flexiblefullpage -
billboard - default
interstitial1 - interstitial
catfish1 - bottom
Currently Reading

6 checkpoints when designing a pediatric healthcare unit

6 checkpoints when designing a pediatric healthcare unit

As more time and money is devoted to neonatal and pediatric research, evidence-based design is playing an increasingly crucial role in the development of healthcare facilities for children. 

By Jane Rohde, AIA, FIIDA, ACHA, AAHID, LEED AP | November 18, 2013
The Rady Childrens Hospital in San Diego is an example of a facility on the cut
The Rady Childrens Hospital in San Diego is an example of a facility on the cutting edge of pediatric design.

As more time and money is devoted to neonatal and pediatric research, evidence-based design is playing an increasingly crucial role in the development of healthcare facilities for children. The Center for Health Design’s Knowledge Repository is an excellent storehouse of relevant research and resources on pediatric and neonatal topics. 

The Facility Guidelines Institute has updated its hospital and outpatient facilities guidelines for 2014, adding the Safety Risk Assessment, as well as additional and updated design guidance that reflects the impact of lighting and acoustics on healthcare environments. The Guidelines for Design and Construction of Health Care and Outpatient Facilities are due out in early 2014 and available at www.fgiguidelines.org. 

For the children and families who will be occupying these spaces, creating facilities that promote healing while offering a safe, comfortable environment is vital. The following are six important factors Provider, Design, and Construction Teams should consider when designing pediatric healthcare facilities:

1. Lighting + Acoustics—Tone it down

From neonates to teenagers, pediatric patients are different from adults in that their bodies are constantly growing and adapting to the world around them. For a child spending much of his or her days in a hospital setting, the constant exposure to indoor lighting is not healthy for still-developing eyes. 

In pediatric design, it’s important to consider the user of the space. What may seem ideal from an engineering standpoint may not be practical for young patients and their families. An older eye is going to perceive light differently than a younger eye when rendering color and pattern. Allowing the patient to control lighting levels is crucial to patient-centered care.

Researchers have found that potential damage can result from children not being able to acclimate to the natural day/night cycle. Pediatric facilities now employ cycled lighting to account for the development of circadian rhythms (the biological change from day to night). 

The Rady Children’s Hospital in San Diego is an example of a facility on the cutting edge of pediatric design. At night, stars appear on the ceiling—a decorative lighting element used to make the unit feel like a nighttime space. 

As for acoustics, the noises associated with hospitals (especially at night) can disrupt the sleep of younger patients, hindering the healing process. Noisy hospital environments have also been known to lead to medical errors (such as incorrect medication dosages), by clinical staff. 

Some hospitals utilize a “Yacker Tracker,” which was originally developed for use in educational settings. It looks like a stoplight: red, yellow, and green. When noise levels raise too high, reaching yellow or red, it is an indication to the nurse manager that voices and activity (particularly at night) need to be reduced. 

2. Privacy—Options for companionship

Privacy and acoustics are closely related, as noise levels can vary based on the number of people in a room. Research in this area shows that patients, parents, and caregivers are more likely to be forthcoming to medical staff when they know others cannot overhear them.

The benefits of private rooms tend to vary based on a number of factors. Pediatric cancer patients, for example, might benefit from and desire the companionship of a roommate with a similar diagnosis and care plan. Patients recovering from an injury, on the other hand, may prefer healing alone. This should be taken into account when designing patient rooms for potential flexible and adaptable configurations, based on the care population and care model. 

3. Positive Distraction—Not just pretty pictures

The concept of positive distraction extends beyond artwork to broader design themes that incorporate wayfinding and healing elements.

Simplifying the navigation around a hospital can help relieve some of the anxiety that accompanies a medical visit. Using clear wayfinding devices that incorporate “big person” and “little person” versions of the same element can be fun for children while alleviating stress for their parents. 

