Healthcare Design - August 2017 - 38

A PLACE TO THRIVE

When the work was completed, CHOP decided
to start with a four-month soft opening, activating only five of the inpatient beds for patients with comorbidities to give the staff time
to refine their processes and learn how to work
together (the other beds were used for regular
inpatient needs until the unit was fully activated in early April). While the unit has been in
operation less than a year, Vanore says the staff
reports that the environment has allowed them
to successfully address patients' dual needs.
Another benefit, Carney says, is the sense of
community that the unit has created for both
staff and patients. "It gives patients a sense that
they're a part of something and that there are
other people experiencing the same thing," he

38

AUGUST 2017

To mimic the solar
day and provide
routine lighting exposure to reinforce
the body's natural
circadian rhythms,
a specialized
lighting system
was implemented
in all patient and
staff areas. The
intensity and color
temperature of
fixtures automatically shift through
a programmed
and controlled time
clock.

Lighting was an
important strategy in
creating a welcoming
and healing environment
for patients in Children's
Hospital of Philadelphia's (CHOP) new
medical behavioral unit.
"Exposure to daylight
is effective in improving
mood and reducing depression, which supports
the goal of providing a
healing environment that
reduces the stress of a
hospital stay for patients
and families," says Sue
Ann Barton, principal at
ZGF and medical plan-

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ner on the project. "If
a patient is depressed,
they'll just want to stay
in their room and keep
the lights off and stay in
the dark."
Using evidence-based
design strategies, the
design team placed windows in all the patient
rooms and corridors
and added a circadian
lighting system, which is
programmed to reflect
natural light as it changes in color throughout
the day (see images
above) to help regulate
body clock rhythms

and synchronize the
sleep and wake cycles
for the patients, Barton
says. The design team
also took advantage of
an existing skylight in
the center of the unit by
locating activity rooms,
the family lounge, and
one of the nurses' stations
underneath it. "The idea
is to keep their circadian
rhythms in balance," she
says. "When those get
out of balance, it can
increase depression, so
we're trying to look at
[lighting] from a number
of different ways."

HALKIN MAS ON PHOTOGRAPHY

MAXIMUM
EXPOSURE

rooms, small patient neighborhoods, and quiet
corridors help promote a calming and welcoming environment that can reduce stress and aggression. Design elements that deliver an added
layer of safety include detailing on casework that
prevents patients from accessing equipment,
durable materials such as rubber flooring, and
tamper-proof hardware.
CHOP's parent and patient advisory groups
consulted on several of the design initiatives,
including stressing the importance of giving
young patients a sense of control during their
hospital stay. To this end, each of the patient
rooms has an LED lighting system embedded in
the ceiling that allows patients to project different colors onto the footwall, depending on their
mood or preference.
Working within the floorplate of the existing
building, the patient rooms are organized along
an L shape, with six rooms on one side and four
on the other. The placement breaks up the unit
into smaller neighborhoods that are easier for
patients and family members to navigate. Decentralized nurses' stations are located between
pairs of rooms with open care team stations in
each neighborhood. Offstage corridors are used
to move supplies, linens, and soiled materials
on and off the unit to further reduce traffic and
noise in the corridors.
Planners also made room for some amenity
spaces that are more common in behavioral
health units than a medical inpatient floor, including an activity room, which can be used for
dining and group therapy sessions, and two comfort rooms where patients can go to be alone or
calm themselves down. "The teams saw it as part
of the care model," Hagerty says. "Kids can cuddle in there by themselves; it's a safer area."
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