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Barbara J. Huelat: Healing Our Healthcare

Beyond Countertops Solid Surface in Healthcare Furnishings
By Barbara J. Huelat, FASID, AAHID, EDAC, IIDA

Why Solid Surface
Solid surface "countertops" are commonly specified materials within healthcare environments. Why? Because they are hygienic, nonporous, stain resistant, thermo-moldable, sustainable, easy to clean, simple to maintain, can be safely used in water areas, can stand up to heavy abuse and they are aesthetically pleasing. Very few products can make these claims. With these incredible benefits, it makes sense to extend this material beyond the simple countertop and into the larger context of healthcare environments.

Bacteria Mitigation
One of the most difficult challenges in a hospital is keeping it clean. Designers and architects must be knowledgeable and diligent regarding how hospital-acquired infections (HAIs) are spread, their sources and the risk to patients.

Bacteria, MRSA (methicillin-resistant Staphlococus aureus), VRE( vancomycin-resistant enterococci), ESNLs (extended-spectrum beta-lactamases), and PRSP(penicillin-resistant Streptococcus pneumoniae)are the most common multidrug-resistant microorganisms that can be found in today's healthcare environments including acute care, ambulatory care and senior living facilities. These microbes and other dangerous pathogens are lurking in corners, crevices, furniture and on many surfaces in some of our most beautiful healthcare environments.

These microorganisms can cause serious illness and even kill. In addition, medical facilities can no longer be reimbursed for any infection sustained by a patient while being hospitalized. Hospital-acquired infections are difficult challenges for most managers of medical facilities and senior living environments as well as those who design them.

Source and Transmission
Where do these organisms come from? Typically these infections come from other people - patients, staff, family and outside visitors. Furnishings, finishes and equipment may also be a source of contamination. These microorganisms have an incubation period and may colonize on a person or object and become a "host/carrier" of the infection.

Transmission between the host and the patient typically occurs by contact, through the air and moist droplets. The outcome of transmission of the infection from the host to a patient can be diverse. Some patients never become ill or exhibit symptoms. Others especially those who are elderly or very young, frail, seriously ill or immune-compromised - are more susceptible to HIAs.

Responsible Design
Some of the healthcare environments most dangerous areas include the Emergency Department, Intensive Care Units, and Oncology, especially where patients are immune suppressed. The most treacherous environment is the dialysis unit where bacteria is so prevalent that 56% of the patients receiving treatment also contract some form of bacteria or infection, a dialysis patient is 100 times more likely get a bloodstream infection from a common bacteria than other people.

As responsible healthcare designers, we explore best practices and creative solutions to mitigate these pathogens. It has been considered that institutional environments that can be easily kept sterile like a "clean lab" provide the solution. However, we also wish to provide a soothing and nurturing healing environment that promotes emotional well-being. Design for the patient's experience has been proven to improve patient satisfaction, which further supports positive outcomes. The challenge is creating an environment that is both easily cleaned and aesthetically pleasing.

Beyond Countertops
Healthcare designers can take "lessons learned" from solid surface countertops and creatively solve the "clean challenge" for many other furnishings found within these environments. Here are a few of my favorite applications.

Furniture Surfaces - This is an easy one. Solid surfaces can easily clad horizontal surfaces on furnishings. For example, put it on all your waiting room tabletops. These tops are extremely durable and will never need to be replaced or refinished. The same is true for arm caps of chairs. This highly touched surface is a logical area to mitigate bacteria with easily cleaned material. You can simply coordinate any of your designs with the wide array of colors and textures of solid surface materials. My favorite for arm caps is HI-MACS R913 Natural from the new Healthcare Collection. It works beautifully with light wood tones.

Most healthcare furniture manufacturers will work with you to incorporate these materials into their furnishings. Manufacturers such as IoA(Images of America) and David Edwards currently have solid surface clad arm caps and furniture case goods available in their collections.

Wet Surfaces - Solid surface is an ideal solution for wet areas. We know that dangerous pathogens are likely to be found in warm, moist areas. Solid surface can help mitigate bacteria in wet areas. The material can be seamed to keep bacteria from growing in transition areas such as between countertops and sinks. Solid surface sinks can provide endless solutions for the diverse needs of sinks in the healthcare environment. Consider these sinks to be ganged in public toilet rooms, hand-washing areas, patient bedrooms, scrub sinks in the OR suite, and the baby bathing sink such as the "cradle" by ASST, Beyond Surface Level Solutions. The adjoining counter material can also be thermo-formed to have gentle curved corners for easy cleaning and elimination of crevices that support bacteria growth.

My personal favorites for sink/counter combinations are LG's new speckled products from the Healthcare Collection. For example, a countertop of HI-MACS R547 Awaken with a sink in R544 Serenity creates a cool, calm watery setting. The two tones of color/pattern assist in visibility. Try it in showers. No ugly grout lines where mold can grow. It can also be engraved to be slip resistant. You can further enhance the design of the shower entry to be ADA accessible. Now, consider taking the solid surface up the wall in the shower for easy-to-clean wall surfaces. You can easily design a complementary shower seat, and accessory niche. The possibilities are endless with this very fluid material.

Nurse Station - Current nurse stations are no longer the big box in the corridor where nursing and clinicians hung out and equipment and carts run into. Today's nursing integrates bedside charting with nurse "touch-down," sub-stations and patient-friendly concierge desks. These smaller and more diverse units are still vulnerable to damage from carts and equipment, and must be easily cleaned. Solid surface is an ideal solution for today's nursing workstations.

The "hospitality look" works best for a concierge desk for welcoming patients and visitors. We have some clients who prefer to clad the entire station in solid surface to provide maximum durability and clean-ability. The architect and design community loves to use reveals. However reveals can harbor bacteria and are difficult to clean. Once again, designing with solid surface allows us to create reveals by "sandwiching" in an accent color between neutrals. This is a great opportunity to use coordinating materials such as HI-MACS R541 Enchantment with R543 Beauty.

Walls - You may have thought the solid surface is just for horizontal surfaces; however this is a myth. With all of the product benefits, structural strength and the ability to seam sheets together, this can be a very exciting opportunity to use solid surfaces on walls creating the ultimate wall for clean-ability.

Just because it is hygienic, it does not have to look sterile. This is the magic. Solid surface can be carved out with your favorite design or pattern and then filled in with an accent color. You can also create a change of color in a horizontal band. We have used this design to indicate the "high touch zone" indicating areas that are touched often. This directs maintenance staff to areas where they need to be most diligent in cleaning.

In areas of patient vulnerability, such as immune suppression, the use of the carved wall designs can help create visible interest and "positive distraction" that can be easily cleaned and maintained without adding wall art. Wall designs can also be used as an accent wall, branded logo wall, or decorative feature wall. Using the translucent solid surface such as LG Opal translucent white can be carved with a design - then color lighting from within the wall can provide a "wow factor" in just the right place.

And Beyond - The creative use of solid surfaces on millwork surfaces, furniture, sinks, shower wet areas, nurse stations and walls are just the beginning. In addition, you may consider solid surface for signage, directories, graphic cutouts, raised letters, especially for donor walls, lighting, water features, ceiling details, benches, and any area that requires durability, low maintenance, easily cleaning and beauty. This material can be cut, chiseled, carved, bent, molded, seamed to keep harmful bacteria out, and used to create smooth non-porous surfaces. It is a must for the designer's creative toolbox. Use it and enjoy.


Barbara Huelat
Design Principal
Huelat Parimucha Ltd. / Healing Design
635 South Fairfax Street
Alexandria, Virginia 22314
P: 703.838.8414