Perspectives 02.05.2021

Health: What’s Trending in Obstetric and Pediatric Care

A look at ways women’s and children’s hospitals are safeguarding the well-being of patients

The Unique Role of Women’s and Children’s Hospitals

Children’s hospitals service the healing of the most vulnerable and precious among us. From arrival to bedside, the patient experience is designed to balance a child’s emotional needs—unexplained terrors, sense of guilt, fright, and worry. A children’s hospital is a place where families are supported and where young patients with complex conditions spend most of their time outside of their home and school.

Just as crucial are women’s services, which center around the celebration of new life—a journey with endless possibilities and infinite complexities. Birthing and newborn centers incorporate high technology veiled by high-touch amenities, such as spas, hotels, and retreats. An exceptional  birthing environment helps many new families forge the bonds of love and attachment that can carry them past the seemingly endless cycle of sleepless nights on a fragile infant’s journey to discharge. It is a supportive environment where women and their families process both tremendous joy and overwhelming sorrow—a place that holds optimism and resignation with equal grace.

The design and planning of women’s and children’s health facilities, therefore, play an integral role in young patients’ healing experiences.  Here are  five trends influencing the creation of these facilities.

Lucile Packard Children's Hospital Stanford
Maximizing outdoor space provides a sense of peace and respite for children and families during their stay

Evidence-Based Design Research Drives Well-Being Design Strategies

Designing a range of spaces appropriate for patients’ developmental stages in regard to physical and psychological health has been shown to positively impact the quality of  care. The patient room integrates an ever growing sophisticated, digitally connected experience for family, work, and respite. Amenities like on-demand food service, entertainment, and in-room positive distraction elements are continuing to evolve. Patient control over the environment is becoming more sophisticated. The patient room is increasingly adapting to facilitate new models of enhanced mother and baby care.

At the Medical University of South Carolina (MUSC) Shawn Jenkins Children’s Hospital and Pearl Tourville Women’s Pavilion in Charleston, South Carolina, for example, well-being is an integral part of the design. The project, designed in collaboration with associate architect McMillan Pazdan Smith Architecture, incorporates a full-sensory experience to reduce stressors for children on the autistic spectrum. Because there is not a one-size-fits-all solution for children who have varying needs, the building provides a variety of spaces to accommodate neurodiversity.

“We aimed to create environments that bring delight and a sense of discovery to the children, without being overly stimulating or distracting to the population on the spectrum,” says Senior Interior Designer Aiko Tanabe. “We paid particular attention to all possible sensory triggers, such as lighting glare, visual clutter, unnecessary noise, odors, and high-contrasting color schemes. We organized the spaces with a clear sense of the path and destination.”

Medical University of South Carolina (MUSC) Shawn Jenkins Children's Hospital and Pearl Tourville Women's Pavilion
MUSC incorporates a full-sensory experience to reduce stressors for children on the autistic spectrum

A robust Child Life program at MUSC also proactively encourages well-being through play, education, and support. Trained specialists work closely with patients to help them understand their treatment to support developmental progress and promote emotional wellness. This occurs at the bedside, playrooms, and “The Atrium”—a roof garden with age-appropriate play areas and plenty of daylight. Here, play and activities provide a sense of place for kids of all age groups and across the spectrum.

“Throughout the process, we worked in close collaboration with families and caregivers to gain valuable insights that helped inform the design solutions,” says Carolyn BaRoss, our Global Healthcare Interior Design Director. “Pediatric care includes patients from infants to young adults, so we created an environment to provide delight for people of all ages. Maximizing access to nature and enhancing interior beauty through the use of original artwork may bring joyful distractions to children and their families at stressful times.

At Lucile Packard Children’s Hospital Stanford in Palo Alto, California (in collaboration with executive architect Hammel, Green and Abrahamson), a series of patient and staff terraces on each nursing unit provide outdoor respite for patients, families, and caregivers. In addition, two major gardens are immediately adjacent to surgery waiting/intake rooms and at the heart of a family amenity floor that is shared by both the women’s and pediatric programs. In addition, a staff garden near the Staff Entrance allows caregivers to privately experience the outdoors.

At Children’s National Medical Center (CNMC), the only exclusive provider of pediatric care in the Washington, D.C. metropolitan area, the Bunny Mellon Healing Garden similarly creates a revitalizing outdoor space where young patients can safely enjoy nature. The rooftop garden offers trees, flowers, and a variety of plants for patients to find respite outside the hospital.

“Throughout the process, we worked in close collaboration with families and caregivers to gain valuable insights that helped inform the design solutions,” says Carolyn BaRoss, our Global Healthcare Interior Design Director.

