How Can We Mitigate Stress for Frontline Healthcare Workers?

Evidence-based Strategies to Build Worker Resilience During the COVID-19 Pandemic and Beyond

September 28, 2020

NCIDQ LEED® AP Senior Associate I Interior Designer, NBBJ

Editor’s Note: This post was co-authored by Katie Davis, Sarah Markovitz and Andrea Rufe. 

 

The impact of COVID-19 touches all aspects of healthcare, but is especially acute when it comes to the wellbeing of frontline workers. Communities look to first responders during times of crisis, which is why the wellness of these individuals is critically important now. The pandemic’s impact on the mental health of these workers is profound, causing psychological distress. It also increases burnout, which can lower work performance and raise the risk of errors. Yet the coronavirus crisis also creates opportunities for positive change.

Key neuroscience insights illuminate strategies to help alleviate the challenges frontline workers face. These findings paired with designs that bring moments of calm and foster connections can create a roadmap for healthcare facilities — from hospitals to ambulatory centers and clinics — now and in the months ahead.

Backed by neuroscience research from NBBJ’s Fellowship Program, this post examines three ways to boost healthcare employee resilience through changes to physical environments, operational protocols and organizational systems. The ideas center on a variety of practices and respite areas — each of which can be implemented at various scales — both in traditional and non-traditional healthcare settings.

 

Support Spaces

Spaces that offer opportunities for caregivers to turn to one another for support and share solutions, especially through talk therapy, can strengthen resilience and happiness. Offer frontline workers ways to connect with someone trained to listen, such as dedicated staff or virtual mental health services. Existing rooms that provide privacy can be repurposed for these conversations with comfortable seating and couches, tables and video conference support. Furthermore, a focus on total wellness via health coaching stations with programmed nutrition, mental health and exercise classes can offer a comprehensive growth-oriented suite of amenities to build a strong support network, improve memory, enhance cognitive function and create a better quality of life.

Restorative Zones

Restorative zones create space for frontline caregivers to recharge — in the good times, but especially so in times of crisis. Restorative zones are hyper flexible: they can leverage underutilized spaces for a moment’s rest such as a quiet alcove at the end of a hallway with a window that overlooks a garden. They could include comfortable high-backed sound-absorbing chairs with ottomans to rest one’s feet and a table to place a rejuvenating refreshment or inspiring book. On a larger scale, a refuge room filled with plants, natural light and the sound of running water — or even a digital wall of nature imagery — can provide an immersive sensory experience.

Mindfulness Rooms

Spaces that facilitate mindfulness can promote mental wellness and greater resilience to challenging situations. Mindfulness can be promoted at various scales. A small niche with room for a yoga mat can help build mindfulness techniques, like deep breathing, that can be called upon anytime during the workday. Mindfulness micro practices can also be cultivated during daily routines by incorporating biophilic design in transitional spaces like stairwells. In addition, meditation, yoga and massage rooms can offer regular mindfulness sessions and promote connections between staff outside of their normal work tasks.

 

Wellness for frontline staff encompasses a whole-health approach for individuals, departments and organizations. It’s powered by meaningful work, relationships and uplifting spaces that support strength in and outside the work environment.

These ideas are part of a comprehensive report by the NBBJ Fellowship Program which outlines ways to mitigate stress for frontline healthcare workers, how to create new work rhythms and how to remain human in a hybrid virtual-physical world. To learn more about these concepts and the supporting research, please email socialmedia@nbbj.com.

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Helping Universities Adapt and Respond

Three Ways to Leverage Campus Real Estate in Support of Mission and Longevity

September 16, 2020

Principal, NBBJ

Editor’s Note: This post was co-authored by Megha Sinha, Kim Way and Britni Stone.

 

As universities evolve strategies for reopening amidst the pandemic, many are also faced with major financial and logistical challenges. The combined impact of the loss of international students, financial strains that predate COVID, and the millions in losses caused by shutting down in-person classes leave many institutions in a serious bind. The space needs of universities are also changing rapidly, with the evolution of teaching models, the need for socially distanced learning environments and hybrid classrooms that support online and in-person learning. Given this context, there is a compelling need for universities to take a deeper look at their real estate assets and be creative with how they leverage their campus.

