Furniture factors

Manufacturers of hospital furniture are updating their product designs to meet new demands in health care environments. One big consideration is the creation of a family-friendly hospital experience for the relatives and friends of patients. Other areas of emphasis include aesthetics, ease of cleaning, sustainability, ergonomics and furnishings for large people.

Health Facilities Management recently discussed these trends with manufacturers of hospital furniture. In this article, these experts share their ideas on both industry trends and innovations in product design.

'Homey' touches

Manufacturers are incorpor­ating aesthetics into their designs to make their products look "homey." The goal is to combine functionality with beauty. Given the realities of the hospital environment, however, this can be tricky.

Michael Zusman, CEO of Kwalu, Atlanta, says that successful health care facilities incorporate a warm and inviting atmosphere where patients and guests can relax. In making furniture selections, however, facilities must take into account the wear and tear and number of guests using each space.

"A facility manager should consider an integrated look throughout waiting areas, treatment rooms and corridors," he says. "Incorporating color waves and collection styles and determining whether a facility is traditional or contemporary—or somewhere in between—goes a long way toward establishing a facility's overall look and experience, making it feel more like home."

According to Lauri Waidner, director of marketing for Champion Manufacturing Inc., Elkhart, Ind., updated designs can help take the edge off the clinical look of hospital furniture. So the company regularly reviews its recliners.

"If we find more aesthetically pleasing components that can support the clinical purpose of the chair without compromising function or performance, we will use them," she notes. The company also strives to balance price point with aesthetics. "We can make a fabulous 'designer' chair that no one can afford. So it's a matter of balancing priorities with patient and staff safety our highest priority."

Nurture by Steelcase, Grand Rapids, Mich., strives to design products that have strong aesthetic appeal and a design that puts people at ease and makes them think less about the environment they're in. "When facility managers tell designers or architects they want a 'homey' environment, they really mean they want an environment that supports the healing process," says Phyllis Goetz, vice president of sales. "They want the same feeling of comfort they would have at home."

Family friendly

Furniture manufacturers also are incorporating family-friendly features into their products. The goal is to make families comfortable when they stay all day or overnight. This consideration is especially important when furnishing patient rooms.

"Again, it's all about the patient experience," Champion's Waidner says. "Our line of overnighter/sleeper chairs are a perfect addition where an overnight stay of a loved one is welcome."

Kwalu sleepers accommodate hospital guests and pa­tients. Featuring plush cushions and easy pullout mechanisms, they are designed for tight-fitting spaces. They combine the comfort of an easy chair with the pullout functionality of a sleeper sofa. Any sleeper can be folded up as a guest chair or opened for overnight visits.

To promote a family-friendly environment, Nurture by Steelcase considers the pa­tient, staff, and family and friends, according to Goetz. "If you don't consider and solve issues for all three," she says, "you haven't built the right health care space because all three will be using that space."

Keeping it clean

Ease of cleaning is another important consideration, given the hospital environment and preponderance of stains it can inflict on furniture. In fact, Ed Miles, director of health care for GLOBALcare, Marlton, N.J., says his company is getting more requests for plastic arm caps and metal frames to accommodate rigorous cleaning demands.

"Design alternatives to maintain sanitary conditions include upholstery choices that are easy to clean and help prevent infiltration of moisture and bacteria," says Liz Sworden, director of marketing for BioFit Engineered Products, Bowling Green, Ohio. "Available furnishing options also feature antimicrobial properties, moisture barriers and seamless construction."

Champion designs its recliners with an "open concept" that allows bodily fluids to fall to the ground, which facilitates cleanup and dis­infection. A removable seat (standard on all medical recliners) is also helpful, and when paired with a swing-away arm, helps achieve infection control.

"Improving a hospital experience for patients and em­ployees starts by taking the work out of cleaning and maintenance and allotting it to patient care," says Kwalu's Zusman. "Choosing furniture and wall protection that require little maintenance, with the ability for instant repairs, frees up administrators and caregivers to do what they do best—deliver superior service to their patients."

To that end, Kwalu designs hospital furniture that requires little maintenance and withstands harsh cleaning regimens, he notes. Finishes are nonporous and will not stain; they also are antimicrobial, high-impact-, and scratch- and water-resistant. Scouring pads and buff cloths can be used to remove nicks and scrapes.

"It's critical to balance in­fection control with sustainability," adds Nurture by Steelcase's Goetz. "We try to use materials that produce surfaces where infections cannot breed, but do not make the product nonsustainable."

'Green' initiatives

Indeed, many environmental friendly initiatives are being incorporated into hospital furniture design. The goal is to achieve sustainability and good indoor air quality. Recycling also is important as suppliers strive to use materials that can be recycled at the end of a product's lifecycle.

"[Sustainability] has become a big factor for health care and in virtually all facilities over recent years and will continue to gain momentum," says BioFit's Sworden. "In furniture design, sustainability and indoor air quality of the end-user environment are focal points to ensure that furnishings are not detrimental to caregivers, patients and the healing process."

The trend is for hospital purchasing departments to be environmentally responsible when deciding which products to acquire, adds Champion's Lauri Waidner. "We review the manufacturing process to see what carbon footprint the product leaves behind. All things are considered—everything from energy efficiencies and waste minimization in the production process to the off-gassing of materials and finishes on the final product that impact indoor air quality."

