Healthcare Lighting

You’ve probably always assumed that lighting is just lighting. But the healthcare environment has particular lighting needs, and patients, staff and visitors can all benefit from improved lighting solutions geared to the healthcare setting. This architect will explain how.

Healthcare lighting must first meet the requirements of all lighting: providing suitable life-cycle performance, and maximizing energy efficiency, while providing light of proper location, intensity, and quality. But the dynamic and ever-evolving nature of healthcare facilities also requires that lighting schemes be flexible and adaptable to change over time. Fixtures and systems in healthcare facilities must also meet stringent requirements of life-safety and user protection, and may be constrained by space or location limitations. Healthcare lighting must also most often be interwoven with natural daylighting to provide a nurturing and healing environment, one that relaxes and soothes. Further, healthcare lighting must serve many disparate user groups: patients, families, medical professionals, healthcare staff and maintenance personnel. And, since many healthcare facilities are large complexes, with vast numbers of somewhat identical rooms, offices, hallways and waiting rooms, healthcare lighting must assist in creating an effective wayfinding system for all. Finally, since the majority of patients in many healthcare settings (as well as a good percentage of staff and volunteers) may well be aged, lighting design must accommodate failing vision and acuity. Cast your vision on rickzworld.

Healthcare lighting design must first focus on the many task-oriented lighting needs of the environs under consideration. What tasks are being conducted, for how long, where and by whom? What are the lighting users’ ages, positions, postures, and specific task needs? How difficult, tiring, and demanding of attention, focus, accuracy and speed are those tasks? Is there need for longer-term flexibility or adaptability of the task or the lighting? What other ambient or background lighting is necessary or appropriate? Can task lighting serve multiple purposes? What degree of lighting control is required? and by whom?

There are also very specific design goals that should be incorporated into any effective healthcare lighting scheme:

• Where possible, daylighting should be incorporated, both for its proven therapeutic effect, and for a more inviting, less intimidating environment (as well as for energy savings).

• Spaces should be glare-free and free of extreme contrasts of brightness, with attractive, ] layered and hidden-source lighting that establishes a clear, inviting and comforting, somewhat upscale, ambience. Indirect lighting often offers advantages over direct lighting.

• Lighting should be varied along one’s journey through the healthcare facility, offering visual interest and visual relief in a choreographed arrangement. Where medical staff is concentrated at tasks, uniform light levels can facilitate operations and minimize fatigue.

• Where patient care and direct attention to medical procedures are paramount, the type and degree of lighting controls and their placement become as important as the lighting itself. So too do the light color quality, intensity, location and orientation of luminaries.

• In patient rooms, the overall lighting design must accommodate a number of different, and sometimes conflicting, demands: patient comfort; patient mobility; bathroom illumination; reading or television; examination by medical staff; medical procedures; staff monitoring; family or visitor needs; daylighting; nightlighting; and so on.

There are a number of professional organizations that can assist in sorting out the best practices for healthcare lighting. These include the American National Standards Institute (ANSI) and the Illuminating Engineering Society of North America (IESNA), which have formulated ‘Lighting for Hospitals and Healthcare Facilities’ to set forth reasonable standards. The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), in conjunction with IESNA, has also promulgated Minimum Energy Efficiency Requirements for lighting controls and lighting power characteristics. Further guidance on outdoor lighting is offered by the Dark Sky Initiative.

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Travel Nurses and Other Healthcare Professionals

Travel Nurses and Other Healthcare Workers

When hospitals and other healthcare facilities find themselves in the position of having more work than healthcare workers, they often turn to travel healthcare professionals such as travel nurses, travel medical technologists, travel radiology technicians, travel physical therapists, travel occupational therapists, travel respiratory therapists, and more. This article discusses What a travel healthcare worker is, how to be come a travel nurse or other kind of travel healthcare worker, companies which place travel healthcare workers, pay and other travel healthcare worker issues.
Travel Nurses
The Demand for Travel Healthcare Professionals

The United States spent about three trillion dollars on healthcare in 2013 and costs will continue to rise at about 4% per year well into the future. One of the results of The Affordable Care Act will be more people insured and therefore more people seeking treatment. The demand for healthcare workers of all kinds remains high. But many healthcare facilities are having a hard time filling positions in many of their departments. There just aren’t enough healthcare professionals to meet all the needs.

When hospitals and other healthcare facilities find themselves in the position of having more work than healthcare workers, they often turn to travel healthcare professionals such as travel nurses, travel medical technologists, travel radiology technicians, travel physical therapists, travel occupational therapists, travel respiratory therapists, and more.

Travel healthcare professionals are individuals who contract with a healthcare facility to fill the position for which they are qualified, for an agreed upon amount of time.
Poll: Are you a Healthcare Professional?
Are you a healthcare professional?

Physician Assistant
Rehabilitation (PT/OT)
Respiratory Therapy
Medical Social Worker
Nuclear Medicine

See results without voting
Healthcare Professions Which Utilize Travelers

If you are a healthcare professional, chances are that travelers are used in your particular discipline. This article would be much longer if an exhaustive list were to be included. Simply go to your search engine and type in “Traveler” or “Travel” followed by the name of your healthcare profession. For example, type in “Traveler histology technician.” There will be two and a half million results in Google. Type in “Travel nurse” and there will be 117 million results.

