“Was it better to be in a hospital than to almost die elsewhere?,” Angelica Thieriot wondered after having a terrible patient experience at a San Francisco hospital while being treated for a mysterious virus. It wasn’t that her medical care was bad. Lying scared in her hospital bed, Thieriot sank into despondency since she had so many questions which no one answered. When she came out of it, she resolved do something to put the human aspect back into hospital care.(1)
In 1978 Thieriot founded Planetree, a non-profit organization based on a simple premise: care should be organized first and foremost around the needs of patients. What began “as one person’s radical idea to create a healthcare environment that engages patients and families as partners and responds to the physical, emotional, intellectual and spiritual needs of patients has transformed into a bona fide movement.”(2) Today this seed of an idea - - a true “kitchen table effort,” has blossomed to include 500+ affiliates in seven continents.(3)
For years I’d known about Planetree’s claim that they’ve “defined what it means to be patient-centered.” As a Design Psychologist, attending my first (and their 22nd!) Annual Planetree Conference, I wondered, does Planetree have ‘design on its mind’-- the physical environment and human experience, when pioneering patient-centered care?
It’s ironic that all of the healthcare design conferences I’ve ever attended are held in venues that suck the life out of you - - large, soulless hotel conference centers without windows or indoor plants and with scant seating for participant coffee klatches. I know. I know. Organizers need to find an affordable space that will accommodate exhibitors, large audiences, meals, etc., etc. Still, can’t a healing conference EVER be held in a mountaintop hotel, or where we can almost taste the sea, or breathe in air, ideas and the smell of coffee while sitting with colleagues by a waterfall?
My grumpy musing vanished when I walked into the Planetree exhibitors’ hall. There I became intrigued by the many hospital room products designed to improve the psychological and social well-being of patients and their caregivers. I was fascinated by the pioneering products that virtually expand the hospital room, connecting patients to the outer world.
Walking around the exhibit hall, I pretended I was the queen of healthcare design creating my ideal patient-centered room. Using my magic wand, I chose furniture by Nemschoff, a division of Herman Miller, for my room because it addresses both patients’ and guests’ needs. For example, recognizing that visitors play a key supportive role, Nemschoff’s hospital room seats, can be lowered so that loved ones can chat on the same eye level as patients in a hospital bed.
Wanting my patients to have a psychologically soothing sensory experience, I then surveyed the amazing array of audio visual technology on display. Tech systems delivering sounds of nature or calming music; soothing videos of sylvan streams and blossoming flowers all claimed to have therapeutic benefits and/or provide a positive distraction.
In the end, it was Aesthetic, Inc.’s intoxicatingly beautiful animated painting that I put in my imaginary shopping cart. I was transfixed as I watched exquisitely painted birds fly across a computer monitor and land on a virtual mountain-by-the-sea scene (like the oasis conference retreat for which I longed!) I kept staring at its colors and forms as this virtual Turner by artist Steve Matson kept changing before my eyes.(4) His pioneering combination of technology and fine art could help patients transcend the hospital’s four walls.(5)
Finally moving on, amongst the mountain of intriguing conference sessions, I focused on examples of how tech wizardry is being applied in a variety of healthcare settings:
• As part of their integrative healing program, the VA of Greater Los Angeles Healthcare System has installed CD holders behind patient’s beds so they can listen to guided imagery. Their Tele-help technology enables patients cut off from the hospital by snowstorms to virtually interact with medical staff.(6)
• One German psychiatrist has a unique patient-centered video playing in the waiting room with recovery stories that prep patients for their visit. It asks patients to set goals and think about how they are getting to their goals based on the way they are behaving.(7)
• Northern Westchester Hospital in Mount Kisco NY(8) partnered with Allen Technologies to develop a hospital electronic tablet they now hand out to patients. The tablet allows patients to check their charts and have access to games, sound machines and the Internet.
In this cyber-crazed world, is it a good thing for patients to have such access or should we be creating an ‘Oasis by Design’(9) that shields them from outside distraction?
Maria Hale, VP of the Office of Patient and Family Advocacy and Patient-Centered Support Services at Northern Westchester Hospital thoughtfully commented:
The essence of this is patient choice. For some no connection with the outside world is a blessing and key to their recovery; for others connection and information is necessary for their well-being. So the tablet is introduced to the patients as a tool for them to be used whenever they are ready to use it. Also in this day and age family members live all over the country and the world so staying connected through the Internet, social media, and video chat is becoming as ubiquitous as visiting at the bedside.
In a final lively discussion with Planetree’s Visionary Design Network I learned about Loch Lomond Village, a 100-bed long-term care facility in St. John, New Brunswick, Canada, which offers a more low-tech approach. There residents can swing on a ‘WhisperGLIDER’ reminiscent of a childhood swing and remember back to a less complicated time and how life used to be. ____________________________________________________________________
1. See http://vimeo.com/35713779
3. Comments from Lisa Platt Planetree Director of Business and Product Development
4. In concert with Aesthetic Audio Systems
5. Commenting on the medical benefits of Matson’s animated artwork, his website states “Steve’s clients have recognized that their relaxing movement has the profound ability to lower blood pressure, calm the mind, and help to alleviate anxiety. Moving paintings are especially beneficial to those suffering from insomnia, high blood pressure, chronic illnesses, stress and hypertension.”
6 .“Interactive Technology and Toolkits: Bringing Integrative Health and Healing to our 12 Sites” presentation by Sandy Robertson, RN, MSN, PH CNS and Dawn Arceneaux, RN, BSN.
7. "The Basics of Shared Decision Making: How to Elicit Patient Values, Decision Preferences and Disease Concepts.” presentation by Dr. Dorothea Wild MPH of Planetree Germany.
8. Northern Westchester Hospital had previously employed Design Psychology to help S.L.A.M. Architects design their on-site Ken Hamilton Caregiver Center. See Israel, Toby, The Nurture Report, “Oasis by Design Psychology” (Online Volume III, Issue 3, December, 2009).