Selecting Fabrics for Healthcare Settings

 

Podcast-Image-2.jpg

Selecting Fabrics for Healthcare Settings

David Dunston - Feb 2018

Why is fabric selection in healthcare design so challenging?

Welcome to the latest edition of the Vinyl in Design podcast, hosted by Terry Murphy.

Today’s conversation is about fabric failures and what to watch for.

Our guest today is Maria Lopez, one of many founder of the American Academy of Healthcare Interior Designers. Lopez is also a member of the Durable Coated Fabrics Roundtable.

In this podcast, we discuss:

  • why durable coated fabric is ideal for healthcare settings
  • the criteria for selecting the right fabric
  • the impact of cleaning protocols on fabric selection

Plus learn about the Forensics of a Failure and how dissecting what doesn’t work is often as important as understanding what does.

6 Questions to Ask About the Science Behind a Study

 

6-Questions.jpg

Have you noticed that we spend a lot of time talking about scientific breakthroughs and information you need to know now?

6 Questions to Ask About the Science Behind a Study

Susan Wade - Jun 2016

Have you noticed that we spend a lot of time talking about scientific breakthroughs and information you need to know now? If you watch local or national news in the U.S., there seems to be something new daily we must do, must avoid, or at least must heed. Maybe it’s about exercising more or a key nutrient that we just have to add into our diet.

John Oliver did a terrific send-up of how science often gets “translated” to make it more sexy for the nightly news.

Of course, it’s not just health & fitness and it’s not just about the sensationalizing of otherwise sound science. The demand for studies to report on has also led to far more reporting on invalid, often ideologically driven studies that lack scientific integrity.

At the American Institute of Architects 2016 conference, for example, several panelists focused on what they claim are bad chemicals in some materials and products. There was even comparison of product labels to food labels. Sure, chlorine is dangerous if you inhale a room full of it or ingest a gallon of it. But as an ingredient in making vinyl resin—or added to purify your public pool—not so much.

Six questions to help separate the facts from the pseudoscience.

To help separate the science from the squishy stuff, we’ve put together six questions to ask to understand the validity of the next study that lands in the headlines or on your desk.

  1. Is it an observational study? If it is, the results are inconclusive. Any study based solely on observing the behavior of a group of participants lacks proper scientific credibility because any number of unknowns can be contributing factors.
  2. Is the study peer-reviewed? If it is not, then it represents only the views of the authors (without any independent validation).
  3. Is causation proven? Studies often confuse correlation with causation. Just because two data points may share a relationship doesn’t mean one causes the other. For example, let’s say people who like bananas tend to drink more coffee. Does that mean eating bananas causes someone to drink coffee? Probably not.
  4. What’s the sample size? If the number of people in a given study is statistically insignificant, how can any reliable scientific conclusions be drawn from the results?
  5. Is the study an outlier? A lone study that challenges a body of scientific literature may prove correct—or not. Either way, a lot of fact checking should take place before concluding these researchers know something no one else does. 
  6. Where was the study published? Like outlier studies, research that appears in obscure outlets that fail to garner the respect of the broader scientific or medical community should be approached with caution. It may be that the research supports an ideological perspective held by the publisher; or maybe the research wasn’t strong enough to appear in a more mainstream publication.

As John Oliver pointed out, most studies are based on sound science—and often it’s the publicists and news shows looking for an angle that bias the way they’re reported. That said, it’s always important to review the science and the rigor of the research just to be safe.

 

 

4 Reasons Vinyl Products Get a Bad Rap

 

4 Reasons Vinyl Products Get a Bad Rap

Terry Murphy - Sep 2015

I sometimes receive a question from an architect or a designer who had a bad experience with a vinyl product. In trying to understand what happened, I often find that the “problem” is either not substantiated or based on bad information.

Here are four common reasons vinyl products get a bad rap.

