This was the premise of an article written by Toby Israel, Ph.D., visionary founder of the new field of Design Psychology, for the Nurture Report.  Working with Toby to get this article published, I became fascinated with Design Psychology.

Design Psychology is the practice of architecture, planning and interior design in which psychology is the principal design tool, used to create places (not spaces) that are not only functional and beautiful, but also emotionally and socially fulfilling. The process begins with vision sessions not only of the space, but the people within the space to ensure that the end result will connect with all those who engage in the space and bring fulfillment across a range of human experience.

Design Psychology draws from Abraham Maslow’s hierarchy of human needs.  Similarly, during design psychology visioning sessions, participants are guided through exercises designed to ensure the project at hand results in an actualized place – one that meets the need for basic shelter, as well as psychological, social, and aesthetic satisfaction.  This process can be applied to any environment: home, work, and healthcare.  In the Nurture Report article “Oasis by Design Psychology”, Israel describes the process of creating a caregiver’s oasis using Design Psychology at Northern Westchester Hospital in Mt. Kisco, NY.

After a focus group with caregivers, loved ones and medical staff,  Israel was able to take a “deeper than deep” dive into their pasts, to find their favorite oases.  Such shared personal experiences of place became part of the collective experience of envisioning the new center and were translated into a final design.  Outcomes included a main seating space that contains a welcoming fireplace.  A “tranquility room” which uses shoji screen-filtered light, a waterfall wall, and a sky-like ceiling to produce a sense of calm.  Throughout, the subdued beige walls, floor tiling that looks like dark wood, and photographs of idyllic nature scenes add to the nurturing effect.

As healthcare environments continue to positively evolve, embracing the patient-centered approach and the healing-environment model, I can only imagine the positive impact that incorporating the formal approach of Design Psychology into the envrionment designs may have as well.  After all, we all want spaces that sustain, inspire, and help us heal, right?  What do you think?

I’ve written about this chart before (an even more informative infographic can be found here.)   Today, however, I thought it’d be a nice accompaniment  to another discussion: ROI a.k.a. return on investment a.k.a. the Holy Grail when it comes to social media. This isn’t easy, and can be a long, arduous, and painful process, so if anyone has any additional ideas, please leave them in the comments!

Read on for an ROI discussion:

The world of social media is one that is large, dark, and can be a little bit intimidating. The best way to get the most out of it is to take the large pie and attack it in chewable chunks. Instead of jumping in and immediately expecting to start landing clients, temper your expectations and set smaller, achievable goals.

Start by building your community. Tweet, re-tweet, follow people on Twitter: the key is to add value. Once people realize you’re tweeting interesting and informative things, or adding helpful info to one of their tweets, you’ve got the ball rolling. If you’re in healthcare sales, pay attention to what hospitals, dealers, design firms, etc. are saying in your territory. Providing them with an answer to a question, or simply knowing what they tweet about, can be a conversation starter, or way to get your foot in the door.

Find people on Twitter using the Advanced Search feature; it’s a simple way to find people in your field, your region, your industry. Start engaging them, and see what happens. But, remember: no one wants to be sold something on Twitter – start with the relationship first, focus on the sale second!

And isn’t that the key to business – the relationship? Twitter (and Facebook and LinkedIn) is a great way to get a relationship started, and it only costs you your time. Your time is valuable of course, so it’s a personal decision how much to spend checking Twitter, reading and re-tweeting important posts, writing comments on Facebook, etc. But as is typical in questions of investments, the more you put it, the more you’ll get out.

Here’s another great TEDMED presentation. Tim O’Reilly, founder and CEO of O’Reilly Media Inc, is thought to be the best computer book publisher in the business, and he uses his expertise and love of innovation, collaboration, and open-source software to talk about their applications to healthcare. His goal is to ‘change the world by spreading the knowledge of innovators’.

How do you innovate? How is that applicable to the future of healthcare?

a.) 80% b.) 40% c.) 73% d.) 10%.

One more: What percentage of infectious diseases are transmitted by touch?

 a.) 30% b.) 80% c.) 55% d.) 68%

Check out the correct answers after the jump…

Amazingly, the actual percentage of the physicians who washed their hands between patients was 10%. And the percentage of infectious diseases spread by touch is 80%.

So doctors, thanks to a fantasy in which they wash their hands way more than they actually do, are a serious risk to spread diseases to the very patients they’re trying to get well. That is a problem.

But how to fix it?

Part of the problem, according to a forthcoming studyin the journal Psychological Science, are the actual signs posted in hospital washrooms urging health care workers to wash their hands. Changing the wording of the sign from “Wash Your Hands to Protect Yourself” to “Wash Your Hands to Protect Your Patients,”  appealing to their foundation in the Hippocratic Oath, the study found could motivate some doctors and nurses to wash their hands more frequently.

