Ask the Experts: Furniture | Spellman Brady & Company

Ask the Experts: Furniture

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As seen in FacilityCare Magazine's October/November 2012 issue.

Healthcare reform is all the buzz these days and doesn’t seem like it will be taking a backseat any time soon with the continued rollout of the 2010 Affordable Care Act. The Department of Health and Human Services will begin offering incentives to hospitals to improve quality of care as part of the new hospital Value-Based Purchase (VBP) program. Under the new value-based purchasing program, an estimated $850 million will be allocated to hospitals in 2013 for their performance on a set of quality measures that improve patient care and satisfaction.

A means of evaluating patient care is through patient satisfaction surveys which examine caregiver communication, staff responsiveness, pain management, medication explanation, patient family communications and the hospital environment, specifically cleanliness and noise.

Interior furnishings play a role in the overall patient satisfaction and experience through the placement and selection of furniture in providing an Environment of Care. First impressions, comfort and control, guarding privacy and security, physical barriers, family participation, and safety/cleanliness are factors to be considered when choosing furniture.


First Impressions

Most people entering a hospital do not know what to expect. Patients and family often enter a hospital with high levels of stress, confusion and vulnerability. A warm and inviting environment creates a sense of calm and relieves anxiety. Natural light, well-placed building lighting and artwork softens a normally institutional setting. Furniture and furnishings must be comfortable and arranged to meet the preferences of those seeking privacy or social interaction. The furnishings and surface materials must look good and be well-maintained and clean.


Comfort and Control

A variety of seating types and groupings allow people to have choices of how they use the space. Furniture may be oriented around windows to take advantage of views of nature or in small arrangements to allow for privacy or encourage social interaction. A variety of light sources like table lamps, overhead lighting and natural lighting provide guests the ability to control whether they wish to read independently, watch television in a group or relax with a view of nature. Operable window treatments allow patients and family to manage heat and light in spaces.


Guarding Privacy and Security

Consideration of patient and family privacy is a huge concern. Quiet rooms or areas set aside for private conversation allow patients and families to have sensitive conversations out of view and earshot of others. A patient’s confidence, comfort and sense of safety during care are paramount. Much of that security is conveyed in the caregiver’s interactions with the patient throughout the duration of the person’s stay. These interactions will take place in many different instances, whether asking about the patient’s pain, obtaining his or her medical history, or administering medication; a lot of that happens at or near the bedside. That “point of care” is sometimes delivered from a mobile cart or wall-mounted solution. Regardless, the most important factor is to maintain eye contact with the patient. For instance, if a caregiver is charting on the computer with his or her back to the patient, that can create uncertainty in a patient’s mind of whether he or she is being listened to and understood. The patient and caregiver should be face to face, encouraging interaction by allowing the patient to have visual access to the computer screen and playing a role in his or her care.


Physical Barriers

Patients and family members come in all sizes and ages. Offering seating options like loveseats, arm and armless lounge chairs, recliners, children’s furniture, and guest chairs is important to accommodate a full range of users including handicapped, bariatric, elderly and children. Each area in the hospital will have that wide variety of people using the spaces. Accommodations need to be made in each location to satisfy that wide range of users. Open decentralized nurse stations can cultivate the relationship between hospital staff and family while encouraging interaction between patients, family and caregivers. The symbol of openness sends a positive message.


Family Participation

The presence of family and friends is essential in the patient’s healing process. Round-the-clock visitation can be enhanced by a variety of spaces that allow family to congregate – either at the patient’s bedside or throughout the hospital. Many patient rooms offer overnight accommodations like sleep sofas and recliners, which allow family members to remain close to their loved ones, in addition to support spaces such as family lounges, libraries, kitchens, chapels and gardens. Proper furniture planning and design can impact a patient’s and family’s ability to rest peacefully – details truly make a difference.

Safe and Clean

All furnishings within the facility must be durable and maintainable. Safety is of utmost importance when making selections. Eliminate any sharp edges or pinch points, making certain all furnishings are solid and able to withstand high use (many items are used 24 hours/day). Replaceable components are a necessity so repairs may be made quickly for items to remain in service. Hospital antibacterial agents and bleach solutions can destroy many materials very quickly. The proper selection of the surface finish materials will ensure a clean and well-maintained appearance for many years.


Furniture Selection

There are hundreds of decisions to be made when planning the furniture and furnishings package for a medical facility, and there are hundreds of products on the market to choose from. To make the proper selections, it takes the proper team and processes to evaluate the best options. A “value based program” for selection and purchase of the products should include these basics: function, safety, durability, cleaning, aesthetics, cost and warranty. A product evaluation team including the end users (patients, family and staff), department leads, nurses and physicians, procurement specialists, engineering, IT, environmental services, in-house design staff, and administration should be considered.

Side-by-side product evaluation and testing by the review team is highly recommended as part of the review process. Taking the time and effort for a proper review process can save thousands of dollars and maintenance headaches in the future.

As an example of the evaluation process and considerations that must be considered on a specific piece of furniture, consider the patient room and the proper solution to accommodate a guest spending the night with the patient. Oftentimes the room is planned using a specific solution such as a built-in daybed, Murphy bed, sleep chair/lounge, extendable settee or sofa/sleeper. The room size and patient bed placement is critical to accommodate any of the proposed solutions.

Once the decision is made for a specific “sleep solution,” the selection must be made from the variety of products available. Make a list of the known requirements for the item and compare that to the various products available on the market. Make a short list of products that meet the functional requirement. Once you have the products that meet the functional requirements, you must obtain the samples and compare them based on the value-based program requirements. That is the time to request quotes from the various vendors and manufacturers to confirm pricing and warranty.

At this stage the selection committee has all of the information necessary to make a complete evaluation of the products. Consideration is made to the function of the item. Is it easy to use? Is it intuitive for the family member to use, or will it require assistance from the staff? Is it comfortable in the closed and open positions? Are there elements that could damage the walls or are unsafe for users? Are components easy to replace or repair if damaged? Is it easy to clean? What are the arm styles and finishes, and what is the best solution? Is the upholstery durable, lightfast, easily cleaned and/or replaced?

Once all the questions have been answered and decisions are made, the final product selection can be made with all the necessary requirements and options. Following that type of process, the various product selections will be the correct solutions to satisfy the needs of patients and family physically and aesthetically for years to come.

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