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5/9/2014

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HEALING SPACES TO PROMOTE WELL-BEING

HEALING SPACES TO SUPPORT WELL-BEING

Presented by:Karen Wendt, MA, RN, PHN, Program Director, Child/Adolescent Mental HealthUniversity of Minnesota Health, University of Minnesota Health, University of Minnesota Health, University of Minnesota Health, Children’s HospitalChildren’s HospitalChildren’s HospitalChildren’s Hospital

Rick Dahl, AIA, PrincipalBWBRBWBRBWBRBWBR HEALING SPACES TO PROMOTE WELL-BEING

� Unique Issues of Mental Health Design

� Concepts for Inspiration

� Strategies for Mental Health Design

� Does it Make a Difference?

– Case Study: University of Minnesota Children’s Hospital

� Takeaways: 8 Action Items for Tomorrow

� Q&A

PRESENTATION OUTLINE


DESIGNING FOR BEHAVIORAL/MENTAL HEALTHUnique Issues of Mental Health Design Unique Issues of Mental Health Design


physical

emotional

Unique Issues of Mental Health Design Unique Issues of Mental Health Design

Emotional: Agitated, angry, isolated, frightened, depressed, lonely, denial, confused, anxious

Physical: Frozen, violent, destructive, unsafe, cold, tired, fatigued, hyper-sensitive, dehydrated

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nature

calm, quiet

Concepts for InspirationConcepts for Inspiration


transitions

places of negotiation



prayer, meditation

inner journey, discovery



foster communication

inviting


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safe, planned


sense of scale


Create transformative environments that encourage health and wellness… and patients will respond.

DESIGN

PLANNING

OPERATIONS/CARE MODEL

CULTURAL/CARE TEAM

Strategies for Mental Health DesignStrategies for Mental Health Design





Additional Patient Room Features

CHALKBOARDS

SENTINEL EVENT BATHROOM DOORS

INTEGRAL PATIENT ROOM DOOR BLINDS

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“does space matter?”

� Literature Review

� Staff Surveys

� Staff Interviews

� Patient Exit Interviews

Case StudyCase Study

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research questions

� Among patients hospitalized on a child-

adolescent mental health unit, which

environmental characteristics contribute most

to patients feeling calm?

� How does the design influence staff

perceptions of the environment and its

influence on patient behavior?

� In addition, this exploratory case study will

begin the process of validation for new

measurement tools.



literature review

� 142 articles reviewed

� Between 1984 and 2013

� 57 were specific to child-adolescent mental health� Over half were 10 or more years old

� This population is underrepresentedin the literature



staff surveys

� Email invitation (75 staff)

� 52 responses

� 70.6% response rate

� Likert-scale questions with open-ended questions



STAFF SURVEY RESULTS

Job RolePsychiatric Associate 44%Physician 4%RN 38%CTC 8%Clinical Rehab 6%

Unit7A 45%7ITC 28%Both 21%N/A 6%

Primary ShiftDays 55%Evenings 34%Nights 11%

9%

26%

38%

15%

6%6%

5 months or less5 months – 1 year1 year – 5 years5 – 10 years10 – 20 yearsOver 20 years

DEMOGRAPHICS

How long have you been working on this unit?

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78%

STAFFSTAFFSTAFFSTAFFATTITUDESATTITUDESATTITUDESATTITUDES

responses for very positive or somewhat positive for the environment’s impact on

“It’s a brighter place to work – makes me happy to be here…”

“…appreciate the brightness and calm therapeutic environment…”

2%

14%

6%

61%

17%

Very negativeSomewhat negativeNo impactSomewhat positiveVery positive



86%

STAFFSTAFFSTAFFSTAFF INTERACTIONSINTERACTIONSINTERACTIONSINTERACTIONSWITHWITHWITHWITH PATIENTSPATIENTSPATIENTSPATIENTS


“The environment contributes to calming the patients.”

“The new unit is something to be proud of and that can ‘rub off’ on the patients.”


10% 4%

48%

38%



60%

STAFFSTAFFSTAFFSTAFF INTERACTIONSINTERACTIONSINTERACTIONSINTERACTIONSWITHWITHWITHWITH COWORKERSCOWORKERSCOWORKERSCOWORKERS


“Better for coordination and collaborative team work. Better places to share confidential information.”


2%

17%

21%

36%

24%



81%

STAFFSTAFFSTAFFSTAFF FEELINGFEELINGFEELINGFEELING CALMCALMCALMCALM

responses for very positive or somewhat positive for the artwork and colors impact on

“Very, very lovely, calming, and healthy emotionally.”


2% 0%

17%

44%

37%

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75%

SENSESENSESENSESENSE OFOFOFOF FEELINGFEELINGFEELINGFEELINGSAFESAFESAFESAFE ATATATAT WORKWORKWORKWORK

responses for very positive or somewhat positive for the safety features impact on


2% 4%

19%

44%

31%



75%

ABILITYABILITYABILITYABILITY TOTOTOTO KEEPKEEPKEEPKEEPPATIENTSPATIENTSPATIENTSPATIENTS SAFESAFESAFESAFE

responses for very positive or somewhat positive for the sentinel event prevention bathrooms impact on

“Not having to check for locked bathrooms allows staff to be more present in the milieu.”


2%

23%

28%

47%



4%

2%

26%

68%

94%

WELCOMINGWELCOMINGWELCOMINGWELCOMINGFAMILIESFAMILIESFAMILIESFAMILIES



“Parents and patients are impressed”

“Parents love it and feel very comfortable leaving their child on the unit once they have had a tour.”