Real estate can be a valuable and untapped tool for universities seeking flexibility and additional resources to support their academic mission and financial stability. There are three key strategies which can support universities in this effort—scenario planning, partnerships, and creating flexible campus environments and spaces.

1. Scenario Planning

Scenario planning is a strategic planning method that universities can use to create flexible long-term campus plans, which can be particularly valuable in this era of uncertainty. Rather than creating a prescriptive master plan that lays out a single vision for the distant future, scenario planning helps institutions to envision multiple scenarios, each of which triggers a different planning approach. This ensures that the campus plan evolves with the changing landscape, and enables a more creative, flexible use of available space.

Each plan is unique as each institution is unique, but there are four key steps for institutions to consider as they develop a scenario plan:

  • Identify the key space needs drivers, both internal and external. This may encompass factors like enrollment trends, technology, areas of academic and research emphasis, evolving teaching models and student life and support facility needs. It is also important at this stage to start with the institution’s academic mission and vision, and consider how real estate can support this.
  • Assess existing facilities. This step involves understanding how space is currently being utilized and the condition of existing facilities. The challenge of addressing deferred maintenance may loom large on the horizon for many universities, though careful consideration should also be given to how facilities in need of renovation can be modified and used to accommodate pandemic related space needs in the immediate term.
  • Explore plausible scenarios. Universities should map out how programs, enrollment levels, and delivery models may evolve and change over the planning horizon, and use these projections to create a range of plausible scenarios. For instance, a university may anticipate steady on-campus enrollment growth, but should also consider the possibility that enrollment levels plateau or decline.
  • Provide a range of near and long-term recommendations. The last step is developing multiple or alternative near and long-term recommendations based upon the scenarios. This allows an institution to pivot to the recommendation that most closely reflects the scenario that plays out. For instance, if on-campus enrollment grows, then the university can adopt the recommendation that helps meet growing academic and student life space needs on campus. If the growth takes place in the online cohort, then the university can adopt the recommendation that enables a smaller real estate footprint, or reinvestment in technology within facilities, if hybrid learning models evolve.

2. Partnerships

Institutions can create more flexibility by partnering with other academic institutions, businesses, developers and allied organizations, utilizing their real estate to further their academic priorities. This approach can include:

  • Raising capital. Universities frequently have valuable real estate which is often unused, including parking lots and ageing or vacant buildings which they can’t afford to renovate. This real estate can be leased or sold to developers to raise capital that can sustain and enhance the institution’s strategic and academic mission.
  • Campus expansion. Universities frequently have facility needs that cannot be met through the traditional capital budgeting process. By partnering with developers through joint ventures or other arrangements, universities can still realize important projects like town/gown commercial districts, research parks, student housing, recreation amenities or other facilities. Some universities, like UC Davis Sacramento, have gone further by seeking out developers to finance, develop, own and manage significant parts of a new campus.
  • Partner with mission-aligned organizations. Universities can also raise capital and further their academic priorities by partnering with mission-aligned organizations, such as industry partners. For instance, co-locating with and renting campus space to companies allied with an academic research program or incubator space could bring financial benefits to the university while strengthening its research capabilities or commercialization efforts.

3. Create Flexibility in Existing Campus and Facilities

The pandemic demonstrates the importance of flexibility, as universities scramble to repurpose athletic facilities, outdoor space and other unconventional settings for socially distanced learning, dining or other functions. As part of a more long-term strategy to enhance adaptability and resilience, universities should consider flexibility as a central premise for the design of their campuses and spaces. But in the more immediate term, there are a number of strategies which can enhance flexibility within existing spaces to promote social distancing.

A fair degree of flexibility has been built into classrooms over the last decade, and this can be leveraged to make learning environments safer. For example, movable partitions in seminar rooms can be used to create smaller hybrid classes, and reconfigurable furniture can be spaced out to support social distancing. Similarly, shared common areas can be repurposed and zoned for lower density, serving as secondary spaces for learning, with the existing technology potentially used for virtual learners in a hybrid classroom. With an increase in remote work, some institutions may even rethink the design of staff space, adopting hoteling or shared hub strategies that provide the same choices offered in classroom environments and third spaces to faculty.

