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Overview

Healthcare is moving beyond the walls of the hospital. This is partially due to a growing population of patients who require medical care but are stable enough to be treated at home (including older adults with acute and chronic conditions). Caring for these populations in their own home is more convenient and cost effective than providing that same care in a traditional medical setting. Home environments that support medical care can reduce unnecessary hospitalization, influence health and wellbeing, and help to maintain a person's independence.

  • Layout (Overall)

    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Access to sink or alcohol gel dispenser in care areas
    Desirable Outcome(s)
    • Safety; medication safety
    Design Strategies
    • Visual and auditory separation of care areas away from any distractions (e.g. pets, children). citation
    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Care areas located on main level (i.e., street level) when possible, or entire home on one level. citation
    • Clear/turn space at least 5 x 5 ft. in living area. citation
    • Maximize open areas around furniture and primary paths of circulation.citation
    • Minimum hallway width of 42 in. citation
    • Flexible layout allowing for reorganization of space (e.g., easily moveable furniture, modular elements) to accommodate changing needs.
    • Adequate space for durable medical devices (e.g., hospital beds, wheelchairs, walkers) and medical equipment (e.g., oxygen tanks, home dialysis units, infusion pumps, blood glucose meters, feeding tubes, catheters, commodes, ambulation aids, patient lifts/hoists, specialist equipment) to support changing levels of care. citation
    • Adequate space to install ramps/stair lifts. citation
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Care areas located on main level (i.e., street level) when possible, or entire home on one level. citation
    • Clear/turn space at least 5 x 5 ft. in living area. citation
    • Minimum hallway width of 42 in. citation
    • Flexible layout allowing for reorganization of space (e.g., easily moveable furniture, modular elements) to accommodate changing needs.
    • Adequate space for durable medical devices (e.g., hospital beds, wheelchairs, walkers) and medical equipment (e.g., oxygen tanks, home dialysis units, infusion pumps, blood glucose meters, feeding tubes, catheters, commodes, ambulation aids, patient lifts/hoists, specialist equipment) to support changing levels of care. citation
    • Adequate space to install ramps/stair lifts. citation
    Desirable Outcome(s)
    • Minimize undue strain during recovery
    Design Strategies
    • Care areas located on main level (i.e., street level) when possible, or entire home on one level. citation
    • Clear/turn space at least 5 x 5 ft. in living area. citation
    • Flexible layout allowing for reorganization of space (e.g., easily moveable furniture, modular elements) to accommodate changing needs.
    • Adequate space for durable medical devices (e.g., hospital beds, wheelchairs, walkers) and medical equipment (e.g., oxygen tanks, home dialysis units, infusion pumps, blood glucose meters, feeding tubes, catheters, commodes, ambulation aids, patient lifts/hoists, specialist equipment) to support changing levels of care. citation
    • Adequate space to install ramps/stair lifts. citation
    Desirable Outcome(s)
    • Psychosocial support
    Design Strategies
    • Space for family members to sit with patient without obstructing care. citation
    • Designated space and provisions for pets (e.g., bed, feeding, access to outdoors) if appropriate.
    Desirable Outcome(s)
    • Minimize patient stress/anxiety
    Design Strategies
    • Access to positive distractions (e.g., nature-themed artwork, windows with nature views, music, TV, Internet, reading materials).
    Desirable Outcome(s)
    • Patient recovery
    Design Strategies
    • Designated space to support and encourage physical therapy and/or light exercise routine.
  • Caregiver/Clinical Staff Workspace