6%

13%

35%

46%

81%

STAFF INTERACTIONS STAFF INTERACTIONS STAFF INTERACTIONS STAFF INTERACTIONS WITH FAMILIESWITH FAMILIESWITH FAMILIESWITH FAMILIES

responses for very positive or somewhat positive for environment’s impact on


“Families share their feelings of safety and comfort.”

“7A is better set up for interacting with patients”


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2% 2%

44%52%

96%

FAMILY ROOMS FAMILY ROOMS FAMILY ROOMS FAMILY ROOMS ACCOMMODATING ACCOMMODATING ACCOMMODATING ACCOMMODATING OVERNIGHT STAYSOVERNIGHT STAYSOVERNIGHT STAYSOVERNIGHT STAYS

responses for very positive or somewhat positive for

“It makes it a more private affair for the family…”




87%

PATIENTS’ PATIENTS’ PATIENTS’ PATIENTS’ BEHAVIORSBEHAVIORSBEHAVIORSBEHAVIORS



“Sensory and game rooms are fantastic.”

“More options of calming, soothing places…”


4%9%

59%

28%



79%

PROMOTING PROMOTING PROMOTING PROMOTING PHYSICAL ACTIVITY PHYSICAL ACTIVITY PHYSICAL ACTIVITY PHYSICAL ACTIVITY FOR PATIENTSFOR PATIENTSFOR PATIENTSFOR PATIENTS



“We are able to encourage patients to explore and apply a wider variety of coping skills for in and out of the hospital.”


10%

11%

47%

32%



79%

CALMING PATIENTSCALMING PATIENTSCALMING PATIENTSCALMING PATIENTS

responses for very positive or somewhat positive for artwork and colors impact on


“Light dimmers and music are great.”

“Quiet room and play room are great for individual time.”


21%

51%

28%

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0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50 5.00

Desks at Hall Ends (7A Only)

Seclusion Room

Porches Outside Patient Rooms

TV in Patient Rooms (7ITC Only)

Physician's Interviewing Rooms

Circle Seat by 7A workstation

Bench in Patient Rooms (non-ADA/Family rooms)

Semi-Private Phone Areas

Game Room (7ITC Only)

Blinds on Patient's Windows to the Outside

Blinds on Patient's Hall Doors

Quiet Room (7A Only)

Rainbow Room

Music Room (7A Only)

Light Dimmer in Patient Rooms and Group Rooms

Music in Other Group Spaces (e.g. Rainbow Room, Game Room, Playroom)

Color (LED) Light Panels (in Sensory Room, Game Room, and Rainbow Room)

Pool

Sensory Room

Rating Average

n= 52

TOP 5 FEATURES


TOP 5 FEATURES/SPACES

MUSIC

PANEL

COLORED

LIGHTS

POOL LIGHT

DIMMERS

SENSORY

ROOM


OTHER HIGH RANKING FEATURES/SPACES

QUIET

ROOM

MUSIC ROOM(INTEGRAL)

BLINDS ON

EXTERIOR

WINDOWS

RAINBOW

ROOM

(INTEGRAL)

BLINDS ON

PATIENT ROOM

HALL DOORS


patient exit surveys

� Staff administered

� 197 collected surveys

� 3 versions (to test measurement tool)

� Consistent results


PATIENT EXIT SURVEY RESULTS

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n= 197

TOP 5 FEATURES

0% 10% 20% 30% 40% 50% 60% 70%

Windows in Pool Area

Art

Front Porch

Sensory Room

Playground

Rainbow Room

My Desk

Bench in My Room

Light Dimmers

Pool

My Room

Colored Lights

Music Panel 60%

54%

54%

52%

46%



TOP 5 FEATURES/SPACES

OTHER HIGH RANKING FEATURES/SPACES

MUSIC

PANEL

COLORED

LIGHTS

MY ROOM POOL LIGHT DIMMERS

BENCH

IN

ROOM

MY DESK RAINBOW

ROOM

PLAYGROUND SENSORY ROOM


staff interviews

� 15-minute individual interviews

� 27 staff members� Psych Associates, RNs, Clinical Treatment

Coordinator, Occupational Therapists, Child

Psychologist

� 6 questions (semi-structured)


There are more options for interventions with patient behaviors.

“ “

STAFF INTERVIEW RESULTS

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STAFF INTERVIEW RESULTS

This unit decreases the disparity saying mental health care is as valued as medical care.

“

“


ANALYSIS

Does Space Matter?


STAFF

MUSIC

PANEL

COLORED

LIGHTS

POOL LIGHT

DIMMERS

SENSORY

ROOM

ANALYSIS/FINDINGS

MUSIC

PANEL

COLORED

LIGHTS

POOL LIGHT

DIMMERS

MY ROOM

HOW DO THEY COMPARE?

PATIENTS


STAFFimpact areas

� Calming Environment

� Sense of Pride

� Interactions with Patients

� Safety

� Attitudes

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PATIENTSimpact areas

� Calming Environment

� Interactions with Staff

� Safety

� Opportunities for Physical Activity


FAMILIESimpact areas

� Welcoming Environment

� Sense of Confidence in Care and Decision to Leave Child

� Opportunity for Overnight Stays


Take Action Today� De-clutter

� Reduce Noise

� Lighting

� Art

� Paint

� Clean/Maintain

� Incorporate Exercise

� Culture

8 Actions Items for Tomorrow8 Actions Items for Tomorrow


Thank YouQUESTIONS?

Karen Wendt, Karen Wendt, Karen Wendt, Karen Wendt, MA, RN, PHN, Program Director, Child/Adolescent Mental HealthUniversity of Minnesota University of Minnesota University of Minnesota University of Minnesota Health, Children’s HospitalHealth, Children’s HospitalHealth, Children’s HospitalHealth, Children’s [email protected]

Rick Dahl, Rick Dahl, Rick Dahl, Rick Dahl, AIA, [email protected]

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