Firm's role on the project: Create a behavioral health setting within the ED.
To design a behavioral health setting within the emergency department (ED) that is non-institutional and calming for patients. To provide solutions that will meet the needs of a diverse behavioral health patient mix.
The space is intended to be a place where peer counseling can occur with stable patients, along with simultaneous caregiver and family care. Special attention was given to reduce environmental stressors so that patients will be able to relax and “de-escalate.” The intended result is for patients to react more positively to treatment, report reduced negative outcomes, and aid in the care of one another. The project will be completed in 2014 and an in-depth, multi-year research study is planned to develop and test a new model for how environmental and operational determinants are linked to improvements in patient care, quality, safety, and other key project performance targets.
Behavioral health settings are guided by strict safety design regulations often resulting in spaces that are stark, plain and isolated—potentially exacerbating environmental stressors and escalating already difficult patient situations. Acute care emergency settings also have a particular set of challenges and the organization predicts that there will be increased visits from behavioral health patients in the ED.
Faced with this challenge of designing a behavioral health setting in the ED, the project team developed a variety of design solutions based upon literature reviews, institutional experience, tours and case studies. Using client feedback, the team hypothesized that the creation of a crisis stabilization unit (CSU) that featured a “living room” would help to provide a higher quality of care to patients and also support the staff’s ability to quickly consult and treat a diverse set of patients entering the ED. The CSU was created to separate the behavioral health patients from the main ED to better address their unique needs and avoid unnecessary inpatient admissions to the hospital. Once patients present at the ED, they are evaluated and medically cleared before moving into the CSU. Within the CSU, various acuity levels can be accommodated with six rooms that are designed to be safe for patients while also creating a desired aesthetic to avoid feeling “institutional.”
The “living room” within the CSU looks similar to a home living room— complete with wood millwork, comfortable seating, artwork, a round dining room table, glass French doors, and a fish tank. The upgraded materials and design are intended to be therapeutic for patients and help put them at ease. The fish tank and the associated calming effect of the water is a main feature of the design.