When Kimberly Brown goes to the new Cancer Institute at St. Joseph Medical Center to receive her weekly chemotherapy treatments for breast cancer, she says she actually looks forward to her visits.
It wasn't always that way.
"When I had my first treatment last October, all the patients were in beds in one room," recalls Brown, a supervisor for Arbitron, Inc. "There were curtains between us, and at the time I felt like I was really sick."
All that changed when St. Joseph opened its new cancer institute last October.
"When I saw the new facility, I [still] knew I had an illness, but I have found it to be so much more susceptible to healing—the open space, the sun, the plants, the comfortable chairs," Brown says. "It just lends itself to a much more communal feeling amongst patients and we speak with each other about what we're going through. The care hasn't changed—there is still a great group of attentive doctors and nurses, but it has made me feel more optimistic. I feel like this is more of a healing center than a place to be sick and get medicine."
Brown's experience is not an unusual one. These days, most major medical centers have breathed life into what were once cold, sterile settings.
"This is the greatest period of hospital rebuilding and reconstruction since World War II," says Rick Wade, senior vice president of the American Hospital Association (AHA). And with all the construction comes new opportunities for interior design. Instead of fluorescent lights, uncomfortable hard-back chairs, and drab, institutional green walls, hospitals and doctors' offices have now been transformed by atriums and skylights, waterfalls, exotic hardwoods, meditation areas, harp music, Internet cafes, and even places to eat fresh sushi.
"It's a trend that has been evolving," notes Wade. "It began back in the 90's, and it was women who started it around the birth experience, where we moved away from operating rooms to birthing rooms."
Women asked themselves, why can't I humanize my medical experience?
"I remember at one Maryland hospital, a woman wanted her golden retriever in the room because it helped calm her," chuckles Wade. "Then patients had the special music requests, and the husbands wanted to be there with the camera. Once that door was open, all kinds of things began to change as well as the notion that an institution didn't have to feel like an institution."
Adds Mercy Hospital's director of media relations, Dan Collins, "These days people are more educated. They are more savvy. They expect more, particularly in Baltimore because we are medical central."
With its massive Plexiglas canopy suspended by stainless steel beams, perfectly proportioned brick and limestone exterior designed by internationally renowned architect Robert A.M. Stern, an interior with gallery-quality artwork by celebrated artists (Joyce J. Scott, Ross Bleckner, Nan Montgomery), German greenstone flooring, and a meditation room overlooking a Zen labyrinth, Sheppard Pratt's new $65 million Weinberg Building looks more like a luxury hotel than a landmark psychiatric hospital.
But that's nothing new for the hospital. When Sheppard Pratt was built by esteemed architect Calvert Vaux (who also designed Central Park) in the 1860's, it was unique even then for its dedication to design.
"The design was an imitation of what the 19th century psychiatric asylum was supposed to look like," explains Bonnie Katz, the hospital's vice president of corporate business development. "It was very focused on the setting as being central to healing. In those days, before talk therapy and psychotropic drugs, [psychiatric hospitals] became people's homes. They came with their own furnishings, and they stayed for a long time—for years in some cases. Even the land was very thoughtfully planned in terms of what it meant for healing."
Sheppard Pratt may have been ahead of its time in considering the impact of the environment on one's health, but it is getting lots of company.
Case in point: Mercy Hospital's splashy new $42 million Weinberg Center, which features a 21-foot-tall black marble fountain flanked by two floating staircases and an endless expanse of multihued granite undulating in a flowing pattern to suggest the movement of water. In fact, the center is so "uninstitutional" looking, a scouting crew for a television series considered using the lobby as the headquarters for a pilot about teen Secret Service agents. (Ultimately, the pilot was never picked up.) The building's elevator floors have a unique green Connemara marble imported from Ireland, and just off the lobby—in the shadow of construction for a new $400 million tower—is an on-site medi-spa offering Swedish and deep tissue massage, facials, and Brazilian bikini waxing.
One force behind the trend? A need to keep up with the times. "Your office has to reflect that you're up-to-date," says Dr. Alvin Sanico, whose stylish state-of-the-art Asthma Sinus Allergy Program at Greater Baltimore Medical Center (GBMC)—with its resin canopies, stainless accents, bold coral, teal, and gold striped palette, and an Internet cafe—is a celebration of contemporary design. "If your decor looks out of date, people might think your services are, too."
But Rita St. Clair Associates vice president Ted Pearson, whose firm has done several healthcare design projects, says the trend is also quite simply a response to forces in the marketplace: "It's really a trend that has just gotten started, and that's because these hospitals are in competition with each other."
Inside the Cancer Institute at St. Joseph Medical Center, the offices of Breast Center director Dr. Michael Schultz are a study in pale peach, pink, and neoclassical artwork. Schultz took his office decor so seriously, he recruited his style-conscious wife Joan to help with the design and even brought several pieces from his own home, including a stunning tapestry to adorn the entryway walls. And while competing with other hospitals may be part of the picture, Schultz and other physicians recognize the advantages of a patient-friendly environment.
"This space is specifically designed to make patients feel that this is not the typical doctor-patient relationship—it's a personal relationship," says Schultz, who, in his pink oxford shirt and pink striped tie, has managed to be color-coordinated with the institute's decor. "It's our all encompassing way of saying to patients, 'We will take care of you. We want you to feel comfortable here.'"