Once you have determined that there are travelers involved in your healthcare profession, it is time to look into which travel healthcare agencies you will contact.

United States Medical Centers of Excellence for Premiere Healthcare

What Is a Medical Center of Excellence? — Multiple Systems, Public and Private

A United States government-designated and recognized Center of Excellence, beginning in the mid-1960s, is a facility or organization that creates healthcare value above the average found in a specific location. These facilities make up the best of the best in American healthcare in a particular region.

In the late 1990s, the US Health Care Financing Administration (HCFA) began to examine and compare treatment outcomes among hospitals paid by Medicare. Other divisions of government, as well as the private sector, have developed their own systems for rating and/or developing Healthcare Centers of Excellence.
Examples of Excellent Healthcare Facilities
19th Century Civil War Healthcare
USS Red Rover, which sailed 1862-1865, illustrated by Theodore R. Davis. The picture is a ward on this early US hospital ship. Health related Centers of Excellence develop better healthcare practices for current and future needs.
USS Red Rover, which sailed 1862-1865, illustrated by Theodore R. Davis. The picture is a ward on this early US hospital ship. Health related Centers of Excellence develop better healthcare practices for current and future needs.
Healthy People Program

The United States Federal Government established national centers of excellence in health and medical care in the 1990s through their Department of Health and Human Services (DHHS). At the same time, the Surgeon General’s Office was conducting research for a foundation for setting goals for the Healthy People 2000 program.

Our national goal in health and medicine was to increase the human lifespan for as many health years as possible, and to offer the best of prevention and treatment coast to coast. By 2016, we have not as yet met all related goals, but healthcare has improved.

Since 1998, other new systems resulting in Centers of Excellence have emerged, including a system of

Medical centers under the supervision of the US Veterans Administration and a
Medical centers developed by insurance companies, specifically Cigna HealthCare, along with Prominence Health Plan (in four western states).

Other systems exist as well and the healthcare consumer is wise to investigate the history, development, and certification rationale for any medical or healthcare “center of excellence.”

These centers are not all the same.
Some Medical Centers of Excellence Privatized, as Did Our Space Program
Cigna HealthCare

Cigna offers a brochure designed to help patients select the healthcare most appropriate and most affordable to themselves. It is named

CIGNA HealthCare Hospital Value Profile Tool and Centers of Excellence:


The Cigna selection process for “excellence” is based on a scoring system that looks at

Positive patient outcomes and
Cost efficiency in treatments offered in 19 separate healthcare categories in hospitals and medical centers.

The system also awards these healthcare institutions with an overall score.

Individuals insured with Cigna are granted access to check individual hospital scores per treatment category and the overall score at the CIGNA Hospital Value Profile Tool at the company website. Patients may then choose the Cigna Center of Excellence that feel is best for them or select a medical center or hospital that is not a Cigna Center for Excellence.

This all is a little like the AAA recommended (AAA Certified) auto repair shop program and can help healthcare consumers in a manner similar to the help given auto repair consumers.
US Veterans Administration

The impressive Veterans Administration system of Centers of Excellence (COE) is well organized and seems designed to provide and to further develop the most accurate, results-driven, up-to-date, and efficient healthcare solutions to American Veterans. This system is for US veterans.

Every one of the separate centers develops a unique research agenda. All are connected with a local VA Medical Center.

Each COE partners with local Schools of Public Health, Universities, and Medical Colleges.

Opt Occupational Therapist Job Openings

Talented professionals aiming to shape their career as occupational therapists can now find a number of OPT job openings in premium healthcare facilities throughout the United States. These include multi-specialty hospitals, nursing clinics, long term healthcare facilities, home healthcare agencies, rehabilitation centers, acute care clinics and several other settings.

Criteria for Utilizing OPT Job Openings

Optional Practical Training is an employment authorization given by the United States Citizenship and Immigration Service (USCIS), for the students in F-1 status to work temporarily in areas related to their academic discipline. This program is intended to help the professionals gain more practical experience by applying the knowledge obtained through classroom training in real environments outside the campus.

For utilizing OPT job openings, the candidates must have enrolled with USCIS recognized schools continuously, at least for a period of nine months. Besides, they must have F-1 status at the time of applying. Students satisfying these prerequisites can undertake the program in the following four instances:

• As part-time (while the school is in session)
• As full-time (during annual vacation and at other times)
• After the completion of your degree course requirements ( but before the submission of thesis or dissertation)
• After obtaining your degree

To enable the students to work in their area of study for a longer timeframe, the Department of Homeland Security (DHS) in the United States has recently extended the OPT training duration from 12 to 29 months. The students can therefore gather sufficient experience and concentrate more on their job search without being concerned about their graduation dates and so on.

