What Manufacturers Need to Know about Healthcare Design

At the Design Connections – Healthcare Conference in Ponte Vedra, Florida, designers who work in all types of healthcare settings talked about what they need from vinyl product manufacturers. The February 13–15 meeting was attended by an interdisciplinary group focusing on healthcare trends, care models, technology, product design, sustainability, adverse events, and interior design of acute care, outpatient care, and long term care settings.

Several certified healthcare interior designers from the American Academy of Healthcare Interior Design, including many from large healthcare systems; Inova Health System, Johns Hopkins, Life Bridge Health, Adventist Health, and New York Presbyterian, attended the conference. The meeting was also attended by innovators in behavior health community-based programs from Creative Health Services and from Flip the Clinic, a research-based organization that evaluates outpatient care to change paradigms of care through evidence.

The manufacturers in attendance provided case studies, received designer feedback, and presented research in healthcare design. In addition, the manufacturers held one-on-one sessions with designers to review their specific needs and discuss trends related to specific product applications.

Three key areas of focus emerged from these conversations, educational programming, and key note presentations.

1. There’s a disconnect between cleaning protocols and manufacturer recommendations.

There has, historically, been a disconnect between cleaning and disinfection protocols and manufacturer recommendations for cleaning. The reason: healthcare providers follow different guidance, usually influenced by the Centers for Disease Control as part of quality assurance and infection control measures. In addition, the environmental services department responsible for cleaning usually has a high staff turnover rate, reducing the effectiveness of training and often leaving teams understaffed. These factors create disconnects that can negatively impact vinyl products in healthcare settings.

One specific issue raised at the conference is having consistent cleaning methods developed to clean and disinfect vinyl products that reinforce and support vinyl products’ durability and ease of cleaning. For example, bleach- and hydrogen-peroxide-based products are often used on vinyl upholstery; while a perfect fit for durability, the surfaces are not then rinsed after application as part of the overall cleaning process. As a result, the concentration of the cleaning chemical eventually impacts the integrity of the product.

To address this disconnect, there is a need to convene an interdisciplinary group to make recommendations to organizations, such as the Association for the Healthcare Environment (AHE), the environmental services arm of the American Hospital Association, to better protect the vinyl products that have an important role to play in reducing the rate of infection within healthcare settings.

2. More outreach is needed on product life cycle assessment and sustainability.

Sustainability in healthcare settings was discussed by designers from larger firms, indicating a need for additional education around “PVC-free” and inappropriate deselection of product for the design community providers and end-users of healthcare settings. Many vinyl product manufacturers have certified to multiple attribute standards and have completed or are in the process of completing environmental product declarations (EPDs). There is a need for additional outreach, marketing, and education around the availability of third-party product certifications and declarations – to the end that designers realize that these represent a life cycle perspective for selection of products. It is also important for vinyl product manufacturers to provide clear messaging to the architectural and design community on the value of moving away from a “red list” deselection approach to products in relationship to health, safety, and sustainability.

To address this need, the Vinyl Institute sponsored a panel, Becoming Certified: A Product’s Sustainability Story. The goal of the presentation was to provide designers with an understanding of the robust process required for a product to become third-party certified. In addition to Terry Murphy, who moderated the panel, panelists featured Rich Krock, the VI’s vice president of regulatory and technical affairs, Bill Freeman, a regulatory and technical consultant for the Resilient Floor Covering Institute, and Josh Jacobs, technical information and public affairs manager for UL Environment. A key discussion point was the advent of the LEED v4 Pilot Credit focusing on multiple attribute standards – and it is clear from the discussion that further education on a life-cycle approach to evaluating products and specifications around vinyl products is needed. Bill Freeman outlined NSF/ANSI 322 Sustainability Assessment for Resilient Floor Coverings as an example during the panel discussion. In addition, Beth Rich from LSI stated that the Wallcovering Association is completing a new continuing educational program for the design community that will include information on the multiple attribute standard for wallcovering (NSF/ANSI 342 Sustainability Assessment for Wallcovering).

3. Product manufacturers have a role to play in avoiding healthcare adverse effects.

Another key issue that we heard a lot about was the need to avoid “adverse events” within healthcare settings as they relate to product selection. An adverse event is something that happens to a patient or resident that is not part of their original diagnosis or part of their treatment/care plan for the original diagnosis or chronic condition. For example, if you go into the hospital to have a knee replacement and you acquire a secondary infection as a result of the surgery that would be an adverse event. In addition to healthcare-acquired infections, other examples include medication errors, medical errors, and falls.

There are direct connections between the environmental design of a healthcare setting and adverse events avoidance. Products that are easily cleaned and disinfected, for example, assist in reduction of infection – particularly for materials associated with touch points (i.e., surfaces that are regularly touched by staff, patients / residents, and family members, such as light switches, bed rails, chair arms, door knobs, handles, sinks, faucets, cubicle curtains, and handheld devices).

Handwashing and cleaning are the two main defenses related to infection control. As a result, seamless products that are formulated with maintenance in mind and have demonstrated outcomes are key. One such example is the Kwalu furniture products made from extruded vinyl. From a medication error perspective, lighting and acoustics are important factors in reducing medication errors, especially in conjunction with design – locating medication areas to reduce interruptions on staff preparing and administering medications. To reduce the risk of falls, it’s helpful to have surfaces that do not produce glare and to place grab bars and handrails at appropriate locations; good night lighting and the type and placement of furnishings are also a part of the design evaluation for selecting products for healthcare environments. Products that are formulated and designed to meet many different healthcare criteria are needed to meet ever-growing needs, in addition to the aesthetic requirements of design professionals.

Healthcare environments are complex. The products in them need to be performance-based and meet the needs of 24/7 operational settings. Vinyl is perfectly positioned as a product that can support the needs within acute care, outpatient care, and long-term care settings – providing safety first for patients, residents, families, and staff.