Nurture by Steelcase, which uses sustainable materials in its products, plans to be poly­vinyl chloride-free by 2012. "Unfortunately, sustainability is still a charge that is in its infancy, and the cost of materials can sometimes preclude a hospital from being able to do it," Goetz says. "Our job is to manufacture products that are easy to clean, sustainable and affordable for an average health care facility."

Janice Carlson, vice president of marketing and product development for Nurture by Steelcase, adds that health care infection control will always trump sustainability. That's because the agents needed to make sure they're not transferring infection from one source to another can make developing those sustainable products a challenge.

One example of green design is offered by Lyon Workspace Products, Montgomery, Ill., which uses paints that contain no volatile organic compounds (VOCs) in its hospital lockers, thus providing healthy air quality for the life of the product. "This is an important improvement in hospital facilities," says Chris Rudella, director of marketing. "The antimicrobial, silver-based compound is inorganic and protects against mold, bacteria and some facility-born viruses." As a result, the lockers are easily cleaned with a mild soap. No harsh chemicals are required.

Another example is hospital furniture manufactured by Northland Furniture Co., Bend, Ore., which incorporates zero urea-formaldehyde and low-VOC finishes, promoting healthy indoor air quality, says Mike Angus, director of operations and general manager. With an eye on the indoor environment, the company uses water-based adhesives for laminate application and water-based wood glue on all joints to ensure no odor or VOC emissions. The UV finish on plywood is 99 percent solids, which nearly eliminates off-gassing once the finish is cured.

Back talk

Another trend is growth in the area of ergonomics. "In the health care arena, ergonomic furnishings are more critical than ever—from specialized seating used in the operating room to that used by patients post-surgery, as today's re­covery regimens mandate patients sit up sooner and for longer periods of time," says BioFit's Sworden.

Ergonomic features also are designed for hospital employees, allowing them to work more efficiently and injury-free.

"You can look at ergonomics in two ways—products that are designed to support the way people move; you also can look at ergonomics from a safety perspective—are we keeping patients, their families and the staff safe during their time in a health care facility?" notes Nurture by Steelcase's Goetz. "Our products are designed based on observational research around the way people work because our expectation is that we're going to build products that support the work that people do, not that they're going to have to change their behaviors to work with our products."

Champion designs its hos­pital recliners to support the ergonomic needs of both patients and staff. For example, the height of its recliner allows staff to work without extreme bending. The height of the recliner's arms makes it easier for staff to start a patient on an IV drip while it gives the patient optimum support under his or her arms. In addition, the removable seat and swing-open arm design make cleaning and maintenance easier.

Kwalu's Zusman says usability is a key concern in any health care environment. For patients and caregivers alike, access to resources, space efficiency, and ergo­nomic and supportive furnishings can make the difference be­tween functional and im­practical spaces. To im­prove ergo­nomics in hospital environments, the company manufactures chairs that feature motion seat backs, full up­holstery, and seat and arm heights designed for easy ingress and egress.

Accessible design must be incorporated in furniture designed specifically for health care, adds Northland's Angus. Furniture heights, Americans with Disabilities Act compliance, ease of use and transportability all must be considered when designing and manufacturing furniture.

Big challenge

Bariatrics is another important factor in hospital furniture design. Considerations for this patient segment continue to rise. The goal is to meet the needs of large patients in a safe and respectful manner.

"Bariatrics is an important element of furniture design," says GLOBALcare's Miles. "Patients are getting bigger and heavier. We are seeing higher weight requirements. In fact, 500-pound-weight-capacity chairs are becoming popular. Hospitals are even asking for 750- or 1,000-pound capacity." Larger arms are critical on bariatric seating, so that bariatric patients can grab them to keep their balance, Miles notes.

He says oversized chairs should be available in public areas such as lobbies and waiting rooms as well as examination rooms and other patient areas.

"Many hospitals have a room or two on each wing specially designed for this type of patient," Miles adds. "These rooms require larger beds, tables, seating and lifting equipment … not to mention specialty bathroom design and fixtures. Larger capacity recliners and patient chairs for bariatric patient rooms are a popular request."

Champion's Waidner notes that furniture manufacturers must meet the needs of large patients in a safe and respectful manner, while preventing injuries to staff that assist them. Bariatric patients are often frail and need special consideration during handling.

Waidner says there are also practical considerations for aging facilities with narrower doorways. This results in an ongoing battle between the size of standard doorways in facilities and the size of equipment needed to treat bariatric-sized patients, which posed a design dilemma for Champion. The solution: The company designed its larger recliner with swing-open arms to pass through a standard size door while maintaining a wider 27.5-inch seat.

Nurture by Steelcase's Carlson says her company is seeing standard requests from designers for 20 to 25 percent of seating in bariatric offerings. "More hospitals are requesting a bigger seat—not bariatric. They are requesting chairs that will fit a larger person, but not necessarily a person that weighs over 300 pounds. We have several lines that offer two seat widths."

"Unfortunately, there are no bariatric standards right now," adds Nurture by Steelcase's Goetz. "We're working with the industry to create standards to make sure that all furniture manufacturers build products that support large people with dignity and respect." hfm

Neal Lorenzi is a freelance writer based in Mundelein, Ill.