Register with a Competent Staffing Service Provider

By depending on reliable healthcare staffing solution providers, one can easily find OPT job openings for occupational therapists. When you register with these agencies, they will provide expert assistance to secure permanent or temporary placements in competent medical care facilities providing attractive emoluments and benefits.

Entry Level Speech Pathology Jobs

There are several openings for entry level speech pathology jobs in well-known medical facilities across the United States. Speech language pathologists who satisfy the essential entry level requirements have great opportunities to build their rehab career in challenging environments. Securing employment in the established facilities in the US also enables them to enjoy a high level of job security, as well as excellent monetary and insurance benefits.

Entry Level Speech Pathology Jobs: Eligibility Criteria

To secure entry level speech pathology jobs, jobseekers should have a master’s degree in speech language pathology from an accredited university. They must have the necessary licensure or certification requirements as well. Along with the academic credentials, job aspirants should possess excellent communication and interpersonal skills, as well as the aptitude and willingness to support their patients in each and every phase of the treatment.

Nature of the Job

Entry level speech language pathologists have a series of responsibilities. They have to evaluate, diagnose and treat individuals struggling with cognitive-communication, speech, language, fluency, swallowing and articulation disorders. They need to have the ability discuss communication disorders with various treatment professionals and families; they have to plan and implement treatment programs. They also need to have excellent oral and written communication skills.

Openings in Established Facilities

Entry-level speech pathologists can secure jobs in rehabilitation centers, multi-specialty hospitals, nursing clinics, long-term healthcare facilities, acute care clinics, child development centers, government agencies, educational institutions, and so on. They can opt for temporary, permanent, short-term, long-term, part-time or full-time jobs. They can also secure travel speech pathology jobs. All established medical facilities in the US ensure good remuneration and an assortment of other benefits for talented speech pathologists. They benefit from:

• Professional liability insurance
• Section 125 cafeteria plan
• Continuing education programs
• 401k benefits
• Short-term disability insurance
• Health care insurance
• H1b visas and green cards
• Immigration processing support
• Additional state license

Healthcare Staffing Agencies for Professional Assistance

Enrolling with established healthcare staffing firms enables you to obtain information about the fresh opportunities for entry level speech pathology jobs. As these firms are closely associated with healthcare providers, they can provide up-to-date information and the necessary support to secure convenient placements in popular facilities. Browsing online directories and the yellow pages would provide you with lists of staffing firms from which you can choose an experienced agency to help with your job search.

Medical Tourism – Quality Healthcare Away From Home

Everyday thousands of people from the US and Europe are waking up to the phenomenon called medical tourism that has become quite a rage in recent times. The practice of visiting new places in search of favorable climate or on just being advised by a doctor to go ‘on a change’ is not new. Medical tourism is just an evolved form of this age old habit of humanity.

Medical tourism combines care for your health with international tourism. The primary reason behind its surging popularity is better healthcare services at an affordable budget. When one’s health is one’s concern, it is natural to look for the best treatment options within one’s budget. Countries such as India are fast coming to the forefront as provider of world-class healthcare facilities. These include a wide array of highly skilled healthcare professionals, trained in various specialized disciplines, state-of-the-art equipment and modern amenities, impeccable service and personal attention to every need of the patient and all these, at a cost that’s surprisingly affordable.

Most people in need of specialized healthcare services feel daunted by the high cost associated with them. Countries such as US, Canada or some European nations, offer the same high standard healthcare facilities as India, Malaysia or Dubai, at a cost that’s substantially greater. Let’s face it, not everybody can afford the high cost associated with healthcare services in his or her own country. Nor do all of us enjoy the benefits of a high medical insurance coverage.

All this naturally necessitates the need to look for similar healthcare services elsewhere, where the cost is significantly lower. Healthcare tourism makes it possible to save up to 80% (as compared to US/UK) on medical costs by opting for countries like India. Healthcare tourism in India is fast gaining in popularity because of this simple reason.

Medical tourism also gives you other advantages such as reduced waiting periods for your treatment. If there is a critical treatment involved, or an operation that needs to be done quickly, you can initiate the process almost immediately after contacting the healthcare professionals in these countries. Most hospitals or medical establishments in the US or UK have lengthy waiting lists and necessitate wait for a substantially longer period of time.

Smart and well-informed professionals, speaking fluent English and attending to every detail with meticulous attention, only add to the overall experience. You can rest assured knowing that the task of caring for your health is in good, able hands. You will also find comfort in the thought that when you are fully treated and about to return home, you will not be handed bills that will make you fall sick all over again.

So what are the reasons that contribute to the ever increasing popularity of medical tourism?

Why Is Healthcare Facility Construction So Expensive?

Healthcare cost in the United States continues to rise at an alarming rate. With the aging baby boomer population, the impact of the Patient Protection and Affordable Care Act and current economic climate attempting to understand and control these costs has become more important than ever. One aspect of healthcare cost that always seems to cause confusion and even frustration is healthcare facility construction. Why is healthcare facility construction so expensive?