For example, providing animal characters at a child’s height that are tactile, recognizable, and consistent from space to space on the same floor assists children in finding their way in a fun and entertaining way. Graphics, themes, and landmarks—like an indoor tree or a magical mobile or sculpture—are other ways to add a sense of wonder to what can often be a scary environment. 

Creating a connection between indoor spaces and the outdoor environment can also be a successful positive distraction. Windows provide a view to the outdoors but also help remove patients from the often-clinical feeling of the hospital environment. This helps to restore homeostasis by providing the horizon as a reference and also has a positive impact on the healing process. 

 Common play areas for patients and families to interact can be a source of healing and distraction for children and their families. Siblings have something to do while parents are participating in the care of the patient. 

4. Infection Control—Clean where it counts

Provider, Design, and Construction Teams need to think through how infection control measures shall be included during construction, as well as how to integrate them into maintenance procedures. It is recommended to clean using “touch points” as part of the protocol, such as a light switch, door handles, bed rails, chair arms, and other surfaces that come into contact with hands. From cell phone and tablet screens to bed controls and call buttons, the many devices being used in today’s healthcare units are primarily controlled by touch, which is the easiest way to transmit infection. Hand washing is still the most effective way to control the spread of infection.

The Dr. Carling Method includes the utilization of UV markers on touch points, which allowed the cleaning of touch points to be tracked with the use of a black light. Once staff was retrained to clean touch points, infection rates decreased. 

5. Furnishings—Maximizing flexibility

When planning healthcare units, space is always at a premium, trying to accomplish multiple zones within patient rooms while minimizing square footage and cost. For that reason, furnishings must be compact, yet flexible enough to serve a number of purposes. They also must adapt to the needs of each particular patient.

Pediatric units must be fit to serve children of all ages. The care plan for a five-year-old will be different from that of a 15-year-old. Provider, Design, and Construction Teams must take the varying treatment scenarios into consideration when specifying furnishings for a unit. Creating a space that is adaptable to a variety of circumstances can help save costs and precious floor space. 

Pediatric patients often have visitors at all hours of the day and at least one parent spending the night. To address this problem, one manufacturer offers a couch that can convert into two chairs and a table and can be easily made into a bed for overnight visitors. Talk about flexibility! 

6. Surfaces—Seamless is best

In specifying floor materials, seamless surfaces are best, particularly where infection risk is highest, such as surgical areas. For sinks, solid surfaces with integral sink bowls minimize seams, contributing to infection control measures. Infection risk can also be minimized through careful selection of furnishings and materials. The less porous a surface, the easier it is to clean and maintain.

The common misconception among maintenance staff is that if something is shiny, it is clean. However, shiny does not equate with clean, as a non-waxed surface takes less water, chemicals, and down time than a highly polished waxed surface. Shiny floors create glare that can be distracting and contribute to falls, as shiny spots are often mistaken for wet areas. Design professionals should evaluate matte surfaces with a high coefficient of friction to reduce fall risk.

Jane Rohde, AIA, FIIDA, ACHA, AAHID, LEED AP, champions a widespread global cultural shift toward de-institutionalized senior living facilities through her consulting, sustainable approach, research, and advocacy, which provides services to nonprofit and for-profit developers, government agencies, and senior living and healthcare providers. She also provides education to providers, regulators, and peers on senior living and healthcare trends, programming, and design that supports and improves the lives of elders and patients.

Rohde’s consulting practice includes the promotion of person-centered environments, sustainability, and universal design solutions. She sits on the Environmental Standards Council, part of The Center for Health Design, and is the former AAHID Board of Regents VP. Her leadership has garnered the creation of the Facility Guidelines Institute’s Guidelines for Design and Construction of Residential Health, Care, and Support Facilities, a guideline utilized as code for the licensing of long-term care and related facility types.

This groundbreaking document includes guidance on not only traditional models but provides guidance for designers, regulators, and providers for creating person-centered environments. Rohde founded and chairs the Senior Living Sustainability Guide committee, a committed group of volunteers that created a sustainability guide for senior living projects that has been accessed for utilization in more than 10 countries, including China Senior Care, the first residential aged-care facility in China that focuses on skilled nursing and adult day care. Rohde speaks internationally on senior living, aging, healthcare, evidence-based design, and sustainability. 