    Desirable Outcome(s)
    • Safety; medication safety
    Design Strategies
    • Designated “workstation” (e.g., a desk) located in a clean, well-lit, distraction-free area for procedures involving sharps or medication preparation. citation
    • Safe, easily accessible storage for medication, supplies, and medical equipment (refrigerated, if needed). citation
    • Easily accessible storage and disposal for non-reusable supplies (e.g., medication, adult diapers, incontinence pads, bandaging). citation
    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Designated “workstation” (e.g., a desk) located in a clean, well-lit, distraction-free area for procedures involving sharps or medication preparation. citation
    • Large sharps containers with leak-proof covers. citation
    • Easily accessible storage and disposal for non-reusable supplies (e.g., medication, adult diapers, incontinence pads, bandaging). citation
    • Easily accessible storage for cleaning supplies needed urgently (e.g., in case of soiled bed linens/floor). citation
    Desirable Outcome(s)
    • Safety; risk mitigation
    Design Strategies
    • Defibrillator(s).
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Designated location for medical equipment manuals. citation
    Desirable Outcome(s)
    • Caregiver respite/support
    Design Strategies
    • Designated space for caregiver to take breaks from patient, family, and visitors. citation
    • Telesupport systems (e.g., telephone support groups, teleconferencing, telepresence systems) for patients and providers to communicate with supervisors/other medical professionals during home visits. citation
    Desirable Outcome(s)
    • Efficient delivery of care
    Design Strategies
    • Designated “workstation” (e.g., a desk) located in a clean, well-lit, distraction-free area for procedures involving sharps or medication preparation. citation
    • Safe, easily accessible storage for medication, supplies, and medical equipment (refrigerated, if needed). citation
    • Easily accessible storage and disposal for non-reusable supplies (e.g., medication, adult diapers, incontinence pads, bandaging). citation
    • Easily accessible storage for cleaning supplies needed urgently (e.g., in case of soiled bed linens/floor). citation
    • Designated location for medical equipment manuals. citation
  • Flooring

    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination citation
    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Level, smooth flooring with minimal variations allowing for freedom of movement, especially when navigating with medical equipment. citation
    • Smooth, non-glare, non-slip/slip-resistant flooring. citation
    • Tack down edges of carpets and rugs; remove loose rugs. citation
    • Avoid deep pile carpet or loose/worn carpet. citation
    • Avoid flooring materials with intricate, high-contrast patterns (especially for patients with impaired vision). citation
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Level, smooth flooring with minimal variations allowing for easy push/pull of floor hoists. citation
    Desirable Outcome(s)
    • Minimize strain during recovery
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
  • Walls

    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Handrails on both sides of stairs. citation
    Desirable Outcome(s)
    • Safety; risk mitigation
    Design Strategies
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Handrails on both sides of stairs. citation
    Desirable Outcome(s)
    • Communication/ interaction with care provider
    Design Strategies
    • Neutral color (preferably light blue or green) on background wall to enhance visibility of patient and enhance flesh tones during video-conferencing. citation
    • Electric and Internet outlets located at least 24 in. off of floor. citation
    • Outlets located in convenient locations for medical equipment to avoid obstruction of walking paths by cords. citation
    Desirable Outcome(s)
    • Accessibility; ease of use
    Design Strategies
    • Preprogrammed and easily adjustable thermostat. citation
    • Light switches lowered to 44 in. off of floor. citation
    • Light switches at top and bottom of stairs. citation
    • Easy-to-read and easy-to-reach operational (remote) controls for window treatments, lighting, temperature, and audio/visual components (e.g, TV, music).
  • Ceiling

    Desirable Outcome(s)
    • Safety; risk mitigation
    Design Strategies
  • Windows

    Desirable Outcome(s)
    • Safety; air quality
    Design Strategies
    • Operable windows allowing for cross-ventilation and fresh air (with minimal openings to reduce risk of disoriented patients exiting through window). citation
    Desirable Outcome(s)
    • Minimize patient stress/anxiety
    Design Strategies
    • Windows and/or skylight providing plenty of natural light. citation
    • Views of nature or the outdoors.
    • Window treatments allowing patient to block/reduce natural light (if needed).
    • Easy-to-read and easy-to-reach operational (remote) controls for window treatments, lighting, temperature, and audio/visual components (e.g., TV, music).
    Desirable Outcome(s)
    • Patient satisfaction and comfort
    Design Strategies
    • Windows and/or skylight providing plenty of natural light. citation
    • Views of nature or the outdoors.
    • Window treatments allowing patient to block/reduce natural light (if needed).
    • Easy-to-read and easy-to-reach operational (remote) controls for window treatments, lighting, temperature, and audio/visual components (e.g., TV, music).
    Desirable Outcome(s)
    • Support telemedicine
    Design Strategies
    • Teleconference exam area located away from windows (to avoid washing out video image and reduce shadows). citation
  • Doors

