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TBI Clinic Redesign

 


Walter Reed National Military Medical Center - 2015
Role: Architectural design, user research
 

Rethinking spaces for traumatic brain injury treatment

Traumatic brain injury is a complex and difficult condition to deal with.  Careful investigation has led me to discover that traditional inpatient hospital wards are suboptimal for managing these injuries.  This design responds to specific patient needs while reinforcing the clinical and social interactions that play a critical role in the treatment and healing process.

Inpatient hospital wards typically look and feel impersonal and institutional.  They're usually not a place where you would like to spend much time.  Research strongly indicates that these environments are not conducive to the healing process.
 
At the WRNMMC Traumatic Brain Injury Clinic, patients sometimes stay up to several months while undergoing extensive treatment.  When asked to develop the schematic redesign of this space, I decided to take a patient-centric approach.  

How can space design be optimized for the treatment of TBI?

 

 
 
                                                               
 
 

Gathering insights

Traumatic brain injury is mysterious in nature and physicians have yet to gain a complete understanding of its implications.  In order to create an effective design, I first needed to know and research the underlying mechanisms behind this perplexing condition.  

 
 
 
 

Focusing on the details

After much brainstorming with clinicians, patients, and staff, a design emerged that not only challenges the status quo but also seeks to reshape the treatment process. 

 
 

Rethinking illumination

Patients with traumatic brain injuries can be very sensitive to light, especially to the harsh and direct forms typically found in healthcare environments.  Strategically placed task/ambient lighting (1) focuses light where it's needed the most (near the floor surface).  This greatly increases lighting efficiency (less light is required to illuminate the space adequately), but more importantly, it increases safety as many TBI patients are highly susceptible to tripping and falling.  Way-finding (3) is also gently illuminated to assist the visually impaired while specialty materials help patients distinguish different areas within the ward (2). 

 
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Creating a sense of hospitality  

Patients can stay up to several months while undergoing treatment.  These suites are designed with a hospitable approach.  The lighting (3) is soft, welcoming and strategically placed for safety/functionality.  

The furniture (2) is comfortable, modern, and can accommodate couples (as many spouses and family member accompany patients during treatment).  Specialty materials (1) like wood paneling, assist those who rely primarily on touch to navigate their way around, while also concealing medical gas systems and other equipment that is typically left exposed.  The setup includes ample closet space and an integrated audiovisual system used to deliver therapeutic sights and sounds. 

 
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Making accessibility seamless

TBI patients are fragile, clumsy and prone to serious injury as a result of slipping and falling, especially in lavatory areas.  The objective was to create a safe lavatory that minimizes the risk of injury. Simple fixtures (1) that interface smoothly with wall/floor surfaces, proper illumination (2), handrails (3) and continuous floor surfaces work together to provide a safe environment.

 
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Transparency

TBI patients can also be impulsive and unpredictable.  An open floor plan with transparent materials (e.g. glass walls) allows for effective patient supervision.  An integrated fall protection system (1) lines the corridors, allowing amputees and severely handicapped patients to move about safely and freely.  Carefully placed lights (2) illuminate the floor surface and specialty materials (3) appeal to the tactile sense.  

 
 

Creating community

Research strongly indicates that most patients (regardless of injury) experience the best treatment outcomes when they have a strong social network.  This design places an emphasis on social interaction and encourages communal living among residents.  Patients can enjoy a relaxed atmosphere to share stories (1), spend time with loved ones and participate in group activities like preparing/sharing a meal (2). 

 

Looking forward

The design has been met with enthusiasm from physicians, staff, patients, and leadership.  The next step of the process is to complete the technical/detailed design which will then progress into a project award and construction.  This project is currently scheduled for FY16/17 execution.