Pulse healthcare design

Halff Associates has completed the new

office of Dermatology Consultants, Inc.,

on the Texas Hospital for Advanced

Medicine campus.

P 2

Halff Associates has been interviewed by

Interior Design Magazine, New York.

P 3

Halff Associates has the answers to your

questions on new build-outs, expansions

or renovations to existing office space.

P 4

ISSUE 1 FALL 2009

Increasing concerns on hospital-acquired infectionsEvidence-based designs may be the best deterrent to rising healthcare crisis

thE growIng body oF EvIdEncE-bASEd dESIgn

knowLEdgE IS EnAbLIng hEALthcArE dESIgnErS to

crEAtE bEttEr hEALIng EnvIronmEntS wIth ProvEn

ImProvEmEntS In PAtIEnt oUtcomES.

Infection control ranks extremely high as a priority concern

for healthcare providers. Today, we find our nation fighting

the spread of flu epidemics such as H1N1, and we spend

billions annually treating two million patient cases of reported

nosocomial bacterial and fungal hospital-acquired infections.

As much as we want to control and eradicate disease, we

expect we will always be vulnerable.

As evidence-based medicine is the application of best

practices from scientific documentation for the best patient

outcomes, evidence-based design is the process of basing

design decisions about the built environment on credible

research to achieve the best possible outcomes. The way

we design healthcare facilities can have a profound impact

on human behavior including the care and outcome of

patients’ health.

For more than two decades, architects and designers

have tested and learned the important role design plays in

healthcare facilities. In 2000, the Center for Health Design

Research created the Pebble Project program. For the last

nine years we have learned through scientific protocol how

to better design for healthcare. In 2006, one of their research

contInUEd on PAgE 2

The body of design evidence has dramatically grown, and

it is believed that the ripples of the Pebble Project will soon

become a large wave. The US government is already requiring

architects to be capable of implementing evidence-based

design into their medical facilities. In 2009, the first evidence-

based design examination was prepared by the Evidence-

based Design Accreditation and Certification Board (EDAC).

dan Lee, AAhId, AIA, ASId, IIdA, and vice President

of Healthcare at Halff Associates, was among the first

100 healthcare design leaders to be certified to practice

evidence-based design in the United States. He will present

“An Introduction to Evidence-based Design” on September 22

at the UNT Health Science Center, Fort Worth, Texas. You

are invited. See “Keepers” section on Page 4 for details.

At right: Laboratory facility for Baylor Health Care System,

Dallas, TX

contInUEd From PAgE 1

A new design masterpiece:Dermatology Consultants, Inc.

halff Associates has completed the new office of dermatology consultants, Inc., a medical practice on the texas

hospital for Advanced medicine campus in Farmers branch, texas. this office and the practice of drs. michael

maris and rebecca Euwer are known for their advanced techniques in cosmetic surgery.

A recent fire damaged the doctors’ office, forcing them into a temporary space as all of their furnishings, equipment, and

accessories had been destroyed. For their celebrity practice, the physicians knew they needed an exceptional interior

design solution in the shortest time possible. Halff Associates was contracted to provide overall design and coordination

services including furniture specifications, procurement and move coordination.

Halff project manager, Dan Lee, recalls meeting the physicians the first time: “They understood their practice model

and their patients’ expectations. They worked well together and allowed themselves latitude for individual taste without

compromising the overall design intent. They understand the work habits of their staff and healthcare professionals and

were able to communicate specific programming requirements that allowed Halff to move quickly into the design phase.”

Team participation, along with a supportive landlord and hospital, made it possible for Halff to design a healing environment

reflective of the physicians’ brand and at a cost that was agreeable to everyone. p

“working with halff Associates has been a delight. they made great use of unusual materials and finishes but worked them into a style where every detail was coordinated.

my only regret was that the project got finished!” – dr. michael L. maris, m.d.

projects was referenced in “The Impact of Design on Infections

in Healthcare Facilities” by Anjali Joseph, Ph.D. This white

paper included research information about the placement of

hand washing sinks in hospital settings to improve frequency

of use and duration of use. By simply placing the sink on the

path to the patient bed and in a position where the caregiver

could face the patient, its usage was greatly increased, and

hospital-acquired infection decreased.