Doctors and nurses often enter patient room with their hands full, holding a chart, rolling a cart, or carrying something else. But this is no excuse not to pause a moment to clean their hands; when hand hygiene compliance in a hospital goes up, patient infection rates go down. About 1 in 20 hospital patients becomes ill with an infection — many or most of them from the hands of health-care workers. Hospital-acquired infections are the fourth leading cause of death in America: over 100,00 deaths a year. And treating these unnecessary infections end up costing $28 to $45 billion each year.

Hospitals are going to lengths such as video monitoring systems, with posted results to appeal to a caregiver’s competitive nature. These systems have proven to be effective in raising rates of handwashing but are an expensive solution to a problem that seems so simple to solve. With so much money, not to mention lives at stake, infection control is a crucial issue in healthcare today and in the future, and it seems the simplest solution may be the best – inform caregivers of these dire statistics, and handwashing rates are sure to rise.

Zappos’ mission statement is ‘Create Happiness’. Everything they do revolves around trying to create happiness for their consumers. This should be the motto for the healthcare industry as well. Obviously, shoes and healthcare are different things, but whether it’s a nurse taking a temperature, a doctor performing an examination, or even a company making products used in a healthcare environment, their goal should be to do it compassionately and with empathy.

“A recent Health Affairs survey of 800 recently hospitalized patients and 510 physicians found broad agreement that compassionate care is “very important” to successful medical treatment. However, only 53 percent of patients and 58 percent of physicians said that the healthcare system generally provides compassionate care.” So there is currently a compassion gap that needs filling in healthcare – maybe this is the perfect time to create some happiness. What can you do in your work to ‘create happiness’ for your customers?

In fact, noise levels in most hospitals far exceed recommended guidelines, according to research published by Anjali Joseph, Ph.D.; and Roger Ulrich, Ph.D published for The Center for Health Design, Sound Control for Improved Outcomes in Healthcare Settings.

The study determined that sound can have a positive or negative impact on patients, staff, and visitors in hospitals – the manifestations of sound can range from soothing and therapeutic to stressful and disturbing.  For patients, high noise levels can have serious consequenses ranging from sleep loss and aggravation to elevated blood pressure.

Beyond the poor physical outcomes, other compromises may occur due to poorly designed acoustical environments.  Patient confidentiality may be seriously compromised if a private conversation between staff or staff and a patient is overheard by unintended listeners.  Also, a poor acoustical environment can compromise communication between patients and staff and between staff by making speech and auditory signals less heard or noticeable.  All of these potential situations, have the ability to compromise patient safety and impact patient outcomes.

Research reviewed by Joseph and Ulrich indicates that patients were more satisfied with the care provided by the staff under good acoustic conditions. And most importantly, the incidence of re-hospitalization was higher among patients treated under bad acoustic conditions. The bottom-line: the better acoustic the conditions, the more improved the outcomes.

The study by Josephy and Ulrich provides environmental design strategies that can be implemented to improve the auditory environment, including:

• Single patient rooms enclosed with walls from floor-to-ceiling
• High-performance, sound-absorbing acoustical ceiling tiles and other interior finishes
• Removing or replacing loud noise sources on hospital units, such as medical carts as well as paging and alarm systems
• Adding music therapy

In addition, a white paper written by Susan E. Mazer, MA, Hospital Noise and the Patient Experience: Seven Ways to Create and Maintain a Quieter Environment, provides ways to improve the auditory environment at the bedside.

1. Get everyone involved. Establish a sound committee.
2. Assess the Sound Environment.  How noisy is it?
3. Establish Sound Standards.
4. Establish Equipment Maintenance and Purchasing Standards
5. Be the Patient Advocate: Make decisions about patient-appropriate equipment
6. Educate Staff: Model sound-sensitive behavior
7. Measure Results

As with anything, it takes recognizing there is a problem first to begin addressing it.  Assessing the situation as Mazer suggests is a great first step.  And, even the best environments always have a bit of room for improvement –  that’s what makes them great.  Beyond that, realize that patients won’t be the only ones to benefit from a better auditory environment, the staff will as well.  The study by Joseph and Ulrich also examines those benefits, Sound Control for Improved Outcomes in Healthcare Settings.

TEDMED 2011

Here is another in a long line of fantastic presentations coming out of TEDMED 2011.  In this one, Farzad Mostashari, National Coordinator for Health IT at the DHHS, and Aneesh Chopra, the U.S. Chief Technology Officer, talk about how open access to electronic health data can reform physician pay and patient care.

The use of EHR’S are being encouraged as a way to increase patient safety, improve overall patient care, and lower costs by increasing efficiency. Do you think these guys are on the right track?

In theory, I should be impressed by the doctor, the staff and the facility.  On the surface, it’s everything it should be.  Everyone is very professional.  The building is new and well designed.  The technology is very current, I updated my medical records on an iPad and the nurse used an EMR to input my vitals.  Everything is clean and the color palette is soothing, but something is just amiss.

