Editor's Note
Space Matters
On a frigid night in January 1979, the Metropolitan Medical office building in Minneapolis erupted into flames. The next morning, with the thermometer at -19 degrees F, the lower half of the building was draped in bizarre icicles, and it was obvious that our clinic’s fourth-floor office was unusable. Thanks to the generosity of Metropolitan Medical Center, our six-doctor group set up a clinic in a corridor of what had once been Swedish Hospital, with receptionists at make-shift desks, patients perched on World War II-vintage exam tables, and doctors scurrying to find tongue blades and vaginal speculums, bumping into each other as we tried to see a full roster of patients each day. Months later, when our clinic returned to its fumigated, cleaned quarters in the office building, we had learned an unwanted lesson about the importance of space design.
Preoccupied with wounds and warfarin, physicians frequently coast through their day unaware of their environment—until something isn’t in the right place. Then a missing blood pressure cuff or a misplaced instrument adds irritating minutes and unwelcome difficulty to an already complex day. Designing a medical environment that works for physicians and patients is an art that enhances the business of providing health care, making it more efficient, safer, and healthier.
Back in 1979, our clinic learned how the layout of a facility can erode efficiency. Extra steps mean wasted time and mounting hassles. Just having to think about workflow distracts from more important thoughts. Health care architects have become connoisseurs of workflow, crafting hospital wards that work for the workers and clinics that free up personnel by letting patients room themselves.
Good design also means enhanced safety. From rooms that discourage infection to floors that minimize falls to pill bottles that read clearly, how things are built can make patients safer.
The architects who specialize in health care have wider vistas today. Realizing that medical facilities spew waste and gobble energy, designers have embraced “green,” striving for smaller dumpsters and energy parsimony. Heeding the literature that says noise is bad for patients, designers try to isolate them from the high-decibel bustle that is the modern hospital. And aware that “healing” in any facility is part physical and part emotional, health care planners have endorsed therapeutic spaces by planting gardens, installing aquariums, and placing windows so patients can look out at a woods or lake.
For some physicians, the concept of “healing spaces” may seem a bit New Age-y, touchy-feely. They understand the efficiency and safety that a well-designed clinic or operating room can offer, but they may wonder whether a bunch of trees and plants can really make patients feel better. I believe they can.
In southern Wisconsin, halfway between Madison and Milwaukee on Golden Lake, sits a white frame cabin that was dubbed “Nestledown” more than a hundred years ago by my grandfather and his brother. Each summer during my childhood, I traveled there with my family to swim endlessly in the lake, play kick-the-can on the front lawn, and eat fresh corn on the cob at dinner. Now when I go there, I still swim and eat corn, but mostly I sit on the broad porch with its floor-to-ceiling screens, listen to the crickets, feel the breeze off the lake, hear the murmurs of my forebears, and know that I’m healed.
Charles R. Meyer, M.D., editor in chief
Dr. Meyer can be reached at cmeyer1@fairview.org