    Desirable Outcome(s)
    • Accessibility; ease of use
    • Safety; fall prevention
    Design Strategies
    • Minimum door width of 36 in. citation
    • Minimize thresholds (less than ¼ in. vertical, or between ¼ and ½ in. beveled). citation
    • At least one exterior double door to facilitate option to bring in large medical equipment (if needed). citation
    • Easy-to-open doors (consider handle grip, mechanics, and weight).
    Desirable Outcome(s)
    • Accessibility; ease of use
    Design Strategies
    • Minimum door width of 36 in. citation
    • Minimize thresholds (less than ¼ in. vertical, or between ¼ and ½ in. beveled). citation
    • At least one exterior double door to facilitate option to bring in large medical equipment (if needed). citation
    • Easy-to-open doors (consider handle grip, mechanics, and weight).
    Desirable Outcome(s)
    • Minimize patient stress/anxiety
    Design Strategies
    • Dog door (and fenced-in yard) for patients with dogs.
  • HVAC

    Desirable Outcome(s)
    • Safety; risk mitigation
    Design Strategies
    • Comfortable air temperature, relative humidity, and flow speed, maintained consistently between spaces.
    • Reliable and fully functional heating and air conditioning to reduce risk of heatstroke or hypothermia. citation
    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Ventilation system featuring HEPA filters or 100% outside air to minimize air contamination.
    Desirable Outcome(s)
    • Minimize patient stress/anxiety
    Design Strategies
    • Comfortable air temperature, relative humidity, and flow speed, maintained consistently between spaces.
    • Reliable and fully functional heating and air conditioning to reduce risk of heatstroke or hypothermia. citation
    Desirable Outcome(s)
    • Patient satisfaction and comfort
    Design Strategies
    • Efficient ventilation to minimize unpleasant smells.
  • Electrical

    Desirable Outcome(s)
    • Safety; risk mitigation
    Design Strategies
    • Update electrical system to support all medical equipment without overloading outlets citation
    • Electric and Internet outlets located at least 24 in. off of floor. citation
    • Outlets located in convenient locations for medical equipment to avoid obstruction of walking paths by cords. citation
    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Electric and Internet outlets located at least 24 in. off of floor. citation
    • Outlets located in convenient locations for medical equipment to avoid obstruction of walking paths by cords. citation
    Desirable Outcome(s)
    • Communication/ interaction with care provider
    Design Strategies
    • Appropriate electrical system to support reliable Internet access. citation
  • Lighting

    Desirable Outcome(s)
    • Safety; medication safety
    Design Strategies
    • Moveable and adjustable exam lighting in care area. citation
    • Sufficient illumination level for dispensing medication to minimize errors (in any areas where medication dispensing is performed by caregiver or patient). citation
    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Interior motion lighting/sensor-activated lighting without glare, and/or nightlights. “Meridian at Home,” 2017; National Research Council, 2011
    Desirable Outcome(s)
    • Efficient delivery of care
    Design Strategies
    • Moveable and adjustable exam lighting in care area. citation
    • Sufficient illumination level for dispensing medication to minimize errors (in any areas where medication dispensing is performed by caregiver or patient). citation
    Desirable Outcome(s)
    • Communication/ interaction with care provider
    Design Strategies
    • Diffuse light located in front of patient to provide even illumination and reduce shadows. citation
    • Moveable lighting options to illuminate different parts of patient’s body when using telemedicine devices (e.g., otoscopes). citation
    Desirable Outcome(s)
    • Accessibility; ease of use
    Design Strategies
    • Light switches lowered to 44 in. off of floor. citation
    • Lighting (remote) controls accessible from couch/chair.
  • Furniture/Accessories

    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
    Desirable Outcome(s)
    • Safety; fall prevention
    Design Strategies
    • Adjustable lounge chairs with elevated footrest setting, sit-to-stand chairs, or lift chairs with built-in lift mechanisms (if needed). citation
    • Avoid chairs too low/deep to allow patient to stand without lift mechanisms.
    Desirable Outcome(s)
    • Minimize undue strain during recovery
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
    • Adjustable lounge chairs with elevated footrest setting, sit-to-stand chairs, or lift chairs with built-in lift mechanisms (if needed). citation
    • Avoid chairs too low/deep to allow patient to stand without lift mechanisms.
    Desirable Outcome(s)
    • Minimize patient stress/anxiety
    Design Strategies
    • Built-in pet feeding system. citation
    • Self-cleaning litter box for cats (if needed).
  • Casework/Storage