Many medical facilities house patients who are receiving critical services. Because of the critical nature of these services the individual patient may not be able to adequately care for themselves in fire, emergency or other threatening situation. As we will see, many of the systems and features in healthcare buildings are designed and installed in such a way as to protect the patients who may be incapacitated or compromised. The easiest way to demonstrate this and why healthcare facility construction is so expensive is to take a virtual a tour. With a tour, we can demonstrate and identify the unique features and inherent cost of a typical healthcare facility, many of which are designed to protect the patient user.

Let’s start our tour at the main entrance. Often, you can pull the car, van or ambulance right up to the front entrance under a large canopy or the porte cochere. This canopy or porte cochere is typically equipped with sprinklers, special lighting and designed for the loading and unloading of the handicapped. For medical buildings, there are often two porte cochere, one for the general public and one for patient transfers. If we take a moment to walk around the building, before going inside we might also notice windows enveloping each floor (windows for each patient room), extra wide sidewalks, multiple handicapped parking spaces and access points, handicap van or ambulance throughway and parking and covered or reserved parking for physicians. In addition, we might find an oxygen tank and other medical gases for delivery of these gases to patient room or surgery suites. Medical gases delivered to patient rooms and or surgery suites are a very unique feature almost exclusive to medical facilities.

If we continue our walk around the building we might see the HVAC system. A healthcare oriented HVAC system must deliver specially, filtered and controlled air and do so evenly though out the entire building. As we pointed out earlier, we are often dealing with incapacitated or compromised patients who may be weak, in pain or physically handicapped. Fundamental patient comfort like, clean, controlled, even air flow must be a non-issue in healthcare facilities. Finally, the outside tour of the building might reveal a generator. A generator can be used to power emergency backup and certain life safety systems. These generators are often housed in large, separate structures and can have a material impact on overall building cost.

As we approach the main entrance the building signage may indicate the facility is operated on a 24 hour, 7 days a week basis. The 24/7 nature of the building coupled with the safety concerns of incapacitated or compromised patients is very important in relation to hidden costs and features associated with healthcare facility construction. Almost all MEP systems (mechanical, electrical and plumbing) in a healthcare building will be oversized and or redundant. The oversized or redundant nature of these systems allows for part of the system to be worked on while the rest of the system continues to function. Healthcare facility HVAC air handlers for example, are often larger than typically required to achieve higher static pressures and the required air flow capacities mentioned earlier. Oversized or redundant systems are a common theme in medical building construction and significant contributing feature to the expensive nature of the facility.

Once inside the building we will find a fire or emergency control panel. The panel for fire and emergency systems for many commercial buildings, including healthcare are often found just inside the main door. This placement helps facilitate action by appropriate personnel when alarm sounds or disaster strikes. However, healthcare oriented fire and emergency control systems often build-in unique or special features. The systems are often more flexible, allowing for multiple choices and options. Options such as evacuation notice or warning, barrier control, zone by zone evaluation, general or isolated announcements and lock down.

As we step into the main lobby there are likely to be two elevators types, one for public use and one for transporting patients. A patient designed elevator must accommodate a gurney or stretcher and often opens to the front and the back. Since patient elevators open to the front and the back, space needs are greater than a typical passenger elevator. Exit corridors off the patient elevator to the patient oriented porte cochere are common in healthcare facilities. In a well designed, well operated, medical building you will rarely see a patient rolled out on a stretcher through a main lobby or public hallway. As we stand in the main lobby and look up or down we might also see safety lighting features, special ceiling tiles, and large number of sprinkler heads, specially designed flooring and even bacterial resistant window coverings.

If we could look behind the walls or beneath the floor we are likely to find significantly greater plumbing requirements, increased fire wall separation, reinforced foundation and sophisticated monitoring or tracking systems. Often the hallways themselves will be much wider than typical office building and handrails may be installed. Of course, you are likely to continue to find; safety lighting, increase sprinkler heads, special ceiling tiles and safety flooring. We can’t go much further into the building without getting into specific tenant needs but you are likely to find features unique to medical facilities. Features such as telemetry, sophisticated call systems, biometric or customized security systems, and exotic tracking features. There are also more practical issues and needs that must be addressed in medical tenant space such as; special air filtering and exhaust, infectious waste disposal, unique storage issues, family meeting and grieving areas and even chapels.

There are many other special features and systems in healthcare facilities. However, there is at least one remaining material issue that clearly adds cost. All of the special, unique or important systems and features are expected to be transparent to the patient, their family and visitors. In today’s healthcare environment, the patient and family expect and even assume the facility will be state of the art but user friendly, convenient and comfortable!

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Planning and Design of Behavioral Healthcare Facilities

In keeping with most districts of healthcare, the marketplace has seen a boom in the construction of Behavioral Healthcare facilities. Contributing to this increase is the paradigm shift in the way society views mental illness. Society is placing a heavier value on the need to treat people with serious addictions such as alcohol, prescription and elicit drugs. A large percentage of people suffering from behavioral disorders are afflicted with both mental and addictive behaviors, and most will re-enter communities and either become contributors or violators.

