Healthcare Design - June/July 2020 - 30

exactly where it was necessary to spend money
on upgrading safety, Cheshire adds. "That really
helped us afford the building," he says.
Although it was a delicate balance to answer
desires for safety, durability, and noninstitutional design, Cheshire says the environment
achieved was the result of a mindset that considered the 90-95 percent of kids who will be
treated at the pavilion and who won't exhibit
aggressive or dangerous behavior as opposed to
the 5-10 percent who will. "If we have a child who
we know may be really destructive, really harmful to the environment, maybe we need to think
differently about how we care for that child,
what the staff ratio is, and not let the worst-case
scenario rule the design process," he says.
Extensive mock-up studies were conducted to refine products used within
the inpatient rooms,
including the joinery on
millwork, wall base, and
plywood finish applied
to patient beds. The beds
also include a unique integration of patient and
parent accomodations to
allow overnight visits.

EXPERIENCE AND SAFETY

Experience-for patients, family, and staff-
was a key project imperative, as well, especially
understanding how underlying elements of
safety play a role in developing experience. The
process began with a recognition of the brand
already created at Nationwide Children's and
figuring out how to translate that to the behavioral health setting. "We agreed early on that it

© EDWARD CARUS O PHOTOGRAPHY

domestic touch to the room and give patients another element of control
over their environment."
To further support the effort and make decisions that would work across
the spectrum of the facility, a design toolkit was developed to identify a
set of complementary furniture pieces that worked well as a whole while
also addressing the variety of functional needs throughout the building,
Beltran says. "For example, within our furniture selections, there were
pieces that offered hard versus soft molded options, heavy-weighted versus light-weighted options, and safe additive assemblies versus monolithic
construction. The thinking around having such a set of complementary options was to ensure that if in the future a specific product was deemed not
appropriate for a particular care unit because it was too hard or too heavy,
it could be replaced with a softer and lighter product that was already part
of the toolkit and wouldn't compromise the aesthetic unity of the project."
Finally, yet another challenge was approaching the delineation of spaces
across the massive program housed within the pavilion that serves kids
ages 3 to 18 from diagnoses and treatment across an array of care settings
and care models. To manage that inherent complexity, the team took a
closer look at the differences between outpatient and inpatient care, specifically, conducting a risk assessment that led design decisions in terms
of the "what, where, and how" of every decision impacting material usage
within the patient environment, Pitts says. "We ended up with a gradient
moving from less emphasis on self-harm in the outpatient environment
and much more emphasis within the crisis, residential, and inpatient environments, but always also guided by sections that were both safe and
noninstitutional." The process also helped Nationwide Children's target

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Healthcare Design - June/July 2020

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