Cancer Center Unit Redesigned to Create Healing Environment

SAN DIEGO--More than a year after the opening of the Barbara Ann Karmanos Cancer Institute, patients and staff alike are giving its design high marks. Dore Shepard, RN, MS, OCN, administrative manager for Cancer Patient Services at the Institute, said that the goal was to have a facility that creates a healing environment for patients.

Ms. Shepard explained the 18-month design and construction process and its results in her poster presentation at the 26th Annual Congress of the Oncology Nursing Society (abstract 141).

"Many cancer organizations are going through hospital renovations. I belong to a group called the Center for Health Design," she said. "It works on developing designs for hospital environments that create a positive impact on patients."

The hospitalization experience in itself can be a source of stress for patients, she said. Research studies have confirmed the effect environment has on patients. While this stress can occur no matter what the illness, she said that cancer especially demands a healing environment that takes into account the patient’s mental, spiritual, and physical comfort.

Peter Karmanos donated $5 million for the 25-bed, 15,000 square-foot cancer unit at Harper Hospital in Detroit. Ms. Shepard said she was given carte blanche to design it, and she sought input from patients and staff.

A Patient Advisory Council was shown a selection of original artwork from which they selected. Patients and family members chose the guest room furniture. Staff members from the most recently renovated unit were surveyed regarding design areas to improve on, and nursing staff had input throughout the process.

One of the key areas addressed was noise. "Patients don’t want a noisy environment," Ms. Shepard emphasized. The result was a glass-enclosed nursing station, acoustic panels that may be covered with artistically designed fabric, and softly vibrating beepers for nursing staff that notify them of patient requests.

Staff Input

The staff had input in other practical issues as well. "They wanted equipment to be accessible, but not in the hallways where it would look cluttered, so we designed cubbies in the hall," she said. "They didn’t want plugs to be low to the ground, which requires a lot of bending over. They wanted a cheerful conference room and increased lighting."

Because the staff was also involved in selecting items like wall color—creamy ecru and muted teal—and artwork, Ms. Shepard feels they are much more invested in their environment, which she also believes has had a side benefit—a low attrition rate. "At a time when it is difficult to retain RNs, I’ve had only one nurse leave since the unit opened in May 2000. That’s because she was promoted within the organization," she said.

While process assessment led to a decision to have huge, centrally located medication rooms, aesthetic considerations resulted in signature watercolors and framed miniature quilts hanging on the walls of these rooms. Patient rooms are in shades of blue and plum. Furnishings and finishes emphasize soft curves and light wood tones. Guest chairs convert to beds. Subdued lighting creates a relaxed ambiance. Ms. Shepard is pleased with the results and with the patient response. "We send a survey to patients after they’ve returned home, and the Press Ganey Patient Satisfaction results for pleasantness of room decor went from 68.9% prior to renovation to 83.4%."