lights S citation
    • AFCI (Arc Fault Circuit Interrupter) & GFCI (Ground Fault Circuit Interrupter) outlets specified whenever possible citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Use tamper-proof electrical outlets citation
  • Lighting

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Avoid “institutional lighting” citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Rooms for older patients have accessible bathrooms and higher lighting levels citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved access/ wayfinding
    Design Strategies
    • Differentiate areas through color, lighting, carpeting, wall graphics, and furnishings citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Night lighting in all patient rooms and bathrooms citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Light fixtures with substantial lenses securely anchored in place and frames secured with tamper-resistant screws citation
    • Good electric lighting citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Soft, indirect, and pervasive or full-spectrum lighting citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Soft, indirect, full-spectrum lighting with sparingly used and carefully placed spotlight-type recessed lighting citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Soft, indirect, and pervasive or full-spectrum lighting citation
    • Avoid “institutional lighting” citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Soft, indirect, and pervasive or full-spectrum lighting citation
    • Lighting supportive of healing and positive distraction citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Soft, indirect, full-spectrum lighting with sparingly used and carefully placed spotlight-type recessed lighting citation
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Improved patient engagement
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    Desirable Outcome
    Improved family presence and engagement in patient care
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    Desirable Outcome
    Improved patient healthy behaviors
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    Desirable Outcome
    Improved sleep quality
    Design Strategies
    • Night lighting in all patient rooms and bathrooms citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • Regulate sensory stimulation (e.g., glare, noise, light, familiarity, orientation, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Night lighting in all patient rooms and bathrooms citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Ligature resistant ceiling lights S citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid ligature points citation
    • Avoid objects, fixtures, and furniture which might be used as weapons citation
    • Ligature resistant ceiling lights S citation
    • Light fixtures that cannot be damaged citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Lighting must limit patient access to light bulbs and electrical contacts (e.g, table lamps should generally be avoided) citation
    • Light fixtures with substantial lenses securely anchored in place and frames secured with tamper-resistant screws citation
    • Wall-mounted ligature-resistant over-bed lighting with high strength acrylic lenses (not correctional type) securely fastened to the wall with tamper resistant screws S citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
  • Fixtures/ Equipment/ Appliances/ Accessories

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Warm light gray paint with cool blue accent wall, woodgrain built-in’s and doors, solid surfaces, stainless steel fixtures and hardware citation
    • Safe features in patient toilets (e.g., solid-surface countertops, integral sinks, ligature-resistant faucets, recessed cabinet pulls, and securely locked doors that enclose under-counter pipes) S citation
    • Porcelain toilets (not stainless steel) with fixed seats, push-button flush actuators, concealed piping, and flushing and flooding controls citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved access/ wayfinding
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Unincorporated waste receptacles should be lightweight, non-weight-bearing, and free from liners citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Heavy-duty platform beds with rounded edges and provisions for restraints are dimensionally sized for mobility limitations citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Safety; infection control and hand sanitation
    Design Strategies
    • Toilet paper dispensers should consist of a soft spindle (recessed holders without spindles pose infection control concerns) citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Ligature resistant towel racks citation
    • Conceal plumbing citation
    • Unincorporated waste receptacles should be lightweight, non-weight-bearing, and free from liners S citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid ligature points citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Ligature resistant towel racks S citation
    • Conceal plumbing citation
    • Unincorporated waste receptacles should be lightweight, non-weight-bearing, and free from liners citation
    • Alternative to wall-mounted alcohol-based hand rub (ABHR) dispensers citation
    • Alternative to non-recessed life safety devices (e.g., chimes, strobes, pull station, smoke detectors, sprinkler heads, fire extinguishers, hose cabinets, etc.) citation
    • Restrict access to cords citation
    • Alternative to wall-mounted equipment (e.g., medical devices, television, etc.) citation
    • Alternative to non-recessed monitoring, communication, and access equipment (e.g., speakers, cameras, phone, access card readers, wireless access points, etc.) citation
    • Durable plumbing fixtures and concealed piping citation
    • Anti-ligature items and elimination of ligature points (e.g., patient-safe sliding doors, continuous grab bars, standard doors, bathroom fixtures, etc.) S citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Standard toilet seats with a hinged seat and lid are not a significant risk for suicide attempts or self-harm citation
    • Lockable cabinets and carts (e.g., housekeeping, laundry, dietary, etc.) citation
    • Liner-free equipment and accessories (e.g., waste receptacles) citation