I believe it’s the neglect of the New Five Senses as proposed by Linda Porter Bishop, IIDA, ASID, AAHID, LEED AP, and I think she’s
onto something.  According to a recent webinar, “Evidence-Based Design and the New Five Senses,”  by Vendome, Healthcare Design, and sponsored by IIDA, Bishop discusses how both the biological and psychological components of a person work together to heal the body in the healthcare environment, as well as how the design of those
environments influences both.

Bishop discusses the idea that healthcare facilities need to move beyond the patient-centered approach and become “Level 3” environments – meaning they need to be places where the focus is on the restoration of the self and the whole person through a base of biology, environmental design, and psychology.  The idea goes beyond the well-accepted “healing-environment” model to the next level of care which needs to engage Bishop’s “new Five Senses.”

• A Sense of Place
• A Sense of Life
• A Sense of Compassion
• A Sense of Community
• A Sense of Security

In the clinical environment I visited today, I didn’t feel Bishop’s new Five Senses touching my experience. I didn’t get the sense of place, life, true compassion, connection through community or sense of security beyond knowing that I was physically safe. These new Five Senses are critically important to evolving healthcare environments to next level, and are well explained throughout the webinar.

Bishop’s ideas on achieving healthcare environments that take the new Five Senses into consideration are thought-provoking.  The question becomes: how can it be done?  During the Q&A section Bishop points to the fact that it starts with people and their attitudes toward the healthcare environment.  She’s careful to point out that it’s not just the caregivers in the environment who can benefit from training in these new Five Senses, but all staff.  She also points out ways to make affordable changes in existing environments to incorporate the new five senses.

Bishop has provided some intriguing thoughts on the possibility of further enhancing healthcare environments. The question remains will one or all of these new Five Senses be adopted in the way she’s proposing?  If so, another positive transformation in the way healthcare is delivered may occur.

Lee Aase talks on Social Media

The Mayo Clinic (check out their excellent blog) has made an impressive and important commitment to social media, as spelled out in the video above, and is leading the charge when it comes to connecting with and informing their patients.

With the prevalence of the internet, smartphones, and social media platforms, especially in healthcare, joining up and searching out your clients and partners online really is a no-brainer. It’s cheap, easy to use, and an absolute necessity to control your online brand reputation – what more reason do you need?  

Here’s another great talk featuring Lee Aase, Social Media Director from the Mayo Clinic.

Lee Aase from Mayo Clinic on Social Media

Nurture^® by Steelcase has made its entire product catalog available to architects, designers and others who use Revit.

A Double-sided Sync Revit Symbol

Autodesk Revit Architecture — often referred to as simply Revit — is a powerful, Building Information Modeling (BIM) software developed by Autodesk. Revit allows users to design with both parametric 3D modeling and 2D drafting elements.

Building Information Modeling is a Computer Aided Design (CAD) paradigm that employs intelligent 3D objects to represent real physical building components such as walls and doors.

While a select number of Nurture’s products (primarily modular casegoods and workstations) were previously available in Revit symbols, making the company’s entire product catalog available is another first for Nurture in the healthcare environments marketplace.

“Revit is a fantastic tool. Making the entire Nurture portfolio available on it will help everyone who works with our products,” said Nurture General Manager Kyle Williams.

“Drawings and renderings generated from Revit help support effective communication across A&D firms, between disciplines / contractors, and most importantly to the final client to enhance decision making.”

Streamlined, Enhanced, Accurate

A main benefit of Revit is eliminating redundancies such as having multiple models across industries.

Currently, architects, consultants, general contractors, and manufacturers all create their own models and databases from information handed down in a chain of command. BIM replaces this approach with a more centralized solution.

Revit models created in different disciplines (Architectural, Structural, and Mechanical) can be linked and/or combined into one model. This allows a single model and associated database to be kept, ensuring that all parties have the latest information and that there are no errors in translation.

Revit also utilizes its rendering engine to remove the interpretation from complex geometries, allowing more intricate designs to be made and understood.

“Nurture is committed to supporting and helping improve the way our partners and clients work and publishing Nurture Revit model libraries to assist in complex design work is just another example of that commitment,” said Williams.

Prior to making the catalog available in Revit, Nurture took the opportunity to share some of the symbols with some of our A&D for their feedback. The responses were overwhelmingly positive. Here are two examples: “I took a look at the Revit families for Sync.  They are quite good and seem to perform well. They would certainly be very usable in projects…” and “It’s very encouraging to see a manufacturer put forth such a well built Revit families.”

Caregiver Thought Starter

In addition to the comprehensive symbol library, healthcare environment planning ideas – a variety of great thought starters – will be supported in Revit as well.

Nurture is excited to share this tool with our partners in the effort to improve healthcare environments and ultimately outcomes for patients, providers and partners in care.

The Nurture Revit symbol library can be found here.