Evidence-Based Design Impacts Patient Bathroom Construction: Part I of II Same-Handed Design

Results emerging from more than 1,500 studies have shown the importance of hospital room design in reducing medical errors, infections and falls, as well as patient stress.1 As a result, today's leading architects and design professionals are incorporating principles of "evidence-based design" (EBD) to reduce anxiety and assist healing across a wide variety of health care applications.2

EBD covers a number of areas from room orientation to wall color. The most controversial aspect of EBD is same-handed room design where room orientation is identical throughout a hospital wing or department. The benefit to this is medical staff don't have to hesitate when entering a patient's room during an emergency because all equipment, medication, bathrooms, etc. are always in the same location ultimately reducing the risk of error.

However, this design comes with an increased cost. Instead of sharing plumbing between two toilet rooms, as in mirrored image design, same-handed bathrooms require plumbing for each toilet room. At $3,000-$5,000 per room, this cost can add up to as much as $500,000 for a 100-bed hospital.3 While an argument can be made that reducing staff errors justifies the added expense, not enough evidence exists to convince some hospital developers to incur the extra costs.

There are many factors involved when choosing between mirrored image or same-handed design for your next hospital project. Medical staff processes, current research and overall cost must all be considered. Whichever design you choose, Eggrock can help because we understand the engineering, architecture and construction issues associated with building hospital bathrooms and can value-engineer a solution that meets your needs.

We see a lot of plans for new hospitals and can often share learning from one project to the next. Designing patient rooms to be same-handed may require some extra plumbing. However, by using bathroom pods that are produced in a factory setting you may be able to leverage savings to make this a cost-neutral proposition as compared to the standard mirrored image design. In addition, the bathroom design can be value-engineered in a manner that cannot be accomplished with site built construction.

Not all same-handed bathroom designs require additional plumbing. The picture shown illustrates one way to execute a same-handed design with a shared plumbing chase. Like all choices, there are compromises and, in this case, the same-handed design results in a nested room design that has pro's and con's of its own.

1. "Health Outcomes Driving New Hospital Design," New York Times, 18 May, 2009, Carol Ann Campbell
2. Ulrich, Roger, Ph.D., et al. "The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity." Sept. 2004. Report to The Center for Health Design for the Designing the 21st Century Hospital Project. This project was funded by the Robert Wood Johnson Foundation.
3. "Inboard, Outboard, or Nested?" Healthcare Design, 1, March, 2009, Camie Maze, AIA, LEED, AP. See http://www.tka-architects.com/content.html