    • If present, dumbwaiter controls and access need to be secure from patients citation
    • Warm light gray paint with cool blue accent wall, woodgrain built-in’s and doors, solid surfaces, stainless steel fixtures and hardware citation
    • Lockable water taps citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Avoid features typical of hospital (e.g., 2’x4’ light fixtures, paddle-style hardware, gas outlets, nurse call systems, etc.) citation
    • Shard/shatter-proof, ligature-resistant, securely anchored bathroom fixtures (e.g., concealed plumbing, sloped top flush valves and piping, pushbutton-activated valves, tight-fitting pipe covers, tempered glass distortion-free mirrors with security film and stainless steel, tamper-resistant frames, recessed towel shelves, etc.) S citation
    • Safe features in patient toilets (e.g., solid-surface countertops, integral sinks, ligature-resistant faucets, recessed cabinet pulls, and securely locked doors that enclose under-counter pipes) S citation
    • Showers without curtains instead of bathtubs with valves and spouts citation
    • Heavy-duty platform beds with rounded edges and provisions for restraints are dimensionally sized for mobility limitations citation
    • Shower and bathroom floor drains for slab depressions of 2” [50.8 mm] or less; slope length of bathroom floor to shower drain for depressions 4” [101.6 mm] or greater citation
    • Porcelain toilets (not stainless steel) with fixed seats, push-button flush actuators, concealed piping, and flushing and flooding controls citation
    • Solid surface lavatories with integral sinks and sensor activated faucets temperature mix of 110° F [43.34° C] with concealed piping and tamper-resistant screws citation
    • Accessible, attractive and durable showers with solid surface panels and pans, recessed stainless steel panels with anchor proof dual-head assemblies and controls that prevent the need for shower curtains (where necessary, recessed tracks with plastic clips or Velcro tabs that collapse under more than 4 lbs [1.81kg] of weight) citation
    • Wall-anchored reflective polycarbonate mirror with shelf-less stainless-steel frame citation
    • Toilet paper dispensers should consist of a soft spindle (recessed holders without spindles pose infection control concerns) citation
    • Fixed grab bars (not swinging) with a welded horizontal bottom plate citation
    • Securely attached drains with tamper-resistant screws citation
    • Paper towel dispensers in patient bathrooms should be recessed citation
    • Soap dispensers should be wall-mounted with sloped tops to prevent anchor points citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
  • Furniture/ Accessories

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Avoid “institutional colors” (i.e., “institutional green”) citation
    • Minimize “safe” design features citation
    • Continuous “chaise longue” sloped angle surface between top of 18-inch bench and a 27-inch desk citation
    • Doorless storage cubbies for clothing and personal items citation
    • Movable furniture that increases control without sacrificing safety citation
    • Therapeutic furniture that patients can rock slightly (e.g., ottoman) citation
    • Secured, homelike, non-breakable artwork, marker board, etc. citation
    • Secure trim, headboards and soothing colors contribute to the residential feel citation
    • Durable furnishings and finishes that are residential in character citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Attractive aesthetic space citation
    • Attractive furniture citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in furniture that maximizes safety and minimizes institutional aesthetics citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved access/ wayfinding
    Design Strategies
    • Differentiate areas through color, lighting, carpeting, wall graphics, and furnishings citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Use furnishings that limit use as weapon (e.g., heavy, weighted, etc.) S citation
    • Ligature-free furniture and fixtures S citation
    • Continuous “chaise longue” sloped angle surface between top of 18-inch bench and a 27-inch desk citation
    • Doorless storage cubbies for clothing and personal items citation
    • Movable furniture that increases control without sacrificing safety citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in furniture that maximizes safety and minimizes institutional aesthetics citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Nature art and prints citation
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    • Attractive furniture citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Possibility to adapt furnishings and décor to personal preferences citation
    • Continuous “chaise longue” sloped angle surface between top of 18-inch bench and a 27-inch desk citation
    • Doorless storage cubbies for clothing and personal items citation
    • Movable furniture that increases control without sacrificing safety citation
    • Therapeutic furniture that patients can rock slightly (e.g., ottoman) citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Built-in furniture that maximizes safety and minimizes institutional aesthetics citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
    • Ligature-free bed with multiple locations and orientations along headwall(s) S citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Damage-resistant furnishings that are easily repaired or replaced citation
    • Nature art and prints citation
    • Well-maintained high-quality features and environment citation
    • Avoid “institutional colors” (i.e., “institutional green”) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Minimize “safe” design features citation
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Heavy-duty platform beds with rounded edges and provisions for restraints are dimensionally sized for mobility limitations citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Comfortable furniture citation
    • Attractive aesthetic space citation
    • Maximize bed comfort citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
    Desirable Outcome
    Improved patient engagement
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    Desirable Outcome
    Improved family presence and engagement in patient care