Related Stories

University Buildings | Dec 5, 2023

The University of Cincinnati builds its largest classroom building to serve its largest college

The University of Cincinnati’s recently completed Clifton Court Hall unifies the school’s social science programs into a multidisciplinary research and education facility. The 185,400-sf structure is the university’s largest classroom building, serving its largest college, the College of Arts and Sciences.

MFPRO+ News | Dec 5, 2023

DOE's Zero Energy Ready Home Multifamily Version 2 released

The U.S. Department of Energy has released Zero Energy Ready Home Multifamily Version 2. The latest version of the certification program increases energy efficiency and performance levels, adds electric readiness, and makes compliance pathways and the certification process more consistent with the ENERGY STAR Multifamily New Construction (ESMFNC) program.

Architects | Dec 5, 2023

Populous celebrates its 40th anniversary with a photo exhibit of its works

The firm partnered with Getty Images to assemble more than 60 images, many capturing fan ardor.

Office Buildings | Dec 1, 2023

Amazon office building doubles as emergency housing for Seattle families

The unusual location for services of this kind serves over 300 people per day. Mary's Place spreads across eight of the office's floors—all designed by Graphite—testing the status quo for its experimental approach to homelessness support.

Mixed-Use | Nov 29, 2023

Mixed-use community benefits from city amenities and ‘micro units’

Salt Lake City, Utah, is home to a new mixed-use residential community that benefits from transit-oriented zoning and cleverly designed multifamily units.

Giants 400 | Nov 28, 2023

Top 100 Laboratory Design Firms for 2023

HDR, Flad Architects, DGA, Elkus Manfredi Architects, and Gensler top BD+C's ranking of the nation's largest laboratory architecture and architecture/engineering (AE) firms for 2023, as reported in Building Design+Construction's 2023 Giants 400 Report.

Engineers | Nov 27, 2023

Kimley-Horn eliminates the guesswork of electric vehicle charger site selection

Private businesses and governments can now choose their new electric vehicle (EV) charger locations with data-driven precision. Kimley-Horn, the national engineering, planning, and design consulting firm, today launched TREDLite EV, a cloud-based tool that helps organizations develop and optimize their EV charger deployment strategies based on the organization’s unique priorities.

Market Data | Nov 27, 2023

Number of employees returning to the office varies significantly by city

While the return-to-the-office trend is felt across the country, the percentage of employees moving back to their offices varies significantly according to geography, according to Eptura’s Q3 Workplace Index.

Resiliency | Nov 27, 2023

All levels of government need to act to cope with climate-driven flooding and sea level rise

The latest National Climate Assessment highlights the need for local, state, and federal governments to adopt policies to mitigate the effects of climate-driven flooding and sea level rise, according to a policy expert with the National Resources Defense Council.

Data Centers | Nov 22, 2023

How is artificial intelligence impacting data center design?

As AI is reshaping how we interact with machines and the world around us, the design of data centers needs to adapt to this fast-changing landscape. So, Page pairs expert thinking with high-performing solutions to meet the needs of rapidly advancing technologies.

boombox1 - default
boombox2 -
native1 -

More In Category


DOE's Zero Energy Ready Home Multifamily Version 2 released

The U.S. Department of Energy has released Zero Energy Ready Home Multifamily Version 2. The latest version of the certification program increases energy efficiency and performance levels, adds electric readiness, and makes compliance pathways and the certification process more consistent with the ENERGY STAR Multifamily New Construction (ESMFNC) program.

halfpage1 -

Most Popular Content

  1. 2021 Giants 400 Report
  2. Top 150 Architecture Firms for 2019
  3. 13 projects that represent the future of affordable housing
  4. Sagrada Familia completion date pushed back due to coronavirus
  5. Top 160 Architecture Firms 2021