Children's Memorial revamp heralds new thinking about healing kids
Monday, April 04, 2011
There's a revolution taking place in the design of children's hospitals. And Lurie Children's Hospital in Chicago is at the forefront, with an eye-catching space meant to support and uplift families. An added bonus: the design may even help kids heal faster.
It started with a picture of a prison cell. Bruce Komiske, in charge of designing the new Ann & Robert H. Lurie Children's Hospital, stared at the image in an effort to understand the patient experience: what it feels like to be boxed in, stripped of control, robbed of the basic sensory pleasures of light and color.
"The similarities are too real," the chief designer says. "You get an identification number and institutionalized food. You're by yourself. It's the most dehumanizing thing you can do to anyone."
At the new facility, slated to open in June 2012, Komiske and a team of more than 1,000 architects, designers, administrators and construction workers are trying to transform the hospital experience for Chicago's pint-sized patients.
"What do you do to change how a hospital looks, tastes, smells, feels, acts?" he asks, concerning the design process for the hospital, which now is nearly 80 percent constructed in Streeterville.
In the past, architects designed hospitals simply to deliver health care. A doorway had to be big enough for a bed to fit through; spaces had to be efficient to allow for the flow of doctors and nurses; the color palette of a patient's room was industrial bland, never whimsical. But in the 1980s, evidence emerged linking poor design to anxiety, elevated blood pressure and increased intake of pain drugs-the very factors that keep patients from being released and cost hospitals money. Hospital designers began to rethink their approach and built the more family-friendly spaces we use today.
Modern and experimental, Lurie may change the face of children's hospitals once again. The design caters to kids' wild imaginations rather than their sad circumstances. Imagine: a 5,000-square-foot indoor garden, a glass-floored treehouse, a bamboo forest, a whale replica that hovers over your head while you wait in the lobby.
This is not your mother's hospital.
What kids really want
The idea to build the hospital-the largest building project in Chicago right now-germinated eight years ago at Children's Memorial in Chicago's Lincoln Park. The hospital, ranked as the region's top provider of pediatric specialty care, had long outgrown its space and turns away about 200 kids each year to seek treatment elsewhere. It desperately needed a new building.
Planners decided to incorporate kids' ideas into the process, creating a Kids Advisory Board where 10 teenagers, used to living within the walls of Children's Memorial, could consult with the new building's designers. Board member Ellen Gordon, 17, diagnosed with juvenile arthritis, has been in and out of Children's since fourth grade. She believes input from young patients is crucial.
"(The designers) try and think like kids, but they're not kids so they don't know," Ellen says. "This is a hospital for kids. Kids should be the ones telling you what you should do. We know what we like."
Of all the design elements, Gordon most loves the Crown Sky Garden, a space that the kids board asked the designers to create. The garden was the brainchild of landscape artist Mikyoung Kim who admits it was a challenge designing a garden for immune-deficient kids.
"We couldn't create a lushly planted environment," Kim says. "We had to be innovative while still capturing what a garden is." Kim's unconventional garden hinges on faith that "kids can use their imagination in a more abstract way." She used bamboo, mulberry and black walnut trees, which don't pose threats to weak immune systems. Rather than creating a freestanding fountain, Kim designed a waterfall, contained between layers of marble walls, so kids can marvel at the water's flow without being exposed to potential toxins.
Designing the garden was a lesson in what kids really want, Kim says. The adults involved felt the space needed toys, buttons to push and things to play with. But when Kim met with children, she realized that thinking was misguided.
"The kids in the room raised their hands and said, 'We just want a place that's an escape. We don't want the garden to become a collection of things. We want it to be an experience.'" Kim scrapped several ideas, including one to build interactive LED lights into the floor, and created a space that was "more timeless." For patients too sick to enter the garden, Kim built a treehouse with a glass floor, so they can at least view the greenery from above.
The importance of beauty
Judy Rollins, a researcher in children's hospital design, strongly believes there's a need for artistry in hospital care. "These kinds of things can distract people and take them to another place for a while," she says. "Beauty does something to you. If you're in that kind of an environment, you feel like people value you."
Something as minor as a tall nurse's station counter can make hospital staff intimating to a kid, Rollins learned in a study published last year in the Journal of Pediatric Oncology Nursing.
She has experience on the other side of the equation, too, as the mother of a daughter once hospitalized with heart disease. When her 4-year-old had to spend a week in the ICU, Rollins wasn't allowed to stay by her side. Restricted by visitation rules, Rollins slept on the floor of the waiting room and could only visit her daughter every two hours for 20 minutes. Today she celebrates the fact that most ICU units have an extra bed for parents, and hospitals have come far in accommodating families' needs.
"It makes all the difference," she says.
Komiske hopes the new hospital's lobby will offer families momentary calm amid the chaos.
"Parents want their kids' eyes to open up wide; they want them to forget they're here," he says.
The team worked with Shedd Aquarium and tapped the calming properties of water. Shedd donated an enormous fiberglass whale replica that will hang from the ceiling, next to a curved wall that projects moving images of underwater life 24/7.
A revolution in the making?
To fund the construction of the new hospital-with a whopping $915 million price tag-Children's Memorial Hospital is using funds from Chicago's deep-pocketed philanthropists, several massive loans and the pending sale of the old Lincoln Park facility. The hospital's namesake is Ann Lurie, a former nurse at Children's Memorial, and her late husband Robert, a real estate tycoon, who jump-started construction with a $100 million donation.
Is the cost worth it? New research says yes: Though expensive on paper, innovative design may help patients heal faster.
"Design is able to affect health outcomes for children," says Gillian Ray of the National Association of Children's Hospitals. Organizations such as the Center for Health Design are working hard to spread the word within the health-care field. For the past 10 years, CHD has conducted research with children's hospitals, revealing a strong link between simple features-larger windows, better indoor air quality, noise reduction and eye-catching art-and real health improvements, reducing the length of a patient's stay, infection rates and medication errors.
The sky garden at Lurie Children's Hospital is a perfect example.
"Not only do patients heal more quickly when there is a garden in the hospital, but there's proof of lower heart rate, blood pressure and so on," Kim says. "There's lower turnaround of staff and doctors in the hospital, (and) a faster rate at which patients check out. It's a win-win for everyone."
A new study by the Hastings Center states that innovative design can save hospitals upwards of $10 million annually.
Drawing from a palette of 50 jewel tones the design team meticulously selected, walls are being painted with such colors as aquamarine, exotic bloom and marmalade. The red ribbon will finally be cut in June 2012, when all patients in Children's Memorial Hospital will move to Streeterville.
In the coming years Komiske anticipates a powerful effect on the overall heath-care industry, as hospitals start to grasp the impact of simple design innovations.
"Adult hospitals are finally waking up and learning from children's hospitals," he says. "(One day) we'll see buildings that are less scary."