These very specialized facilities do not typically yield the attention from today’s top healthcare designers and their quantity accounts for a small fraction of healthcare construction. However, Behavioral Healthcare projects are increasing in number and are being designed by some very prominent architectural firms such as Cannon Design and Architecture Plus. Many are creating state-of-the-art, award-winning contemporary facilities that defy what most of us believe Behavioral Healthcare design to be.

Changing the Way We Design Behavioral Healthcare Facilities

As with all good planners and designers, A+D (along with facility experts) are reviewing the direct needs of patient and staff while reflecting on how new medicine and modern design can foster patient healing rates, reduce environmental stress, and increase safety. This is changing the face of treatment and outcome by giving the practitioner more time to treat because they require less time and resources to “manage” disruptive patient populations.

The face of Behavioral Healthcare is quickly changing. No longer are these facilities designed to warehouse patients indefinitely. And society’s expectations have changed. Patients are often treated with the belief that they can return to their community and be a contributor to society. According to the National Association of Psychiatric Health Systems (NAPHS), depending on the severity of illness, the average length of stay in a Behavioral Healthcare facility is only 9.6 days.

What has changed?

Jaques Laurence Black, AIA, president and principal of New York City-based daSILVA Architects, states that there are two primary reasons for the shortened admission period:

1. Introduction of modern psychotropic drugs that greatly speed recovery

2. Pressures from insurance companies to get patients out of expensive modes of care

To meet these challenges, healthcare professionals are finding it very difficult to effectively treat patients within the walls of antiquated, rapidly deteriorating mental facilities. A great percentage of these facilities were built between 1908 and 1928 and were designed for psychiatric needs that were principled in the belief to “store” not to “rehabilitate.”

Also impacting the need for Behavioral Healthcare construction is the reluctance of acute-care facilities to provide mental health level services for psychiatric or addiction patients. They recognize that patient groups suffering from behavioral disorders have unique health needs, all of which need to be handled and treated only by very experienced healthcare professionals. This patient population also requires a heightened level of security. Self-harm and injuring staff and other patients are major concerns.

The Report of the Surgeon General: “Epidemiology of Mental Illness” also reports that within a given year about 20% of Americans suffer from a diagnosable mental disorder and 5.4% suffer from a serious mental illness (SMI ) – defined as bipolar, panic, obsessive-compulsive, personality, and depression disorders and schizophrenia. It is also believed 6% of Americans suffer from addiction disorders, a statistic that is separate from individuals who suffer from both mental and addiction disorders. Within a given year it is believed that over one-quarter of America’s population warrants levels of mental clinical care. Even if these statistics were cut in half, it cannot be denied as a serious societal issue.

With a growing population, effectively designing in accordance with such measures is at the heart of public health.

Understanding the Complexity of Behavioral Healthcare Design

Therefore, like Corrections, leading planners and designers specializing in Behavioral Healthcare are delving deeper to better understand the complexity of issues and to be the activist to design facilities that promote treatment and healing – and a safer community.

The following is a list of key design variables that are being studied and implemented:

1. Right Sizing

2. Humanizing Materials and Color

3. Staff-Focused Amneties and Happiness

4. Security and Safety

5. Therapeutic Design Tenants


Today’s Behavioral Healthcare facilities are often one-story single buildings within a campus size. Often debated by Clients due to costs, this design preference is driven by the demand for natural light, window views to nature for all patient areas, and outdoor open-air gardens “wrapped” within. All of this provides soothing qualities to the patient, reduces their anxieties, counteracts disruptive conduct and helps to reduce staff stress.

“When you look at the program mix in these buildings, there’s a high demand for perimeter because there are a lot of rooms that need natural light. Offices, classrooms, dining areas, community rooms, and patient rooms all demand natural light, so you end up with a tremendous amount of exterior wall, and it forces the building to have a very large footprint.” – James Kent Muirhead, AIA, associate principal at Cannon Design in Baltimore

These design principles are also believed to improve staff work conditions. Unlike a multi-story complex, at any moment staff can walk outdoors and access nature, free from visual barriers, and within a building that more accurately reflects building types that both patients and staff would encounter in their communities.

In addition to right-sizing for the overall building footprint, is right-sizing for internal patient and staff support area. Similar to the move we have seen in Corrections to de-centralize support spaces, Behavioral Healthcare is moving to decentralized nursing/patient units called “neighborhoods.” With mental health facilities there is a large concern with distances and space adjacencies in relation to the patient room and patient support areas such as treatment and social spaces. Frank Pitts, AIA, FACHA, OAA president of Architecture Plus, Troy, NY, advocates neighborhoods that average 24-30 beds arranged in sub-clusters, called “houses”, of 8-10 beds. Thus, each neighborhood consists of three houses. Often these layouts will include a common area where patients congregate and socialize, with a separate quiet room so patients can elect to avoid active, crowded areas. In addition Pitts states, “There’s a move away from central dining facilities. So, while facilities will still have a central kitchen, it’s a whole lot easier moving food than it is patients.” However, it is important for the facility to mimic normal outside daily life routines, so patients are encouraged to frequently leave their neighborhoods to attend treatment sessions, and outdoor courtyards.