A holistic, child-focused, and welcoming hospital design can also be supported by a clear layout and engaging color schemes. The cohesive interior design at the Children’s Eye Centre at Moorfields Eye Hospital in London, United Kingdom offers an engaging experience. A mural of an abstracted optometry cell diagram of the eye’s visual pathway extends across the five floors and creates a sense of wonder for patients who may find their treatment lasting for months or even years. This playful intervention also contributes to the building’s simple wayfinding, which helps to ease stress and anxiety for families navigating the hospital. This playful intervention also contributes to the building’s simple wayfinding, which helps to ease stress and anxiety for families navigating the hospital.

Colored lighting on the façade of Nemour’s Children’s Hospital in Orlando, Florida (in consultation with Stanley Beaman & Sears) is another way to engage the young patients. Here, children can program the color of their room, which lights up the façade as well.

Children’s Eye Centre at Moorfields Eye Hospital
Children’s Eye Centre at Moorfields Eye Hospital
A mural of an abstracted optometry cell diagram of the eye’s visual pathway extends across the five floors and creates a sense of wonder for patients
Nemour’s Children’s Hospital
Children are able to program the color of their room, lighting up the entire façade
Nemour’s Children’s Hospital

Focusing on the Patient and Family Experience Yields Innovative Care Models

Women’s services, long a part of adult academic medical centers, are increasingly included with children’s hospitals. In fact, care for neonates represents a large percentage of pediatric volumes and fetal surgery is gaining momentum. As these populations collocate, women’s and children’s hospitals are incorporating new models of bedded care in response to the unique needs of mother/baby care. Increasingly, couplet-care models are becoming more common, which allow a mother and/or baby who require extra care to room together for an extended period of time. Studies have shown that couplet-care rooms help promote family bonding and can also increase confidence and competence in mothers to care for their newborn(s).

The Pearl Tourville Women’s Pavilion at MUSC is among the facilities in the U.S. to offer couplet-care rooms. Here, the Women’s Pavilion is strategically collocated with the Children’s program to create a safe place for expectant mothers.  Both the mother and newborn are treated by the same dedicated nursing team. The design for these rooms cultivates a calm and nurturing environment necessary for women who have high-risk deliveries or babies that require complex care. The facility seamlessly integrates children’s care and obstetrical services to enhance safety and improve outcomes in high-risk pregnancies. “While the proximity to pediatric care is medically advantageous, we also made sure the mothers would feel as though the space was designed for them and their needs,” says Tanabe.

Family involvement is also a part of the recovery process. These private NICU rooms include comfortable sleeping accommodations, a lounge, and a private, peaceful roof terrace to support families who may spend months in the hospital. “When designing the MUSC bed units, we worked to eliminate elements that contribute to the feeling of institutional space, and instead looked to simplify lighting geometry and effect, and applied interior details to recall a more residential experience,” explains BaRoss.

A rendering of a couplet care room
Click here to read the story of twins who spent the first months of their lives in neonatal intensive care unit at MUSC.

The well-being of families and caregivers extends to all areas of patient care. “Collaboration that includes clinicians, family advisory groups, and the children themselves often yield innovative program elements and places that ensure a bespoke design solution that works,” says Senior Medial Planner Ian Sinnett. Having comfortable sleeping accommodations in patient units, laundry, and shower facilities are a priority so that families can remain with their child at bedside. Patients and families have expressed the comfort of home at Lucile Packard Children’s Hospital Stanford. Spacious patient rooms, complete with built-in sofa beds and amenities like laptop charging stations, are intentionally designed to accommodate family members’ extended stays.

Similarly, the design team at MUSC created a custom sofa design, inspired by boat cabins, that can be easily cleaned and wiped down to avoid mildew and bedbugs. Additional considerations to enhance the family experience include access to kitchens, laundry, and showers as well as business centers, family resource areas, and places for positive distraction. At Lucile Packard, the first floor concourse that serves both women and children include the Marketplace Café with outdoor dining, Sanctuary, destination art installations, retail, and an immersive, interactive garden. “We thought a lot about what families need to comfortably remain at bedside,” says  says Lucile Packard Project Director Robin Guenther.

Lucile Packard Children's Hospital Stanford
Spacious patient rooms provide comfortable accommodation for family members during their extended stays.

Virginia Mason Medical Center made a strategic decision to provide women’s childbirth services on their main adult Seattle campus for the first time in over twenty years. As part of this strategy, they decided to partner with CHI-Franciscan to open the Virginia Mason Birth Center.

Hospital leadership and clinicians aspired to a more innovative delivery care model and committed to providing NICLET care. This model has never before been offered in Washington State and is unique from couplet-care models. NICLET rooms allow critical-care infants to stay with mom in the postpartum room instead of recovering in a separate NICU. “I think the remarkable thing is that this unit wasn’t designed to market to high-risk moms or babies,” says Senior Medical Planner Marie Henson. “Virginia Mason is marketed as a boutique, patient-centered birth experience. But through the design and planning process, the concept of not separating mom and baby became a priority, even if the baby has some NICU needs.”

