'Using positive distractions'

Inner Design Studio's Rebecca Donner talks about the challenge of health care facility design

Rebecca Donner is principal of Inner Design Studio, a Brentwood-based company that focuses on health care facility interior work.

A graduate of O’More College of Design in Franklin, Donner started Inner Design Studio in 1993 with one client and one employee. Today, the nine-person firm handles approximately 650 projects a year.

The Missouri native recently met with Post Managing Editor William Williams to discuss the business of designing interior spaces for health care facilities.   

WW: During the past 10 years or so, what have been the main changes — both with form and function — in interior design for health care facilities?

RD: One example is keeping the needs of the patient in the forefront with an awareness of how one reacts to a physical environment.Studies show that patients’ ability to cope with stress deeply affects their behavior and, in turn, their ability to heal. Designers are tasked now with solving way-finding issues, strategies for reducing noise and space planning for family members to gather. By using positive distractions — viewing nature and natural light — designers are finding success.

Another example of change is understanding the needs of the infection control staff by having a seat available to them at the design table. The selection of finishes must hold up to the ever-changing cleaning methods. Some examples: A 10 percent bleach solution that is used to kill bacterium can destroy an upholstery if not specified with a polyester or a solution-dyed nylon. The floor finish in a burn unit operating room needs to perform in an air temperature of no less than 105 degrees during surgery and then be cleaned with a power washer. This information is key to the design team when making the selections.

Other changes include bringing sustainability opportunities to owners when selecting finishes, furnishings, lighting and drapery, and repurposing spaces.

WW: Regarding these changes, how have they impacted the type training and skills interior designers need?

RD: The training is on the job and unfortunately not always introduced in the schools regarding the evidence-based design. Infection control will forever be evolving and this training will have to take place in the studio. There has been an introduction to sustainability at the college level.  

WW: How does interior design for a health care facility differ from, say, those interior designs of other civic/institutional building spaces (in, for example, universities, libraries, community centers, police precincts, prisons, etc.)?

RD: Health care interiors have a different set of codes state to state, infection control concerns, bariatric needs and psychological considerations when placing art or selecting a color. Lastly, there are special safety requirements.    

WW: Are students who major in interior design focusing more so, than in the past, on health care facility interior design specifically?

RD: I would like to think so. Unfortunately, in the Southeast, I am seeing more of an introduction to health care design versus a primary focus. I understand in the universities there is so much to introduce to the design student that a primary focus would need to be outside the core design curriculum.

WW: How green/environmentally friendly has health care facility interior design become?

RD: It is slowly coming. Most work for us is renovation. And with a building that never closes, it is hard to make changes immediately. There are some cities here in the U.S. that have made new construction projects built to LEED (U.S. Green Building Council Leadership in Energy and Environmental Design) silver certification as a code.

WW: What are the main challenges in health care facility interior design?

RD: Designing with shrinking budgets/reimbursements for increasing patient loads and planning for uncertainty. We have to consider what the physical space will look like in the future as new care delivery models continue to change. We have to enable adaptability.

WW: When did the idea of “atmosphere” and the thinking to change the look and feel of clinical/institutional spaces arise?

RD: In my opinion, this thought process started evolving when patients had a choice in health care institutions. My first experience was with women's services. The hospital's labor and delivery units started competing for the mother's stay. Each hospital wanted to outdo the next with hotel-like features and amenities to lure the potential patient. We also saw this practice with physician lounges as hospitals applied the same idea in recruiting physicians.

WW: On that theme, with some services having been removed from large-scale health care facilities, how has your industry adjusted?

RD: These types of facilities require a similar type of design. The only change would be a faster pace to the construction document phase. You have to remember the ambulatory surgery center business has been around for well over 20 years with imaging centers, physical/occupational therapy and urgent care on its heels. We now have a surge of the freestanding emergency departments. So the design industry has been there all along.