Humanizing Materials & Color

In all facilities that play a role in rehabilitation, design strives to create spaces that humanize, calm, and relax. Behavioral Healthcare patients need to feel that they are in familiar surroundings; therefore, the architectural vocabulary should feel comfortable and normal. Since these facilities are about rehabilitation (when possible) and encouraging patients to merge back into society, the facility should feel like an extension of the community. Their spaces should reflect the nature and architecture of the surrounding region and thus so, no two facilities should look too much alike.

“Our approach to designing these facilities is to view the facility as an extension of the community where patients will end up when they’re released. Interior finishes also depend on geography because you want to replicate the environment patients are used to. You want to de-stigmatize the facility as much as possible.” – Tim Rommel, AIA, ACHA, OAA, principal with Cannon Design in Buffalo, NY.

Therefore, materials and colors within these spaces want to feel familiar to one’s region and everyday life. To soothe the psyche and rehabilitate, they want to feel soft and comfortable, yet visually stimulating. An interior that is overly neutral or hard in appearance is not appropriate. Materials should reduce noise, and colors should lift the spirit. This can help to create an environment in which the patient can learn, socialize, and be productive while easing anxieties, delivering dignity, and modifying behavior. As stated previously, behavioral studies advise the use of softer interior materials-like carpeting, wood doors and tile. Doing so translates directly to both patient and staff well-being, particularly staff safety, and makes for a nicer place to work. In addition, staff have more resources to “treat” instead of manage heated situations. When staff experiences are eased and satisfied, morale is boosted and life-saving rules and policies are more likely to be enforced.

Staff-Focused Amenities & Happiness

While reducing staff stress and fatigue through a healing supportive environment seems like an obvious goal, there are relatively few studies that have dealt with this issue in any detail. More attention has been given to patient outcomes. However, many leading hospitals that have adopted therapeutic tenants into their newly built environments have seen vast improvement through their “business matrixes” and financial reporting.

In one example, the Mayo Clinic, a national leader in implementing healing design in its facilities, has reported a reduction of nursing turnover from a national annual average of 20% to an annual 3%-4%. In another example, when Bronson Methodist Hospital incorporated evidence-based design into its new 343-bed hospital, they cited their 19%-20% nurse turnover rate dramatically dropped to 5%.

Now, both the Mayo Clinic and Bronson Methodist Hospital have had to initiate a waiting list for nursing staff seeking positions. This converts to better-trained and qualified staff, and a reduced error rate. Therefore, more health facilities are investing in staff support areas such as lounges, changing rooms, and temporary sleep rooms. Within these staff spaces and in the hospital throughout, facilities are also recognizing the need for upgrade materials, better day lighting, and an interesting use of color: One soon realizes that the need of patients and staff are interwoven, each impacting positively or negatively the other.

Security & Safety

Without debate, self harm and harm to staff is one of the biggest concerns mental health facilities manage. Often the biggest safety and security concern is the damage patients can do to themselves. “There are three rules I had drummed in me,” says Mark Hanchar; Director of Preconstruction Services for Gilbane Building Company, Providence, R.I. “First, there can’t be any way for people to hang themselves. Second, there can be no way for them to create weapons. Third, you must eliminate things that can be thrown.” Hanchar says that the typical facility is, “a hospital with medium-security prison construction.” This means shatter proof glass, solid surface countertops (laminate can be peeled apart), stainless steel toilets and sinks (porcelain can shatter), push pull door latches and furniture that cannot be pulled apart and used as a weapon. These are just to name a few.

Additionally, removing barriers between patients and nursing staff is a safety consideration. Frank Pitts, AIA, FACHA, OAA president of Architecture Plus, says what may be counter-intuitive for safety precautions, “Glass walls around nursing stations just aggravate the patients.” Removing glass or lowering it at nursing stations so patients can feel a more human connection to nurses often calms patients. There is also discussion of removing nursing stations altogether; decentralizing and placing these care needs directly into the clinical neighborhoods and community spaces. Pitt says, “The view is that [nursing staff] need to be out there treating their patients.”

Therapeutic Design Tenants

As medicine is increasingly moving towards “evidence-based” medicine, where clinical choices are informed by research, healthcare design is increasingly guided by research linking the physical environment directly to patient and staff outcomes. Research teams from Texas A&M and Georgia Tech sifted through thousands of scientific articles and identified more than 600 – most from top peer-reviewed journals – to quantify how hospital design can play a direct role in clinical outcomes.

The research teams uncovered a large body of evidence that demonstrates design features such as increased day-lighting, access to nature, reduced noise and increased patient control helped reduce stress, improve sleep, and increase staff effectiveness – all of which promote healing rates and save facilities cost. Therefore, improving physical settings can be a critical tool in making hospitals more safe, more healing, and better places to work.