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    Desirable Outcome
    Improved patient healthy behaviors
    Design Strategies
    • Non-institutional/homelike spaces that feel welcoming and secure citation
    • Well-maintained high-quality features and environment citation
    • Built-in furniture to delineate room zones citation
    Desirable Outcome
    A healthy environment (reduced negative health effects)
    Design Strategies
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid bedrails citation
    • Tamper-proof bed with minimal leverage points and no sheets/blankets citation
    • Fire-resistant bed citation
    • Features supportive of social interaction, onlooker observation and physical retreat citation
    • No furnishings or objects that provide ceiling access citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Damage-resistant furnishings that are easily repaired or replaced citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid bedrails citation
    • Tamper-proof bed with minimal leverage points and no sheets/blankets citation
    • Fire-resistant bed citation
    • Avoid materials that are breakable, toxic, flame retardant, or can cause suffocation S citation
    • Features supportive of social interaction, onlooker observation and physical retreat citation
    • No furnishings or objects that provide ceiling access citation
    • Anchored furnishings and accessories without openings or sharp edges citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Liner-free equipment and accessories (e.g., waste receptacles) citation
    • Use weight-sensitive collapsible “break away” hooks citation
    • Select furnishings (e.g., chairs, beds, nightstands, etc.) that cannot be used to block or barricade doors citation
    • Use furnishings that limit use as weapon (e.g., heavy, weighted, etc.) S citation
    • Ligature-free furniture and fixtures S citation
    • Continuous “chaise longue” sloped angle surface between top of 18-inch bench and a 27-inch desk citation
    • Doorless storage cubbies for clothing and personal items citation
    • Movable furniture that increases control without sacrificing safety citation
    • Therapeutic furniture that patients can rock slightly (e.g., ottoman) citation
    • Safe and durable familiar furnishings and finishes instead of trendy décor citation
    • Use shatterproof windows with breakaway curtain rods S citation
    • Stainless-steel mirrors citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Color, texture, and natural materials that provide a more residential feel citation
    • Soft, upholstered, durable furniture with wood accents that can be anchored in place citation
    • Sturdy durable furniture anchored in place (no table lamps) citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Secured, homelike, non-breakable artwork, marker board, etc. citation
    • Heavy-duty platform beds with rounded edges and provisions for restraints are dimensionally sized for mobility limitations citation
    • Ligature-free durable desk chairs with arms and rounded edges S citation
    • Built-in or furniture-based open shelving units with provisions for safety (e.g., spring loaded hooks, gypsum board soffit, etc.) citation
    • Clothing or towel hooks should be designed to collapse when any weight above 4 lbs [1.81 kg] is applied citation
    • Durable furnishings and finishes that are residential in character citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Damage-resistant furniture citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in furniture that maximizes safety and minimizes institutional aesthetics citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
    • Ligature-free bed with multiple locations and orientations along headwall(s) S citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Damage-resistant furnishings that are easily repaired or replaced citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Fire-resistant bed citation
    • Well-maintained high-quality features and environment citation
    • Damage-resistant furniture citation
    Desirable Outcome
    Enhanced sustainability
    Design Strategies
    • Damage-resistant furnishings that are easily repaired or replaced citation
    Desirable Outcome
    Reduced resource consumption
    Design Strategies
    • Damage-resistant furnishings that are easily repaired or replaced citation
  • Casework/ Storage

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Well-organized, maintained, and orderly spaces citation
    • Equipment should be built-in/hidden citation
    • Warm light gray paint with cool blue accent wall, woodgrain built-in’s and doors, solid surfaces, stainless steel fixtures and hardware citation
    • Safe features in patient toilets (e.g., solid-surface countertops, integral sinks, ligature-resistant faucets, recessed cabinet pulls, and securely locked doors that enclose under-counter pipes) S citation
    • Attractive and secure built in desks and shelving units citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Well-organized, maintained, and orderly spaces citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Well-organized, maintained, and orderly spaces citation
    • Equipment should be built-in/hidden citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Well-organized, maintained, and orderly spaces citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Well-maintained high-quality features and environment citation
    • Well-organized, maintained, and orderly spaces citation
    • Opportunities to personalize the room citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
    Desirable Outcome
    Improved family presence and engagement in patient care
    Design Strategies
    • Safely accommodate visitors with secure storage outside patient room and first egress access from inside patient room citation
    Desirable Outcome
    Improved patient healthy behaviors
    Design Strategies
    • Well-maintained high-quality features and environment citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid clothes hooks citation
    • Ligature resistant shelves S citation
    • Ligature resistant towel racks S citation
    • Conceal plumbing citation
    • No furnishings or objects that provide ceiling access citation
