Healthcare Design - June 2015 - 12

MONITOR

Using bioinformed design
to reduce HAIs
Researchers are beginning to create a new
paradigm that may change how we design,
operate, and maintain hospitals. This model
looks at biodiversity of interior spaces at the
microbial level to try to determine the healthiest conditions. Jessica Green, biodiversity
scientist at the University of Oregon, named
this "bioinformed design"-how we can design
to promote beneficial microbes and inhibit
harmful ones.
Genome sequencing technology has allowed scientists to establish that our bodies
harbor 100 trillion microbes as a community
of bacteria called a microbiome. We each
shed 37 million bacteria per hour (imagine
Pigpen from the "Peanuts" comics) that leave
a footprint as we move through buildings. In
hospitals, more than 50 percent of patients
take antibiotics, which decimate the bad
bacteria but also normal bacteria that provide
resistance, making patients more open to
healthcare-associated infections (HAIs).
As featured in a recent Wall Street Journal
article, "Designing a Hospital to Better Fight
Infection," the Hospital Microbiome Project
reported the preliminary findings of a threeyear study of the new University of Chicago
Center for Care and Discovery, an inpatient
bed tower. This study looked at how ventilation, humidity, and design features affect both
good and bad bacteria.
The project is mapping where and what
type of microbes occur to potentially target
and eliminate pathogens. Early findings
indicate patient rooms, visited 100 times a
day when occupied, become alive with human bacteria and biodiversity that rivals an
Amazon rainforest.

HCDmagazine.com 07.15

Within hours, a new patient's microbiome becomes the dominant biological
feature in a patient room. Different locations, such as shower heads, bed rails,
and furniture, can harbor very different
types of bacteria. Rooms also have
microbial characteristics influenced by a
number of occupants, temperature/humidity, and type of treatment occurring, so
a one-size-fits-all approach to sterilization
may be futile. In fact, less sterile rooms
may reduce the prevalence of harmful
microbes by making them compete with
healthy ones.
Some scientists believe this emerging
bioinformed knowledge will affect building
design within as early as five years. The
future may bring building features that
can introduce "curative probiotics" that
enhance recovery. For instance, materials
may be infused with properties tailored
to their location and use that to enhance
good bacteria.
There may be more attention paid to the
location and entry of toilet rooms to space
them away from food service and other
sensitive areas. Ventilation systems may
rely more on outside air to infuse more
biodiversity into the indoor environment,
and cleaning and sterilization may become
more customized.
This is an exciting new development that
engages architects and engineers proactively to create healthier buildings based on
growing scientific knowledge.-Sheila F.
Cahnman, founding principal, JumpGarden
Consulting LLC

HCDmagazine.com 05.15

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Healthcare Design - June 2015

Table of Contents for the Digital Edition of Healthcare Design - June 2015