Today’s therapeutic spaces have been defined to excel in 3 categories:

1. Provide clinical excellence in the treatment of the body

2. Meet the psycho-social needs of patients, families, and staff

3. Produce measurable positive patient outcomes and staff effectiveness

Considering the cost of treating mental illness, which is exceedingly high, and wanting facilities to have effective outcomes, a further practice of incorporating therapeutic design is increasing. The National Institute of Mental Health (NIM H) approximated in 2008 that serious mental illnesses (SMI ), costs the nation $193 billion annually in lost wages. The indirect costs are impossible to estimate.

The estimated direct cost to clinically treat is approximately $70 billion annually and another $12 billion spent towards substance abuse disorders. In addition to the increased need of care and the boom in Behavioral Healthcare construction, it becomes an obligation to make certain that we as facility managers, architects, designers and manufacturers therapeutically plan and design these facilities.

Notably, in 2004, “The Role of the Physical Environment in the Hospital for the 21st Century: A Once-in-a-Lifetime Opportunity,” published by Roger Ulrich P.H.D., of Texas A&M University, was released. In a culmination of evidence-based research, research teams found five design principles that contributed significantly to achieving therapeutic design goals.

The report indicates five key factors that are essential for the psychological well-being of patients, families and staff, including:

1. Access to Nature

2. Provide Positive Distractions

3. Provide Social Support Spaces

4. Give a Sense of Control

5. Reduce or eliminate environmental stress

Access to Nature

Studies indicate that nature might have the most powerful impact to help patient outcomes and staff effectiveness. Nature can be literal or figurative – natural light, water walls, views to nature, large prints of botanicals and geography, materials that indicate nature and most importantly, stimulating color that evokes nature. Several studies strongly support that access to nature such as day-lighting and appropriate colorations can improve health outcomes such as depression, agitation, sleep, circadian rest-activity rhythms, as well as length of stay in demented patients and persons with seasonal affective disorders (SAD).

These and related studies continue to affirm the powerful impact of natural elements on patient recovery and stress reduction. Thus, it is clear that interior designs which integrate natural elements can create a more relaxing, therapeutic environment that benefits both patients and staff.

Positive Distractions

These are a small set of environmental features that provide the patient and family a positive diversion from “the difficult” and, in doing so, also negate an institutional feel. These can be views to nature, water walls, artwork, super imposed graphics, sculpture, music – and ideally all of these want to be focused on nature and, when applicable, an interesting use of color. Therapeutic environments that provide such patient-centered features can empower patients and families, but also increase their confidence in the facility and staff. This helps with open lines of communication between patient and caregiver.

Social Support Spaces

These are spaces designed partially for the patient but mainly for the comfort and socialization of family members and friends of the patient; therefore, family lounges, resource libraries, chapels, sleep rooms and consult rooms all play a role. When family and friends play a key role in a patient’s healing, these spaces encourage families to play an active role in the rehabilitation process.

Sense of Control

In times when patients and family feel out of control, it is very healing for the facility design and staff to provide it back when appropriate. Although, this cannot always be done suitably in mental healthcare facilities. However, when applicable, these design features include optional lighting choices, architectural way-finding, resource libraries, enhanced food menus, private patient rooms and

optional areas to reside in. A few well-appointed studies in psychiatric wards and nursing homes have found that optional choices of moveable seating in dining areas enhanced social interaction and improved eating disorders. When patients feel partially in control of their healing program and that the building features are focused to them, an increased confidence of the quality of care enters and tensions lower.

As with all therapeutic design, this allows the caregiver to use their resources healing in lieu of “managing” patient populations.

Reduce or Eliminate Environmental Stress

Noise level measurements show that hospital wards can be excessively noisy places resulting in negative effects on patient outcomes. The continuous background noise produced by medical equipment and staff voices often exceeds the level of a busy restaurant. Peak noise periods (shift changes, equipment alarms, paging systems, telephones, bedrails, trolleys, and certain medical equipment like portable xray machines are comparable to walking next to a busy highway when a motorcycle or large truck passes.

Several studies have focused on infants in NIC Us, finding that higher noise levels, for example, decrease oxygen saturation (increasing need for oxygen support therapy), elevate blood pressure, increase heart and respiration rate, and worsen sleep. Research on adults and children show that noise is a major cause of awakening and sleep loss.

In addition to worsening sleep, there is strong evidence that noise increases stress in adult patients, for example, heightening blood pressure and heart rate. Environmental surfaces in hospitals are usually hard and sound-reflecting, not sound-absorbing causing noise to travel down corridors and into patient rooms. Sounds tend to echo, overlap and linger longer.

Interventions that reduce noise have been found to improve sleep and reduce patient stress. Of these, the environmental or design interventions such as changing to sound-absorbing ceiling tiles, are more successful than organizational interventions like establishing “quiet hours.”

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Medical Transcription Outsourcing – Helping Healthcare Facilities Operate Successfully

Medical transcription services have been around almost as long as healthcare services, documenting the patient- healthcare professional encounter. Though medical transcription has been around for a long time, these services have evolved from mere typing or data entry services to sophisticated services that contribute to the smooth running of healthcare facilities using the right technology, the right people and the right processes. One of the main factors that have been instrumental in this change has been due to the evolution of outsourced service providers specializing in this service.