Through a Lean Design process that consisted of multiple rounds of Integrated Design Events our design team was able to bring together administrations, clinicians, and staff from both health organizations to develop a design that represents their desire to offer a boutique birthing experience utilizing this new model of care. “Increasing attention to the unique needs of the birth experience and infant care, combined with the heightening understanding of the role of the built environment in care delivery, the NICLET model emerged as a new design solution that provided the highest level of patient satisfaction and care for mother and baby,” says Medical Planner Ryan Ramsey.

Staff Safety and Satisfaction is Revolutionizing the Hospital Workplace

It is not uncommon for care teams to face emotionally difficult situations and conversations during their shift. Many hospitals are including spaces where healthcare professionals have the time and space to decompress during their shift and return to work providing excellent care for their patients. That’s why Lucile Packard Children’s Hospital Stanford provides dedicated outdoor terraces for staff.

During the COVID-19 pandemic, convenient outdoor space became especially important to allow staff to shed their masks and shields and decompress during stressful days.

Supporting clinical and service workers is leading to advanced integration of ergonomics in the inpatient unit, ranging from overhead patient lifts to ergonomic seating. Daylit, spacious break rooms that support a range of respite physical activities, from exercise to rest, and leisure activities, such as personal email, is transforming the off-stage time and space requirements. Flexible team workplace also allows for multi-disciplinary team care on all units. “Our evidence-based design research and principles have shown the power of recognizing the need to support staff growth, safety, and satisfaction,” says Guenther. “Having spacious break rooms with plenty of daylight that support exercise and leisure are a few ways that will revolutionize the quality of care.”

“Our evidence-based design research and principles have shown the power of recognizing the need to support staff growth, safety, and satisfaction,” says Lucile Packard Project Director Robin Guenther.

Prioritizing Health Through Sustainable and Resilient Design Strategies

Due to rising rates of asthma, obesity, and diabetes in children—alongside cancer and heart disease—prevention initiatives that focus on linking health and well-being are a prime concern for children’s hospitals. Pediatrician and young people’s concern about climate change and environmental health issues translate into sustainable design strategies.  In fact, children’s hospitals account for 50% of the LEED Platinum hospital cohort. These hospitals have prioritized healthy materials, reduced fossil fuel emissions, improved indoor air quality and acoustics as part of their commitment to health.

The LEED-Platinum Lucile Packard Children’s Hospital Stanford, in particular, uses displacement ventilation systems in inpatient units and public spaces to reduce energy demand by 45% and system noise, while also enhancing indoor air quality. A system of underground cisterns captures rainwater and recycles building condensate to irrigate the extensive gardens. Furthermore, a focus on healthy materials reduces the toxicity of indoor environments. “Sustainability is woven through the children’s experience, from the live building performance dashboard to the gardens and art program,” says project architect Megan Koehler.

Charleston, South Carolina faces significant challenges of sea level rise and MUSC has integrated design measures, including elevated infrastructure and flood barriers, for enhanced resilience during and following extreme weather events. “Maintaining access to the ED and critical hospital functions during flood events was a design imperative; the Emergency Department is on the second floor,” says Managing Principal Jim Bynum.

Design for the Future

Given the rapid pace of change in clinical care for children, it is critical to design for future growth and flexibility. Lucile Packard “outgrew” their 1990 facility in less than 30 years and focused on creating a building that could accommodate future growth and change for the next 50 years. Acute and ICU patient rooms, for example, are the same dimensions to allow for future changes in acuity of care. Alternatively, nursing units can incorporate simulation spaces for staff training.

Healing spaces that cater to the well-being and psychosocial needs of the patient, families, and staff go a long way in making the hospital experience more comfortable. And while innovation in medical technology—such as advanced imaging and precision medicine—will continue to advance pediatric care in exciting new ways, Bynum adds that holistic design strategies will never lose their currency. “By putting these foundational design principles into practice, providers can always ensure the most effective and efficient patient care,” he says.

Thank you to the following team members for their insight and contributions:

Carolyn BaRoss
Jim Bynum
Diana Davis
Ashley Dias
Jeffrey Dreesman
Robin Guenther
Tatiana Guimaraes
Marie Henson
Emily Johnson
Katie Johnson
Megan Koehler
Anthony Mistretta
Ryan Ramsey
Stephanie Schwindel
Ian Sinnett
Brenda Smith
Aiko Tanabe

Click here to view our Women’s and Children’s Health expertise booklet