Each year, a judging panel of healthcare architects, interior designers, and facility executives meets with exhibitors at the annual Healthcare Design Conference + Expo to evaluate product entries in the Nightingale Awards, which recognize product design and innovation that support healing and productivity.
These discussions provide an opportunity for judges to examine the products, hear about specific features, and ask questions of the manufacturers as they consider how the entries meet the awards program criteria.
From these efforts, judges determine Gold and Silver winners in specific product categories, from architectural products to flooring and furniture, as well as recognize those for sustainability and innovation advancements. (Check out the 2023 winners here and in the Healthcare Design’s January/February issue.)
The process also offers an opportunity for judges to see how manufacturers and suppliers are meeting the big-picture needs of healthcare organizations. To understand what was learned, Healthcare Design invited judges to a roundtable discussion to hear what stood out to them during the awards judging at the HCD Conference as well as what they’d like manufacturers to improve and focus on next.
In December 2023, Editor-in-Chief Anne DiNardo moderated a discussion via Zoom with Dee Dee Bonds, vice president and senior interior designer–health at HKS Inc. (Orlando); Ryan Daniels, vice president, Florida healthcare practice leader at CPL (Tampa, Fla.); Julie Dumser, RN, senior manager, health consulting, at EY (Indianapolis); and Sarah Francis, RN, director–planning, design, and construction, at Atrium Health (Charlotte, N.C.).
Here are some of the topics that were top of mind.
Advancements in behavioral health design
Last year, during discussion of the 2022 Nightingale Awards, judges expressed a desire for more products serving the behavioral health population—a topic, they noted, that was at the forefront for designers as they sought to deliver less institutional environments for patients.
A year later, judges of the 2023 Nightingale program say they recognized visible progress in this area with products designed to meet the needs of this patient population as well as moving the needle in aesthetics and functionality.
“We saw a lot of attention to behavioral health solutions and furniture that didn’t feel so institutional at first glance,” Atrium Health’s Francis says.
Among those products getting their attention were behavioral health solutions that meet specific safety needs or better support patients in the care environment.
For example, taking home a Gold Award in the Technology-Integrated Solutions category, Safehinge Primera’s Full-Door Ligature Alarm offers a new approach to door safety with a wireless suicide detection system built into the door that alerts clinical staff if a vertical load of more than 11 pounds is applied anywhere on the door.
Roundtable participants also noted more manufacturers filling a void for products that serve patients with sensory needs, including Pineapple’s Boden Donut Rocker, which received a Gold Award in the Seating category and an Innovation Award.
The furniture is designed specifically to provide support for patients with sensory processing needs and those who find comfort with self-stimulatory behavior, such as rocking back and forth to help find focus and calm.
They also noticed improvements in the aesthetics of products for behavioral health environments that align with efforts within the industry to destigmatize and deinstitutionalize behavioral health settings.
For example, Stance Healthcare’s Lotus Case Goods, which earned both a Gold Award in the Furniture Collections category as well as an Innovation Award, comes in a woodgrain design with four finish options to enhance the ambience of any space.
Within the flooring category, EY’s Dumser says several manufacturers highlighted soothing, neutral color palettes for their products to contribute to calming interiors for patients and staff.
The panelists noted these improved features not only make a space feel less institutional but also provide greater flexibility to healthcare facilities on how to use their spaces.
“The pandemic taught us that we need to be a lot more adaptable and universal in our rooms,” HKS’ Bonds says. For example, a facility facing a shortage of beds may need to put nonacute patients in a behavioral health room.
“By paying attention to the aesthetics, someone in a behavioral health room that doesn’t really need to be there won’t feel so out of place,” Dumser says.
Alternately, she says a patient may present for one medical need and then develop conditions that require a more secure setting. But if a room has already been designed with such features, such as lockable cabinets and antiligature or weighted furniture, the patient could continue to receive care in that same room instead of being transferred to another area.
Adaptive design features
In fact, products that enable healthcare environments to be more adaptable and universal were a big theme in their year’s entries, according to roundtable participants.
Brewer Company’s Versa Exam Table, named Best of Competition, was lauded for its modifications to the standard exam table, which includes a solid base and interchangeable adult and pediatric top configurations.
“You buy one product, and it can serve all of those patients, from pediatrics to geriatrics,” Bonds says. (For more on the Best of Competition winner, read the Q+A here.)
While adapting to changing patient populations, the table also offers flexibility to meet the needs of different medical specialties as well as healthcare settings.