Technology is another enabler which may create new flexibility within existing spaces. With classroom technology becoming increasingly mobile, a number of areas, such as outdoor open spaces, building terraces and indoor atriums with good ventilation can potentially be used as temporary classrooms. Some universities are also deploying mobile hotspots to students in remote locations and boosting parking lot wifi to facilitate online learning.

While the immediate challenges of the pandemic will eventually recede, universities will need to continue to adapt and evolve in response to changing teaching models, enrollment trends and financial dynamics. Scenario planning, partnerships and designing for flexibility will be important tools for universities as they undertake this vital work.

 

How are you and your organization dealing with the coronavirus? We’d like to hear from you. Drop us a line at socialmedia@nbbj.com.

Banner image courtesy Matthew Carbone.

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Person-Centered Design: The Importance of Balance in an Era of Constant Change

September 10, 2020

Principal, NBBJ

Editor’s note: Our healthcare clients are on the front lines of the coronavirus crisis. We seek to support them as they courageously care for the sick. So we’re posting design ideas based on work with them, in the hope that we can contribute from our base of expertise to help combat the epidemic. From all of us at NBBJ to the many doctors, nurses and support staff in hospitals and clinics, thank you from the bottom of our hearts.

 

As a child, I loved seesaws — one moment having my feet on the ground and the fate of the other person in my control, the next second trusting them to lift me so high into the sky I could see over my mom. I learned to create a balance of sorts across from my older brother by sitting far back or scooting closer so that he had a harder time throwing me off.

I’ve been thinking a lot about balance lately. As designers we use it as a basic element in composition; as a civilization we equate it with stability and fairness; as humans we need it to simply stand upright — all dynamic equilibriums needing our attentiveness lest an unknown thing threaten the equation.

This is how the world seems to many of us right now — all was moving along fairly balanced with a degree of control until the pandemic sent us teetering.

Recently, I’ve started two projects that have me thinking deeper about what role balance plays in design, specifically in creating hospitals for person-centered care. Person-centered care is the compassionate perspective that we are all individual human beings first before we are anything else: spouse, parent, student, friend, employee, patient.

Founded by Planetree — an organization that promotes the thoughtful response of healthcare systems to individuals’ human need for respect, control and supportive care — this philosophy focuses on creating environments for positive human interactions between patients, families and care givers. Primary tenets include empowerment with information, integration of the arts and complementary therapies and the nurturing aspects of nutrition, spirituality and human touch — all creating better outcomes.

The physical space within a hospital or clinic plays an important role for connection to take place. It can bring equilibrium between the often-conflicting goals of human-centered experiences and operational efficiencies — that’s where our design teams come in.

So how do I design something centered around another person when I barely feel centered myself in these turbulent times? Can my environment be a part of my solution just as we expect it to be for the patient?

The real work for the patient — and for me in this pandemic — comes from within. Perhaps the space we build outside the patient is only successful if it enables the construction of a healthy space inside the person.

One way to empower this internal effort is to create environments that anticipate personal needs. For example, we know through inquiry and observation that the most frequently asked question at information desks is often the location of the restrooms. Anticipatory design places those elements in easy sightlines before patients stop to ask. By developing experience maps, we can identify and eliminate the outside struggle with blockades that throw people off.

Another aspect is to make spaces that become easy portals to colleagues, friends, and family — more thoughtfully crafted to individual needs, making connections readily available to overcome the disruption of distance. Smart televisions in patient rooms that can accept a video chat from a private phone accompanied by an overbed table device to hold the phone camera would connect families during this isolated time.

By removing barriers to compassionate human interactions in the healthcare setting, we can create conditions for the patient to do the hard work of centering themselves emotionally in their new world of diagnosis, treatment and healing. To find a fulcrum for grounding. To feel themselves again.

On a seesaw, when both people put their feet on the ground, they create a bridge between them, a stable connection built on trust. Design created through a lens of person-centered care enables both those receiving care and those providing it to create balance, building bridges between them.

In a world that is teetering, perhaps extra attentiveness to human-centered design is our chance as architects to scoot closer to those for whom we design, stretch our feet down to the ground and bring back some balance on both ends.

 

How are you and your healthcare organization dealing with the coronavirus? We’d like to hear from you. Drop us a line at socialmedia@nbbj.com.

Banner image courtesy Adobe Stock.

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