Safety for All: Integrated Design for Inpatient Units

By: James M. Hunt, AIA, NCARB: and David M. Sine, DrBE, CSP, ARM, CPHRM

The concept of integrated healthcare – treating the whole person and all of his or her diagnoses, including mental illness, in one location with one team of clinicians—has gained considerable traction in the literature (U.S. Department of Health & Human Services, n.d.). The discussion has largerly centered on outpatient treatment modalities, medical records, organizational structure, and other aspects of implementing this concept. It seems odd, given the importance of the environment to patient care, that the design of inpatient units has largely been missing in this evolving discussion of facilities where integrated treatment may be safely provided to all patients.

When designing integrated inpatient facilities, it is necessary to prepare for the possibility that mental health patients may attempt to harm themselves or others. In addition to patients with known mental health conditions, patients who are taking prescription medications for conditions such as depression but who are not identified specifically as mental health patients must also be considered. All patients will benefit from a facility that has been designed with safety in mind. Contrary to common assumptions, fixtures and design elements used in modern mental health hospitals are functional, attractive, and safer for all patients, regardless of mental health status (Figure 1).

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