For example, Bonds says, a medical office building might be used by a pediatric group three days a week and then an adult doctor’s group the other two days. By using a product like the Versa Exam Table, which can be changed over in less than 10 minutes, the building owner, whether a hospital system or an outside vendor that leases the building, would be able to outfit an office practice without having to worry who’s coming in.
Elements of universality were seen in other products, as well, such as the Mossa Mobile 3-Wheel by Skyline Design, which won an Innovation Award in Furniture: Clinician Support. Engineered to replace the patient curtain, the durable glass partition has a modular design that allows for flexibility in any healthcare space and can be customized with images, including from the company’s digital design library.
“The attention to detail and ability to change out the art was thoughtful,” Francis says. “It doesn’t have to be permanent.”
The panelists say they also appreciated products that are field serviceable, such as furniture cushions that could be repaired on-site without having to replace the entire chair.
In the flooring category, they welcomed flooring lines that allow damaged tiles or planks to be pulled up and replaced without the need for glue or downtime, maybe during the room turnover. “That part is huge because you can’t afford to close down a room so the floor can be replaced,” Dumser says.
Francis agrees, adding that maintainability and durability are key aspects that her team looks for when setting the interior standards at Atrium Health.
“With finances the way that they are in a lot of healthcare systems, first cost has elevated its position in how we make decisions sometimes,” she says. “We really have to try to bring forward things that will last.”
Growth in green products
In recognition of healthcare organizations’ desire for products that support sustainability goals, the Nightingale program expanded in 2022 to include Sustainability Awards, with three rising to the top.
For 2023, the judging panel found seven products that stood out. Specifically, judges noted progress in the flooring category, with several manufacturers touting products that are free of polyvinyl chloride (PVC) and made of recycled materials.
One such winner in the Flooring: Resilient category was EcoServices’ Nada Rx, a high-performance, nonvinyl surface made from recycled rubber.
Roundtable participants say several manufacturers also noted their products as being recyclable. However, judges recognized operational challenges for healthcare systems when it comes to diverting building materials from the landfill at the end of their lifespan.
At Atrium Health, Francis says recycling is a priority, but it’s not always easy in the decommissioning of a project or facility and takes intentional consideration and planning.
Daniels wonders if there’s an opportunity to work with manufacturers to pick up their products at the end of their lifecycle for recycling instead of having a demolition crew collect them for garbage. “Is that something that we need to start being better at?” he says.
Furthermore, the judges noted ongoing challenges with educating environmental services staff on how to care for sustainable products. Bonds, who has served on the American Academy of Healthcare Interior Designers’ Durable Coated Fabrics Task Group, explains that a spray cleaner that should be applied for 90 seconds and wiped off might instead be left on an interior product, which can decrease its lifespan.
The judges also noted the desire for more post-occupancy data from vendors on how their products work in different settings. “You may have the same chair and it performs well in one area but in a clinical space it fails,” she says. “[Can we try] to figure out why it’s failing and how we can prop it up, so to speak, to where it’s going to do better in clinical settings,” Bonds says.
Going a step further, Dumser says she’d like to see more manufacturers and vendors share case studies of their products in real-world settings. “We put [the product] in, but we never get to see what it looks like five to 10 years later. “Why can’t manufacturers show us how it actually performs?”
Improving healthcare product design
While recognizing the strides being made, the panelists say there are some areas where they’d like to see more product innovation, including better aesthetics in lighting fixtures.
“Give me a beautiful fixture that still has infection control, that could be used in universal settings whether it’s an operating room, MRI room, patient room, or over a staff station,” Daniels says. “I want more of that.”
Roundtable participants also shared their desire for products that address caregivers’ needs in the clinical environment, especially in light of staffing shortages and healthcare organizations’ focus on employee retention.
Specifically, Francis notes the need to reduce waste and eliminate steps for staff, such as the Versa Exam Table, which has strategically placed supply drawers that open on either side of the table. The design keeps supplies within arm’s reach while providing flexibility to place the table where it best works in a room.
They also see more opportunities with prefabrication, moving beyond bathroom pods to include exam and patient rooms, among other space types. “How do we utilize speed to market and have customization within it?” Daniels asks. “Some are trying to do it, but that’s what I want to see more of.”
Francis says her organization uses some modular components, such as headwalls, adding that owners are still the ones pushing for prefabrication on many projects.
“I would love to see the general contractors start bringing it on,” she says. “I think we’re getting there because we’ve pushed them to see the value of it, but right now it’s still a project-by-project consideration.”
Anne DiNardo is editor-in-chief of Healthcare Design. She can be reached at firstname.lastname@example.org.