Evidence-based healthcare designs are used to create

environments that are therapeutic, supportive of family

involvement, efficient for staff performance, and restorative

for workers under stress. An evidence-based practitioner

makes decisions based on the best information available

from research and project evaluations. The result is a higher-

quality healthcare experience for patients, families, healthcare

professionals and staff members. p

Typical room layout Better room layout

yoU woULd not conSIdEr hIrIng A SUrgEon

to oPErAtE who hAd not PErFormEd

thE ProcEdUrE mAny tImES bEForE. thIS

common SEnSE rULE APPLIES to SELEctIon

oF A dESIgn tEAm. nothIng SUbStItUtES For

ExPErIEncE. At hALFF, oUr bESt PrActIcES

mAtUrE wIth EvEry ProjEct. wE LEArn

From EvEry SUccESS And EvEn morE From

oUr chALLEngES.

Halff Associates was selected as a subconsultant to the HKS/

Wingler and Sharp JV to enter into negotiations to provide

architectural engineering services to support the Department

of Defense Medical (DoDM) Program. The contract will be

administered by the Huntsville Center. The center is the

U.S. Army Corps of Engineers’ Medical Facilities Mandatory

Center of Expertise and Standardization (MX), which is

charged with delivering medical expertise and the highest

quality medical care and medical research facility life cycle

support to the Department of Defense (DoD), other federal

agencies and foreign governments. Under the contract, the

team will have the opportunity to provide planning, survey,

energy conservation and analyses; comprehensive interior

design; and Requests for Proposals (RFPs) development.

Services will also include design and planning related to new

construction, upgrades, maintenance, and repair of various

medical facilities. Halff Associates is tasked with supporting

the team in the areas of civil and structural engineering,

interior design, landscape architecture, and Antiterrorism

Force Protection.

Halff Associates was selected as a subconsultant to WestEast

Design Group of San Antonio, Texas, to enter into negotiations

to provide architectural engineering services to support the

DoDM. The small-business contract will be administered

by the Huntsville Center. Under the contract, the team will

have the opportunity to provide planning, survey, energy

conservation and analyses; comprehensive interior design;

and RFP development. Services will also include design and

planning related to new construction, upgrades, maintenance,

and repair of various medical facilities.

market watchA sluggish economy often calls for hard decisions on where to decrease spending and how

to prioritize new facility and remodel plans. on the other hand it can be an excellent time to

re-evaluate standards and policies that impact life cycle, workplace injury, energy consumption,

and time management, to mention a few.

The Obama Administration is providing stimulus money to move America’s healthcare system from

paper to paperless. Early participation in 2010 will yield the greatest refunds, and if nothing has

changed by 2017, your facility will find it very difficult to get reimbursement from Medicare or Medicaid.

Only a handful of information technology companies exist that can manage this opportunity. On a

recent trip to the Hill-Rom headquarters, Halff learned that they are positioned to help you integrate

your technology with your facility, including your equipment assets. Hill-Rom has earned the largest

percentage of hospital equipment market share, so it is a good place to start your exploration.

While talking with Hill-Rom you might also ask about several of their new innovations such as

their patient lift machines. Nearly 30% of all nurses suffer back injuries during the course of a year

of employment. Spending money on a lift may be a wise investment when insurance is high and

nurse retention is low. Investigate Hill-Rom’s new “bed-as-a-hub”, which demonstrates state-of-the-art

technology while improving patient outcomes. p

hALFF ASSocIAtES IntErvIEwEd by IntErIor dESIgn mAgAzInE, nEw york

Halff Associates has been interviewed by Interior Design Magazine,

New York. The November 2009 issue will focus on healthcare design

and the trends of this industry. Halff provided trend information for the

article and surveys are being developed based on this information.

These relevant surveys will go to the 100 healthcare design giants

including Halff Associates.