    Desirable Outcome(s)
    • Safety; medication safety
    Design Strategies
    • Safe, easily accessible storage for medication, supplies, and medical equipment (refrigerated, if needed). citation
    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Adequate storage space (e.g., cabinet concealing medical gear) to reduce clutter. citation
    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
    • Multiple storage locations for gloves and other personal protective equipment to facilitate proper safety protocols (e.g., in the event of exposure to blood or other bodily fluids). citation
    Desirable Outcome(s)
    • Minimize patient stress/anxiety
    Design Strategies
    • Adequate storage space (e.g., cabinet concealing medical gear) to reduce clutter and maintain domestic aesthetic. citation
    Desirable Outcome(s)
    • Efficient delivery of care
    Design Strategies
    • Adequate storage space (e.g., cabinet concealing medical gear) to reduce clutter and maintain domestic aesthetic. citation
    • Maximize space for medical supplies. citation
    • Easily accessible storage for first aid supplies.
  • Patient Handling/Movement Equipment

    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Patient lifts (portable or ceiling-mounted) and other repositioning devices supporting safe ergonomic conditions for patient handling and movement. citation
    • Appropriate portable lifts depending on flooring type (i.e., hard surface vs. carpet).
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Patient lifts (portable or ceiling-mounted) and other repositioning devices supporting safe ergonomic conditions for patient handling and movement. citation
    • Appropriate portable lifts depending on flooring type (i.e., hard surface vs. carpet).
    • Designated location for patient handling equipment manuals to support caregivers who may be trained to use different equipment in each home. Beer et al., 2014
  • Technology/Monitoring Equipment/Internet

    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Intercom system, voice-activated smart cell phone technology. citation
    Desirable Outcome(s)
    • Safety; medication safety
    Design Strategies
    • Timed medication dispensing system with built in reminders for patients and alerts (email/text) to physician and caregivers if a dose is missed. citation
    Desirable Outcome(s)
    • Caregiver safety
    Design Strategies
    • Intercom system, voice-activated smart cell phone technology. Beer et al., citation
    Desirable Outcome(s)
    • Communication/ interaction with care provider
    Design Strategies
    • Wireless or wired Internet connection to facilitate telehealth/telemedicine (i.e., video monitoring/conferencing with healthcare providers and support networks, data transmission for electronic medical records, prescription ordering services). citation
    • Comfortable setup for personal computer interfaced with patient’s personal health portal. citation
    • Monitoring devices (sensors or wearables) to record daily living activities and transmit data to caregivers. citation
    • Telemedicine exam equipment (e.g., laptop) with integrated medical devices (e.g., otoscopes, stethoscopes, dermatoscopes, ultrasound probes, vital signs monitors, spirometers, ECG) allowing split-screen viewing between the camera and medical devices. citation
    • Power, data, and conduit pathways to support telemedicine equipment. citation
    • Teleconferencing screen and camera located at eye level, a few feet away from patient, to mimic face-to-face encounters. citation
    • Intercom system, voice-activated smart cell phone technology. citation
    Desirable Outcome(s)
    • Patient control and independence
    Design Strategies
    • Voice-activated connectivity to facilitate activities of daily living (e.g., turning lights on/off, changing television channels, making phone calls, playing music, opening/closing doors).
    • Conveniently located portable electronic devices (e.g., phones, tablets, mobile devices) and charging stations to support easy access to family, photos, games, etc.
    • Opportunities for virtual and augmented reality to connect homebound patients to the outside world.
    Desirable Outcome(s)
    • Psychosocial support
    Design Strategies
    • Conveniently located portable electronic devices (e.g., phones, tablets, mobile devices) and charging stations to support easy access to family, photos, games, etc.
    • Opportunities for virtual and augmented reality to connect homebound patients to the outside world.
    • Robotic pets to provide companionship. citation