Reason #1 – It’s a Different Plastic

About 13 years ago, a water supply pipe broke in my front yard. My neighbors stood around, peering intently down into the big dig, and proclaimed they knew about the problems with PVC pipe. Ironically, however, the main problem was that it wasn’t a PVC pipe in my yard but instead a polybutylene pipe. My neighbors thought all plastic pipes are made of PVC—but this is not the case.

I often use this pipe story to guide architects and designers in understanding the basic differences among, and performance attributes of, different kinds of plastic. It’s all about knowing what plastic materials you are considering and how they are intended to be used.

There are many plastics on the market and they have different chemistries that are designed to be appropriate for specific applications. The American Chemistry Council’s Plastics 101 website has interesting and useful information on this topic.

Reason #2 – It’s Not a Recommended Use

Complaints about a product failure may simply be the result of a product not being used correctly. For example, have you ever melted a plastic container in a microwave oven? Everyone laughs when I say this because we can all identify with this experience. As we often learn the hard way, some plastics are compatible with microwave ovens and some are not. Similarly, vinyl products should always be used for their intended applications. The best way to know what these are is to talk to the manufacturer about the intended use to be sure the material will perform as desired.

Vinyl resin is an inert white powder very much like baking flour used to make a cake. To continue with the cake analogy, that white powder has little direct commercial use until other materials are added to it and it is made into useful products. The additives in the compounding process are designed with a specific end use in mind. Plasticizers make vinyl flexible, and stabilizers can keep vinyl from breaking down during manufacturing or from exposure to sunlight. For example, PVC pipe will not usually have a UV stabilizer in the compound since pipe is typically buried in the ground or installed within a wall cavity. So if an architect has an application calling for exposed pipe, it should be coated to prevent degradation.

Reason #3 – It Wasn’t Installed Properly

An architect told me recently about the “terrible” problem he had with CPVC fire sprinklers. Sprinkler systems had been mandated on all high-rise buildings, and CPVC was being widely used because it was easy and fast to install. As I dug deeper, I learned that the projects had been rushed and the problems were related to installation errors (and not to the product itself).

It’s important to make sure that your vinyl products are installed properly. Manufacturers go to extensive efforts to develop and publish detailed installation instructions. Downstream trade groups can also be a good source for advice on installation. And some, like The Vinyl Siding Institute offer certified installer programs.

Reason #4 – Products Have Been Improved Over Time

Vinyl is a relatively new material compared to many traditional building materials that designers and specifiers deal with daily. And, like most building materials, it is being improved over time.

I occasionally receive comments from architects who have experienced exterior fading, chalking, plasticizer migration, or drying out of flexible vinyl products—issues that deal with poor performance with early versions of these products. Some architects have also had experience with early unreinforced vinyl roof membranes that failed prematurely.

That was then—and this is now. Vinyl products have changed and advanced over time through better design and improved material formulation.

Healthcare Design for the Future

 

Healthcare Design for the Future

Jane Rohde - Jul 2015

I think everyone in the healthcare industry would like to have a crystal ball – one that allows us to clearly see the future of an industry that is rapidly changing and uncertain. Healthcare Finance Magazine requested illustrator Mark Armstrong to complete a cartoon to embody how we’d utilize that crystal ball to understand where we are going.

From reimbursements to higher acuities of care, to shorter stays in acute care settings, to understand the meaning of the continuum of care, a strategic plan is in order as we approach healthcare spaces in the coming years. No matter what the size or type of healthcare setting, planning and programming for the future—in order to fully identify the strengths and weaknesses of an organization—allow for the development of an understanding on how a provider fits within the continuum of care. And following a product selection process that focuses on exposure and risk can take these environments very safely into the future.

Sustainability, Resilience, and Maximizing Space Utilization

I sit on the GSA Green Building Advisory Committee (GBAC), and one of the key priorities is evaluating the crossover and intersection of sustainability, resilience, and maximizing space utilization. 