This key issue will reach the audience attending Healthcare 09 in

Orlando, Florida. Comments include a focus on how a new national

healthcare program will impact all aspects of this industry and a focus

on the number, size, and types of military healthcare projects. Lastly,

the new EDAC exam will have profound influence, much as LEED,

in forming opinions on usefulness of design data that is important

for clients and designers to consider when planning change for a

healthcare facility. p

dESIgnotes:halff’s Senior Interior designer,

jim marstiller, FASId, has been

awarded the Annual AAHID/Nurture

by Steelcase Scholarship for the

Advance of Healthcare Design

Education. Jim was selected from a

national pool of candidates, and this

scholarship will further his completion

of his PhD in Healthcare Interior

Design. Jim’s research will be focused

on dementia care within the senior

population. p

experiencematters

contInUEd on PAgE 4

Change can be a stressor — draining time and money or it can be a strategic decision that empowers, enables and refreshes your business.

Most medical providers care most about their patients. If a move will disrupt the care and service they provide their patients, the change

will be avoided until there is a crisis. Sometimes a fire or the landlord’s sale of the property forces change. Other times, it is required to

accommodate a new partner or service line. Whatever the reason, every project values change. When I started my design career I was

told to always oversize the business center of the

office as that was usually the first place to feel the

pain of a growing practice. But then again, I started

my design career when huge copy machines, long

rows of file cabinets, and spare typewriters were

stationed around the room. Technology changed the

programming of space dramatically, and it was the

patient area that ended up needing more space.

Any good design should plan for and forecast some

degree of change. While none of us has a crystal

ball and most of us designer-types lack the foresight

to appreciate what science will do next, we know to

design modularity that accommodates some degree of flexibility. Working with the structural language of the building, appreciating the cost

of plumbing installations, and keeping in mind that patient flow will always be important are but a few of the basic guidelines for planning

a new medical office.

The healthcare delivery system is in constant flux, too. Unexpected reimbursement changes may alter the procedures you offer and

thus change your office layout requirements. Integrating space for patient interviews near the front business office is vital to maintain the

privacy of patients who have payment concerns. Finding a way to welcome and accommodate all patient types can be very important to

your financial success. For example, planning for bariatric seating in the waiting and interview rooms is as important as providing second-

language assistance throughout your medical office.

In a tight economy where landlords cannot afford high-dollar finish-out allowances and tenants want to look like a million dollars for a

few bucks, the designer brings value to the relocation experience by carefully learning the project constraints and creatively designing

affordable solutions that fit within the budget and aesthetic framework. It is paramount that designers be hired who understand the specific

uniqueness of various medical practice types as well as the ergonomic requirements of that practice’s patient population. Simply creating

a beautiful “spa-like” environment is not enough. In today’s healthcare office, adherence to code compliance, personal privacy, infection

control, security, and employee retention can be key issues that differentiate healthcare-certified architects and designers from the rest of

the design profession. p

halff Associates, Inc.1201 north bowser roadrichardson, tx 75081-2275

214-346-6200 214-739-0095 fax

www.halff.com

Expanding your practice or moving into a “new” space? Here is some sage advice...

FAcILIty SUrvEyS | IntErIor dESIgn | PLAnnIng | grEEn dESIgn | wAyFIndIng dESIgn

EngInEErIng SErvIcES | LAndScAPE ArchItEctUrE | ArchItEctUrE | EvIdEncE-bASEd dESIgn “Hosp i ta l - i t y ”

COLUMN by Dan Lee. . . . . . . . .

Halff Associates is tasked with supporting the team in the areas of interior design, hazardous materials investigation, civil and structural

engineering, landscape architecture, and Antiterrorism Force Protection.

The collective experience of this expert team will bring real value to any project that may come from this contract. p

contInUEd From PAgE 3

“keepers”The Health Industry Council Integrated Project Delivery

Irving, TexasSeptember 10, 2009

Halff Associates presents: An Introduction to Evidence-based Design

Alcon AuditoriumThe Center for BioHealth

University of North Texas Health Science Center3400 Camp Bowie Blvd.

Fort Worth, Texas

September 22, 20095:30 - 6:15 p.m. (Registration & Reception)

6:15 - 7:00 p.m. (Presentation)

rSvP to mhogan@halff.com

The Health Industry Council North Texas Health and Technology Forum

Arlington, Texas September 24, 2009

Healthcare and Facilities Symposium Exposition

Chicago, IllinoisSeptember 30-October 2, 2009

World WorkplaceOrlando, Florida

October 7-9, 2009

Healthcare 09Orlando, Florida

October 29-November 3, 2009