The waiting rooms we’ve been waiting for

By Amy Sickeler, Design Principal

HVAC engineers are the new rock stars in architecture. You’ve seen the airflow diagram of that Guangzhou restaurant by now. The one showing how nine people were infected with COVID-19 by an asymptomatic diner seated near the air-conditioner? Translating that reality into the hospital space, the engineers among us are pursuing ideas like headwalls that pull air directly up and back from the patient’s hospital bed. This sort of thing excites me.

It’s exciting because moments like this clarify what is essential and drive forward-thinking solutions and products to address those needs. In this particular moment, the solutions and products will support wellness, protect us, and do no harm in the spaces I happen to care most about: healthcare spaces. Yet this moment has also clarified how sacred our physical spaces are. Just as important as perfecting a product that serves real needs for human health is creating beautiful, serene settings that extend into the outdoor landscape.

It isn’t news that biophilia has myriad therapeutic benefits. The research long ago established that views and access to nature and daylight lead to better, faster outcomes for patients; more effective, present caregivers; and stronger connections to support networks. What is news in this moment is that aerosol transmission of a pathogen has convinced organizations to invest in biophilic design, not as an added value, but as an essential value.

Influential outdoor spaces are, of course, only one important lever in the design of healing experiences. We might tour any healthcare facility’s program to assess the opportunities our brave new world has set in relief: Where and how to be as adaptable and agile as possible? How to reconcile universal design with the universal room? Where, how, and when to use virtual tools to address gaps and risks in the flow of care?

Outdoor cover inspired by Landscapeforms.

I want to pause our tour on the waiting room, though, because it captures in a single space much of what is at stake in the care experiences we design from this moment forward. Everyone on the care spectrum converges on the waiting room. In addition to relevance, efficiency, and safety, it needs to deliver reassurance, connection, and engagement. Waiting rooms can simply no longer be places where patients and their companions expect to wait for care and where caregivers presume to end their clients’ waiting. The spectrum of care should be activated as soon as someone—no matter who—enters the space.

Flexibility in the waiting room might take the form of a demountable world of glass, allowing for swift adoption of the protocols most relevant to the presenting scenario. Efficiency and safety might take the form of virtual assessment, allowing time for agile adoption of the relevant protocols and minimizing the potential for exposure.

"Everyone on the care spectrum converges on the waiting room. In addition to relevance, efficiency, and safety, it needs to deliver reassurance, connection, and engagement."

Virtual tools allow us to confine waiting to places outside the hospital altogether. I, for one, had a delightful experience waiting in my car for dental surgery the other day. (Apparently my concern for the state of our world is so great that I had ground my teeth until they cracked.)

With “waiting” removed from the equation, front-of-the-house spaces can be organized for education and collaboration. When left behind, for example, a patient’s companions can engage in the appropriate stage of the care regimen as they reassure one another—in some privacy if they choose or by connecting with others sharing similar experiences.

In fact, education and collaboration mesh comfortably with the biophilic interventions we can now implement as essential. When communicability poses a serious threat, “engaged waiting” carries easily outside; or it can be sparked in a serendipitous encounter during a break for some air, then move inside, where fast friends can pool and explore resources. These scenarios are not even to mention that outdoor walking paths, healing gardens, and courtyards are known to alleviate every type of pain and diffuse the anxiety that can impair our judgment when faced with the most difficult decisions in the acceptance or delivery of care.

The front waiting area of Piedmont Wellness Center welcomes patients and guests with floor-to-ceiling window of the nearby forest.

While the physiology of color, acoustics, ergonomics, touch, function, and beauty plays a part in every design and architecture project, healthcare projects demand a palette of sensitivities beyond the standard range. I am loving watching the HVAC engineers get their day in the sun, but truly I am excited for all of us working in the healthcare sector. It is an honor to play a part in our clients’ goals by creating spaces and products that help the healing process. We are only just scratching the surface of what can be done.

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