2022 June 13 | Christin Coats
The fundamentals of healthcare design rests on the idea of always putting the patient first. This seems like an easy concept but creating a patient-centered environment requires a much deeper approach and thought process to successfully set a stable foundation for an overall design. Focusing on the patient and delivering an efficient, safe, and comfortable design that meets their needs both physically and culturally, allows adequate means for improving care and health equity for a facility. One sector of healthcare that time and again stands out among the rest in successfully delivering on this specialized approach is hospice care.
Hospice care provides a dignified end-of-life experience for patients and their families and friends. Patients enrolled in hospice have life-limiting illnesses with six months or less of life expectancy. Curative methods, typically seen in palliative care, are less seen in hospice environments, as the patient’s illness has advanced past the point of these methods having an impact on the outcome. The primary priority for the staff is to create not only a patient-centered environment, but an inclusive family-centered environment that focuses on the patient, their family, and friends’ comforts and needs.
The quantity of hospice facilities has grown exponentially over the years. According to the 2019 Report for Hospice Demographics and Outcome Measures issued by the State of Florida Department of Elder Affairs, hospice-focused organizations in Florida have grown from 41 (2009) to 46 (2018).
Hospice organizations can be divided into three categories: non-profit private, for-profit private, and non-profit government hospices. Although non-profit facilities consist of most of the overall total, the number of for-profit organizations has doubled over the last 10 years.
The number of inpatient units has increased from 87 in 2009 to 195 in 2018. The number of patient beds has also increased from 1,329 in 2009, to 1,477 in 2018. 48,304 patients were admitted into hospice facilities in 2018, which has increased from 34,719 admissions in 2009.
Florida hospice facilities typically rank at or above the national average according to the National Quality Forum (NQF). This forum measures the quality of healthcare provided by a facility using the Hospice Item Set (HIS) and the Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS). While hospice facilities rank above the national average for NQF, they typically rank below the average when looking specifically at CAHPS scores. Non-profits tend to rank higher than for-profit facilities on all accounts.
Hospice facilities can be both inpatient and outpatient. Guidelines and codes still apply to these units, despite the fact that they seem to teeter between typical healthcare environments and senior living facilities. Designing a comfortable, residential-like space while still abiding by hospital standards can be challenging. These units need to function safely and effectively, while cutting out all the busyness and noise one might witness in a typical hospital.
Hospice patient rooms are often larger than standard hospital patient rooms. This is because the family space is also considered a priority, and in turn, covers a larger area within the room. Similar to a typical patient room, a hospice room includes a sleeper sofa, desk, small refrigerator, television, and patient wardrobe in addition to the patient bed, headwall, and staff zone. Although these elements are similar, they take on a completely different aesthetic in the hospice environment. The patient headwall mimics that of a headboard, while thoughtfully hiding any clinical elements, like med gases. Countertops imitate warm tones you might find in your kitchen, and fabrics on the furniture appear to be plush and comfortable, yet still carry the necessary cleanability characteristics for healthcare environments.
Additional spaces throughout the unit cater to the patient’s family and visitors. These include Family rooms and a kitchen where families can cook familiar recipes for their loved ones. Quiet rooms for bereavement counseling or meditation are also located within the units. Laundry facilities allow visitors to stay close to their loved ones while still addressing their needs.
The interior design profession affects multiple facets of the built environment and requires a careful blend of technical expertise and creativity. Designers are educators, researchers and practitioners who skillfully take the vision and goals of hospice clients and design a functional, efficient, and beautiful built reality for staff, patients, and families alike.