    • Avoid clothing rods and hangers citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid clothes hooks citation
    • Ligature resistant shelves S citation
    • Ligature resistant towel racks S citation
    • Conceal plumbing citation
    • Fixed, non-adjustable shelves or hooks that support no more than 4 pounds (and no rods or hangers) citation
    • No furnishings or objects that provide ceiling access citation
    • Avoid clothing rods and hangers citation
    • Anchored furnishings and accessories without openings or sharp edges citation
    • Wall mounted items should avoid glass, protruding edges, or exposed corners citation
    • Ligature-resistant features (e.g., lacking points for looped or tied attachments) S citation
    • Warm light gray paint with cool blue accent wall, woodgrain built-in’s and doors, solid surfaces, stainless steel fixtures and hardware citation
    • Color, texture, and natural materials that provide a more residential feel citation
    • Locked doors and drawers with flush pulls and recessed hinges prevent access citation
    • Securely anchored non-adjustable shelves in cabinets without doors and drawers (no hanging rods) citation
    • Safe features in patient toilets (e.g., solid-surface countertops, integral sinks, ligature-resistant faucets, recessed cabinet pulls, and securely locked doors that enclose under-counter pipes) S citation
    • Safely accommodate visitors with secure storage outside patient room and first egress access from inside patient room citation
    • Built-in or furniture-based open shelving units with provisions for safety (e.g., spring loaded hooks, gypsum board soffit, etc.) citation
    • Multipurpose built-in’s (e.g., seat height shelf for storage, seating or lounging). citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    • Built-in’s support various activities (e.g., lounge slope between bench and desk, pass-through cubbies, etc.) citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Well-maintained high-quality features and environment citation
  • Patient Handling/ Movement Equipment

    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Accommodate the elderly and impaired (e.g., closed-bottom handrails, seating for rising, equipment/aides, visible toilet, etc.) citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Ceiling-mounted patient lifts should not be installed in patient rooms S citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
  • Technology/ Internet/ Communication/ Monitoring Equipment

    Desirable Outcome
    Change-readiness/ future-proofing
    Design Strategies
    • Design to incorporate new technology as it develops citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Minimize stigma
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Minimize “safe” design features citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced security
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Avoid over-reliance on technology provisions to address safety citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid objects, fixtures, and furniture which might be used as weapons citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    • No nurse call buttons (not cords) in patient rooms and bathrooms citation
    Desirable Outcome
    Communication; staff to staff
    Design Strategies
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Safe delivery of care
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Avoid over-reliance on technology provisions to address safety citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved Job satisfaction
    Design Strategies
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Patient control/ independence
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    • Access to options for acoustics citation
    • Patient selected artwork using wall-mounted screens with preselected images citation
    • Curb noise and promote auditory control (e.g., sound-absorbing plaster, patient-controlled white noise generator, etc.) citation
    Desirable Outcome
    Patient recovery
    Design Strategies
    • Positive distractions (e.g., indoor plants, garden views, and other nature elements) citation
    Desirable Outcome
    Patient satisfaction
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Opportunities to personalize the room citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Patient comfort
    Design Strategies
    • Minimize “safe” design features citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Improved patient engagement
    Design Strategies
    • Required safety/security features are concealed or as discreet as possible citation
    Desirable Outcome
    Reduced noise
    Design Strategies
    • Good acoustical control citation
    • Curb noise and promote auditory control (e.g., sound-absorbing plaster, patient-controlled white noise generator, etc.) citation
    Desirable Outcome
    Safety; fall/injury prevention and improved mobility
    Design Strategies
    • Avoid ligature points S citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid ligature points citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    Desirable Outcome
    Safety; reduce risk of harm to self or harm to others
    Design Strategies
    • Discreet security features that reinforce safety without compromising experience citation
    • Avoid ligature points citation
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation
    • Required safety/security features are concealed or as discreet as possible citation
    • Alternative to non-recessed life safety devices (e.g., chimes, strobes, pull station, smoke detectors, sprinkler heads, fire extinguishers, hose cabinets, etc.) citation
    • Alternative to non-recessed monitoring, communication, and access equipment (e.g., speakers, cameras, phone, access card readers, wireless access points, etc.) citation
    • Maximize direct visual observation of patients from security/staffing areas citation
    • Facilitate staff surveillance, egress, protection, teamwork and tasks citation
    • No nurse call buttons (not cords) in patient rooms and bathrooms citation
    • Mock-up’s to evaluate efficacy, safety, layouts, finishes, furniture, and equipment citation
    Desirable Outcome
    Enhanced durability
    Design Strategies
    • Avoid objects, fixtures, and furniture which might be used as weapons S citation