Schultz's waiting room overlooks the infusion center where patients receive their chemotherapy treatments while sitting in roomy leather lounge chairs situated inside the heart of a two-story light-soaked atrium. The chairs, modeled after first-class airplane seats, are equipped with DVD players, iPod docking stations, computer outlets, even a tray table and built-in cup holder. Medical director Mark Krasna was inspired to design the chairs while flying home from Italy two years ago with a relative who was suffering from leukemia. "I was lucky enough to get upgraded on the flight," says Krasna, "and as I sat in one of those chairs, I kept thinking about my cousin and her experiences during her cancer treatments, and that's what inspired me." (His cousin later purchased 12 of the $8,000 chairs as a gift to the center.)
While Schultz recruited his wife to help personalize his center, many other area hospitals have sought the expertise of high-end residential designers like Rita St. Clair.
"Fortunately, I've been in and out of hospitals very few times [as a patient], but every time I've gone to one I've noticed that maybe they are paying attention to design in hospitals," says St. Clair, who has done design work at Sheppard Pratt, American Radiology Services, and the Ear, Nose, and Throat Associates at GBMC. Her most recent venture is the soothing Avon Breast Center at Johns Hopkins Outpatient Center, which features a window of pink stained glass ribbons plus photographs, lithographs, and paintings by noted Israeli artist Agam.
"The environments are changing vividly," St. Clair explains. "I think the reason [my firm] has been successful in doing public spaces is that we come from a residential background and, because of that, all of our projects have a human element to them—the chairs should be comfortable, your eyes shouldn't jump from one place to the next, and we never look at trends."
Deborah Stewart, a nurse and breast health care educator at Hopkins Breast Center—and a two-time breast cancer survivor herself—concurs that design needs to be patient friendly. "It's all about making the patient feel good about where she is," says Stewart. "It's like, 'Oh my God, I have breast cancer, and they are asking me to go into this grey and black building [when] I'm already feeling grey and black.' Martha Stewart says, 'Presentation is everything.' It isn't everything, but it's part of the bigger picture that mimics the whole experience."
Marilyn Romano, director of materials and space management at Sheppard Pratt, agrees that paying attention to aesthetics is very much a trend. "And it's a nice one," she says. "We are going for a hospitality look to make people feel comfortable. We are listening when people come in, and we want them to come in and choose us and feel comfortable when they are here. The environment is a big part of the treatment."
Dr. Kathy Helzlsouer, Mercy Hospital's director of the Prevention and Research Center, seconds the notion. "One of the things I hear from the patient side is that Mercy is a very nice, welcoming, and relaxing place to come, especially when you're dealing with something like cancer. Your surroundings can set the tone and the mood, and it's important to establish spots for peace, meditation, and relaxation, and that contributes to a caring environment."
In many cases, the doctors feel personally responsible for their patient's comfort.
"I see myself as a hostess here just as I would in my own home," says Dr. Melissa Sparrow, clinical director of Pediatric Inpatient and Emergency Services at GBMC. Like Mercy's Schultz, Sparrow turned to a family member to give the clinic a homey touch, commissioning her father Russell Marks to create colorful three-dimensional wall sculptures. The walls are also adorned with whimsical artwork from elementary school children at Lutherville Lab School.
"I want there to be color, and I want it to be celebratory," Sparrow says. "Light, colors, textures, even smells all have an impact on human physiology. The art allows children to enter not a scary, sterile, colorless world full of intimidating machines and sounds, but a world full of images created by children themselves."
This patient-first approach to wellness design seems so logical, it's hard to believe that it's a relatively new trend. Union Memorial Hospital's William Howard, an attending physician at Arnold Palmer SportsHealth Center (APSHC), remembers the not so distant past.
"It used to be all that really mattered was a competent physician and space didn't matter," he says. "Patients would understand that they didn't come to the Ritz or the Belvedere. Years ago, I had a patient who was badly burned, and it was obvious he was going to be in the ICU for a long time. He sat there and stared at the wall, and I said, 'We ought to get this guy a TV so he has something to do,' and the [administration] said, 'Oh no. We don't believe in TVs in the Intensive Care Unit,' and I said, 'That's bulls--t,' and I went out and bought him a TV. He was the only patient at the ICU with a TV, and if people in the unit could move around, they would come watch his TV. About a year and a half later, there were TVs in the ICU."
But there's a cautionary tale that comes with all these new TVs and beautiful spaces, notes Thomas Graham, chief of the Curtis National Hand Center at Union Memorial. "Hospitals and hospitality were never synonymous," says Graham, who consulted with Hilton Hotels Corporation and The Cliffs Communities (including the venerable Greenbrier) while forming APSHC. "We think the physical plant is an enabler, as is technology, to optimal consumer experience, but we haven't lost sight of the fact that we have to have that basic clinical excellence. You can build the Taj Mahal, but if you aren't doing your basic job, no one will come."
Lillie Shockney, administrative director of the Avon Breast Center and assistant professor of surgery and gynecology at Hopkins, agrees. "The bricks and mortar," she says with a smile, "are not where the magic is."
