Design from Within
Deb Fournier RN-BC, MSB, NHA
Maureen Carland RN, BSN, NHA
Evan Carroll AIA, LEED, BD+C, Principle
Our Objectives
•
Identify principles of person directed design
•
Describe the resident architect's experiences
and the application of these experiences to the
community
•
Examine the formation and role of advisory
counsels for guiding project development
What Typically & Historically has Happened
•
Decision making by owner
or architect
•
Even small decisions made
away from the user
•
Management makes
decisions
How and Why this Needs to Change
Baby Boomers are Coming!
The next generations wants more choices
Outline
1. An administrator’s perspective: Why and how an
architect came to MVH
2. An architect’s perspectives: Evan’s experiences
3. Lessons learned from Evan’s visit and applications
at MVH
4. Another example: Principles of resident directed
design in a large renovation project at St. Mary’s
What happened
at Maine Veterans’
Home
Evan Carroll
• Architect, Graduate of Roger
Williams University
• Raised in Maine
• Passionate for designing for
aging population
How did this Happen?
Living Through Learning program at UNE
Marilyn Gugliucci, Director of Geriatrics
How we prepared
• Previous Med students
• Faux medical conditions
• Positive results
The best laid plans…
• Uneasiness
• Unprepared staff
Communication
• Rationale and
learning goals
• Concerns and
anxieties
• Careful planning
• Discussion
Outline
1. An administrator’s perspective: Why and how an
architect came to MVH
2. An architect’s perspectives: Evan’s experiences
3. Lessons learned from Evan’s visit and applications
at MVH
4. Another example: Principles of resident directed
design in a large renovation project at St. Mary’s
Living in a Veterans’ Home
•Why have this experience?
•How did I prepare?
•What was it like?
•What did I learn?
Why have this experience?
•People
•Paradigms are shifting
•Empathy
•New solutions
How did I prepare?
•Journal
•Packing
•Self coaching
safe
comfortable
HOME
familiar
secure
What was it Like?
Arrival
• Having a roommate
• Dependence
• Shift Changes
• Smiles
What was it Like?
Settling In
• Staff
• Socializing
• Visitors
• Becoming a household
What was it like?
Two Stories:
The Luau
Rose
What was it like?
A rewarding experience:
• The relationships
• Growing old is a part of life
• Love can overflow
• Designers, residents, families and staff
must work together
What did I Learn?
Kinds of Care
• My two different roommates
Memory/Long Term Care
Rehabilitation
Build friendships
Settle-In
Home
Dependence
Protect self
Wait to leave
Hotel
Hope for Independence
vs.
vs.
vs.
vs.
What did I Learn?
Senses
• Sounds of home
• Smells of home
• Sights of home
• Textures of home
What did I learn? Spaces in a Home
Space to be alone
What did I learn? Spaces in a Home
Space to chat
What did I learn? Spaces in a Home
Space to walk
What did I learn? Spaces in a Home
Space for a group
What did I learn? Spaces for things
• Identity
• Ownership
What did I learn? Spaces for things
Ledges & Shelves
What did I learn? Spaces for things
Frame Rail
What did I learn? Spaces for things
Window Dressings
What did I learn? Spaces for things
Bedding and Rugs
What did I learn? Spaces for things
Shadow Box
What did I learn? Views and Safety
Outline
1. An administrator’s perspective: Why and how an
architect came to MVH
2. An architect’s perspectives: Evan’s experiences
3. Lessons learned from Evan’s visit and applications
at MVH
4. Another example: Principles of resident directed
design in a large renovation project at St. Mary’s
Now that we Know
Small Projects
• Cafe
• MVH Multi-Purpose Room
Remodel
• MVH Room Remodel
Now that we know
• Jake’s Cafe
Now that we Know
New Menu
Now that we know
Multi purpose room
• Residents choose finishes
• Residents choose window treatments
Now that we Know
Room Remodel
• Mock Room
• Resident interviews and
surveys
• Focus groups
• Staff Surveys
Outline
1. An administrator’s perspective: Why and how an
architect came to MVH
2. An architect’s perspectives: Evan’s experiences
3. Lessons learned from Evan’s visit and applications
at MVH
4. Another example: Principles of resident directed
design in a large renovation project at St. Mary’s
An Administrator’s Journey
• What are our key stakeholders telling us?
• Expectations have changed
• Privacy is important
• Desire to be included in making decisions that affect them
• They are individuals and not just patients
• Trust comes from:
• Honest communication
• Prompt response
• Reliable and competent care
Preparing the Culture
• Decision to adopt the principles of patient and family
centered care.
• Changed the wording to patient, resident, and family centered care
• Researched PRFCC models and tools
• Provided education to Board, Leadership, & Employees
• Identified this transition as a corporate goal
• Shared stories of patient, resident, and family experiences
Principles of Patient,
Resident, & Family
Centered Care
Dignity and Respect
Information Sharing
Participation
Collaboration
Reprinted with permission from the Institute for Patient- and FamilyCentered Care: www.ipfcc.org."
Patient, Resident, & Family Advisory Councils
www.ipfcc.org
Who:
Former patients,
residents, and family
members
What:
Serve as advisors to
administration and staff
Patient, Resident, & Family Advisory Councils
Why:
Provides an effective mechanism for stakeholder
inputs. Results in more efficient planning.
How:
Careful selection of skilled facilitator
• Criteria to identify potential council members
• Initial educational session to introduce roll of advisory
councils and principles of PRFCC
• Ask for membership on the council
Advisory Council Charter for
St. Mary’s Rehab Center
• Serve as Advisors for:
• 2.3 million dollar renovation project
• Healing environment
• Evidence based design for seniors
• Guide program transition from traditional skilled care to rehab
center of excellence
• Deliverables:
• Customer satisfaction 96% recommend
• Return to home rate 90%
• 3 year CARF accreditation
Renovation Learnings
• Use of mock rooms
• Getting around the bed
• Swing versus pocket doors
• Width of bariatric bathroom entrance
• Location of head of bed
• Put a picture here?
Renovation Learnings
• Finishes
• Use different yet complementary finishes to enhance way
finding and deinstitutionalizing environment
• Consider color, lighting, and noise reduction
• Consider use of different flooring products
• Intentional use of language
• Suites instead of rooms
• No names outside the suite entrance
Program Learnings
• Most important to Advisory Council Members
• Rehab Center Directory
• Creation of a Dashboard
• Admission letters for communication
• Meal service program based on resident choice
• Use of white boards in resident suites
Advisory Councils
• Ongoing – things to consider
• Terms of advisory council members
• Process for adding new members
• Communication mechanisms
• Opportunities to share learnings with others
• Program enhancements that add value to the customer
• Testing the environment: “Nothing about me, with out me”
Photos are used with permission from St. Mary's Health
System
Results
Photos are used with permission from St. Mary's Health
System
Results
Photos are used with permission from St. Mary's Health
System
Results
Now that we know
Future building plans
Future renovation plans- big or small
Questions?
Comments?
Contact Information
Bild Architecture
PO Box 8235
Portland, Maine 04104
[email protected]
207-408-0168
Contact Information
290 US Route One
Scarborough, ME
207-883-7184
[email protected]
[email protected]
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