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Rising to the challenge
furniture (fur¦ni|ture) Noun: The movable articles that are used to make a room or building suitable for living or working in, such as tables, chairs or desks.
The lexicon – in this case Oxford Dictionaries Online – makes ‘furniture’ sound so mundane. Yet, as with most aspects of hospital life, reality belies the apparent simplicity. Fitting out a complex environment catering for the 24/7 needs of inpatients and outpatients, staff and visitors is a challenge best left to experts, as those interior designers and buyers charged with the task of furnishing a hospital or other healthcare facility will testify.
The manufacturers’ role
The responsibility for furnishing today’s hospitals no longer lies exclusively with interior designers and purchasing managers. Manufacturers also have an increasingly essential role to play through the development and commercial production of furniture which matches the demands of the healthcare arena – demands which are both precise and manifold.
As a result of working closely with customers, specialist manufacturers have been able to bring furniture collections to market that are designed to meet needs across all areas of hospital life, whether catering for defined user groups, answering clinical requirements or actively addressing issues such as infection control, tissue viability or the care of patients with dementia. Standards are high, with all hospital furniture required to conform to BS 7176:2007 ignition test, as well as strength, durability and safety standards BS EN 15373:2007 (chairs) and BS EN 15372:2008 (tables).
Designing out bugs
Infection control remains at the core of hospital routine and extensive R&D investment amongst key players in the contract furnishing sector has resulted in the introduction of healthcare seating designed specifically to reduce the spread of hospital-acquired infections. For some time, anti-bacterial upholstery fabrics and lacquers applied to exposed timber have been standard weapons in the fight against HAIs. However, fundamental design elements now underpin hospital seating to control contaminant build-up: seat/back hygiene gaps, removable cushions and minimal stitching details in patient contact areas all facilitate access for cleaning and prevent the creation of dirt-traps.
Equally specific features have been incorporated into hospital seating to help manage pressure care and tissue viability in long-stay wards. Key pressure-reducing features include waterfall seats, arm-pads and weight-distributing cushions.
Posture and seating
Furniture designers and manufacturers have also acknowledged that good posture is crucial: it not only ensures even weight distribution and reduces shearing forces – hence helping in the management of tissue viability – but also encourages movement, social interaction and self-reliance. Enhanced lumbar support built into patient seating will promote good posture even over prolonged periods in the same chair whilst variable seat depths, seat height adjusters and a choice of chair heights and sizes will enable differences in stature to be accommodated without compromising on comfort.
Infection control and tissue viability are issues with implications for patients affected by a broad spectrum of conditions. However, seating for defined user groups represents a different sort of challenge for furniture designers. In response to demand from hospitals for more furniture to accommodate the rising number of bariatric users, for instance, specialist seating has been developed for visitors, residents and patients who weigh typically 35-50 stones.
Ideally combining style with functionality, such seats should merge comfortably into a mixed setting and complement other seating whilst providing for the special needs of larger users. Armchairs with enhanced size and strength to accommodate bariatric users will feature extra-supportive arms, with handgrips to aid rising and housekeeping wheels to help manual handling. Good posture remains vital: reinforced lumbar support ensures the adoption and maintenance of a correct seating position whilst waterfall seats reduce pressure on the backs of legs.
In addition, recent innovations include chairs designed to accept hoists together with the development of upholstered motorised recliners in order to help bariatric users presenting associated health and mobility problems. With patient-activated remote controls, these allow the seat back to be poised at any angle to facilitate a comfortable position.
The increasing use of recliners in clinical areas is, however, not restricted to bariatric users. A growing variety of options now includes compact recliners designed for tight spaces, models with a ‘tilt-and-space’ action and recliners providing additional support through a snug containment back. Applications are equally diverse, ranging from counselling suites to maternity departments, where recliners seem to be as useful to expectant fathers as they are to mums-to-be. Several models are also fitted with extra-wide arms to ease the administration of treatments like blood transfusions or dialysis while the patient remains in a comfortable seated position.
Recliners are available with either manual or motorised action: in both cases, the recline position can be stopped at any stage to allow the user to find the most comfortable angle. Other standard features include heavy duty, lockable easy-clean castors to assist mobility.
Indeed the day-to-day handling of patients remains a key area of concern to hospital staff, and furniture has been developed with a range of features to ease – and safeguard – the work of healthcare professionals as they move patients around a busy hospital. Specialist patient transfer seating is now available ready-fitted with push handles and castors for easy manoeuvring and adjustable footplates for patient safety, whilst useful options include drop-arms to assist with either bed-to-chair or chair-to-chair patient transfer.
As more hospitals find they have to establish specialist departments to care for patients suffering from varying degrees of dementia, so specialist furniture is being sought with which to furnish them. Here, simple features make a huge difference: highlighted table edges, contrasting carcases/doors and seat arms/cushions all help the visually impaired, whilst upstands on bedside units both contain spills and prevent the loss of personal items.
Visual access to cupboard and drawer contents is also vital to preserve a sense of familiarity and encourage ownership. Dipped profiles to drawer fronts allow immediate visual access to the contents, for instance, as do transparent vision panels in wardrobe doors. Throughout, flexibility is essential, with furniture configurations easily adapted if needs change.
Yet whether furnishing a dementia ward, a maternity department or a long-stay unit, the importance of style when selecting seating, tables and other furniture essentials should not be overlooked. A smart, elegant and thoughtfully-presented hospital interior will lift the spirits of patients and staff alike and even give the patient the feeling of being in a hotel rather than in an institutional building.
Thanks to the development of versatile modular furniture systems and compact beam seating, even the busiest hospital waiting rooms or the most cramped of transit areas can be imbued with a sense of style and innovation, engendering a positive ambience (see picture courtesy of The Fitzwilliam Hospital, Cambridgeshire), spreading a feel-good atmosphere and making a valid – and often under-appreciated – contribution to the healing process.
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