How do outsourced medical transcription services aid in the successful running of healthcare facilities?

To be successful and profitable, healthcare facilities have to basically concentrate on a few main areas, namely:

The ability to communicate health related information to the stakeholders in the healthcare chain: With the emergence of a move towards nationwide healthcare systems, one of the top priorities of healthcare facilities is to develop the ability to be able to exchange health related information in a secure and quick manner. To this end there has been a move to adopt EMR/EHR systems. Professional and technologically savvy vendors contribute to this process, by providing services that include:

– Document delivery modes that facilitate delivery of transcripts to multiple providers involved in the care process

– HL7 interface for adoption of EMR/ EHR while still retaining the preferred method of dictation to transcription

Risk management aspects: Another factor that affects the successful running of healthcare facilities is that of risk management. In an increasingly litigious environment, it is important for healthcare facilities to have robust measures in place to minimize risks. Moreover in an increasingly virtual world the information from patient medical records is vulnerable to misuse. Transcription providers help in this aspect by ensuring the following:

– Helping preserve the narrative aspect of patient medical records helps in preserving the patient story and this plays an important role in judging the sequence of events and justifying the appropriateness of the treatment process

– Transcription vendors have measures in place with regard to technology, processes and infrastructure with regard to security of confidential patient information, which helps in risk management

Optimum pricing and revenue management: A healthy bottom line is a vital ingredient contributing to the successful functioning of a healthcare facility. To this end it is important to curb costs and accelerate revenue. Outsourced medical transcription service providers provide support in achieving this goal by enabling:

– Lowering cost of transcription by almost 40%.
– Eliminating all indirect cost of transcription
– As faster creation of patient medical records can help accelerate the reimbursement process, outsourced services contribute in this aspect by maintaining a shorter turnaround time

Develop competencies in healthcare related to quality, cost and value of services: Though medical transcription has no direct connection with the healthcare process, it provides important support. Vendors providing this service help in this aspect of the healthcare facility operations by enabling the following:

– Maintaining the integrity of the patient medical record by maintaining high levels of accuracy. This helps in providing continued care and keeping progress of the patient’s progress among various other aspects

– Enables the healthcare professionals and support staff to have easy access to the patient medical records by providing archiving facilities. It becomes easier for healthcare professionals to access older transcripts using various search criteria.

– Helps shift the focus of the healthcare professional onto the patient rather than the process of documentation by allowing them to document the patient encounter via preferred and familiar methods.

It can be concluded that having a professional and technically proficient vendor for patient medical record creation can help in the successful operations of the healthcare facility.

The Worth Of Healthcare Pr In Healthcare Facilities

Healthcare PR is undoubtedly an often misunderstood and under-valued healthcare management instrument. To most, it truly is known as just another method of advertising while some dismiss PR as coping with journalists and delivering press releases.

Actually, healthcare PR can engage in a central role inside the achievement of specific objectives in the slightest levels of an organization’s work by concentrating, reinforcing and connecting a powerful message.

Healthcare PR success strategies helps health professionals, dentists, physical therapists and also other healthcare providers identify opportunities and place news reports stories that engage the particular audiences they wish to attract. With increasing level of competition and limited marketing budgets, drug companies are increasing their PR efforts to ensure they are ahead of the game.

The main objective of healthcare PR is to try to increase awareness for that certain product or therapy to acquire sales or patients. Public relations is frequently employed as an alternative to advertising mainly because it provides the same or better final results without costly outlays for media buys or other marketing activity. Furthermore, PR enables the company to connect with their consumers and lets them gather opinions and comments concerning their products.

Beyond product support, healthcare PR pros have recognized that it’s useful for maintaining a public image for an organization through interaction between that organization as well as its publics. Basically, this is a couple of practices that offers any company positive results on their own reputation.

Marketing is really a necessity if a hospital or medical center is likely to succeed. You will find a definite requirement of scrutiny, strategic planning and communication strategies so as to most effectively take advantage of the limited resources while providing top quality health care. This is when hospital media relations and healthcare PR show up in.

Media relations and community relations, both belong to the umbrella of healthcare PR. Even though they are usually confused, they’re different processes. Each one has its unique objectives and concentration.

Media relations is particularly crucial in the healthcare industry. Patients choose a hospital or physician based on trust. Even during the case in which the medical provider is chosen for any patient it is vital that a sense of trust is created. It’s precisely because the trust factor is so vital that healthcare PR is easily the most effective kind of marketing available for hospitals and medical service providers.

Unlike advertisements or direct marketing, healthcare PR is definitely the only sort of marketing that gives the credibility and validation of being featured in the news. The population learns on most new medical developments, scientific studies, or methods coming from the media. The physicians interviewed, or hospitals that are featured benefit from that coverage.

For healthcare PR practitioners, the leading objectives of their campaigns could be to build product awareness – by communicating its advantages and effects. This is often typically accomplished by disseminating more information regarding the product to the target audiences by a few means such as press releases, media relations, the submission of bylined articles as well as the employment of social media marketing.