Sustainability tied to return on investment in healthcare settings is a major consideration – primarily because of the reimbursement climate and impacts of the Affordable Care Act. When budgets and reimbursables are tight, it is often the default, defensive position to evaluate only first costs on a renovation or new project. However, expanding to a lifecycle operational budget model assists with looking at costs over time, as the ongoing operational costs is the most critical from a sustainable operational perspective. For projects that we work on, we look at the value of the products being specified and work with our clients to understand the long term perspective and return on investment (ROI). 

The linkage of climate change with planning for resilience to withstand and thrive during major natural and manmade disasters is particularly important in the healthcare sector. Evaluating preparedness at the beginning of the programming process allows for spatial requirements to be appropriately met. There are resources available from the US Department of Health & Human Services; such as the FACT SHEET: Strengthening the Climate Resilience of the Health Care Sector and a toolkit with reference information, case studies, and additional information available in the Primary Protection: Enhancing Health Care Resilience for a Changing Climate

The healthcare industry, through the utilization and states’ adoption of the Facility Guidelines Institute’s two sets of reference documents -- Guidelines for Design and Construction of Residential Health, Care, and Support Facilities and Guidelines for Design and Construction of Hospital and Outpatient Facilities -- has a primary focus on maximizing space utilization through Part 1 requirements that include completing a Functional Program. Design professionals are used to working with a Physical Space Program that includes square footages and adjacencies and is developed during the planning process or provided by a developer or care provider. However, the Functional Program needs to be completed prior to the Physical Space Program, so that the ultimate built environment can support the occupants utilizing the building, and designers understand the mission goals and nuances of a care model that impact the physical space. From an interior designer’s perspective, it is crucial to be involved in the upfront discussions that clarify the utilization of all types of spaces. Early project involvement results in superior design that supports maximizing physical space utilization. To date, healthcare designs that support occupant desired outcomes – patients, residents, staff, family, and visitors – are successful projects that evaluate all the operational functions, the circulation flows, risk assessment evaluations, and considerations of aspects of the environment of care. These aspects include items such as access to daylight and views, access to nature and the outdoors, and wayfinding that provides clear direction—all of which limit stress and improve outcomes.

Specification of Healthcare Materials

Healthcare materials need to respond to specific issues that impact patient, resident, and staff health and safety within the physical environment. They must be durable and maintainable to support infection control measures, and non-glare and non-slip to reduce falls, fulfill cost constraints, and meet the aesthetic intent. This is not a small charge for designers to specify products to meet all the criteria while withstanding the heavy usage requirements within a newly designed or renovated healthcare environment. 

There is a need to evaluate products from a lifecycle and building service life perspective. It is not recommended to specify products using a “red list” philosophy. For some reason, the advent of deselection has become more mainstreamed, often leading to regrettable substitutions. Product failures have become pronounced, which is not a sustainable product selection from a design, operational, or cost perspective. 

The Green Building Initiative (GBI) Green Globes’ approach considers multiple attributes including Multiple Attribute Standards (such as UL and NSF product certifications), Environmental Product Declarations (EPDs), and Product Life Cycle certifications. USGBC, GBI and standards organizations are all working to improve their product selection approaches to include not only the evaluation of hazards, but also products and their ingredients in the context of exposure and risk (see Green Suite example: www.chemply.com).

An evaluation of a finished product, production process, and intended use that considers potential hazards based upon exposure may pose little to no risk to the worker, installer, or occupant. This is an appropriate approach for building product selection and specification for healthcare environments.

Implementing a strategic planning process to address sustainability, resilience, and space utilization is essential.  Implementation can be completed through workshops, focus groups, surveys, mock-ups, and post-occupant evaluations—all of which lead to building relationships and opening communication channels through provider networks with the planning and design team for a healthcare setting. Once a framework is established, product selections can be made to support the needs of all occupants to meet the desired outcomes of a project.

To source this article, click here.

Subscribe to RSS - Design Practices