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Design from Within
Deb Fournier RN-BC, MSB, NHAMaureen Carland RN, BSN, NHAEvan 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
• Decision making by owner or architect
• Even small decisions made away from the user
• Management makes decisions
What Typically & Historically has Happened
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 happenedat 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
HOME
safecomfortable
familiarsecure
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 vs. Protect selfSettle-In vs. Wait to leaveHome vs. HotelDependence vs. Hope for Independence
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 Family-Centered Care: www.ipfcc.org."
Patient, Resident, & Family Advisory Councils
Who:
Former patients, residents, and family members
What:
Serve as advisors to administration and staff
www.ipfcc.org
Patient, Resident, & Family Advisory CouncilsWhy:
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
290 US Route OneScarborough, ME
