9 Jul 2008

The role of door hardware in evidenced-based healthcare design

A welcome trend is transforming the appearance of long-term care facilities, hospitals and most other healthcare related buildings.

Structures that traditionally sported a bland and sterile look have now taken on an air of elegance. In fact, the average person walking into a newly constructed healthcare facility could be forgiven for thinking they entered a luxury hotel. This growing shift in the healthcare industry can be credited to the principles of evidenced-based healthcare design.

Under this movement, the recent trend in healthcare design has been to create facilities that suggest hospitality rather than hospital. According to the Center for Health Design, evidence-based healthcare designs are used to create environments that are therapeutic, supportive of family involvement, efficient for staff performance, and restorative for workers under stress.

The current school of thought is that evidence-based healthcare design should result in demonstrated improvements in a healthcare organization’s clinical outcomes, economic performance, productivity, customer satisfaction, and cultural measures. Hence the growing popularity of hospitals that appear more like hotels.

Evidence-based design seeks to create a therapeutic environment by eliminating visual stressors and emphasizing pleasant décor. This design principle does not lessen the strict security requirements of a hospital. But it does encourage facilities to seek out security and life-safety solutions that blend in with the rest of the décor.

Design oriented door hardware can contribute to this desired setting. A brute looking lock could standout as a visual cue that a need exists for heightened security within the facility—a subconscious and unsettling reminder that danger lurks. Decorative locks, on the other hand, blend in with the building design motif and create the appearance of a free and more relaxed atmosphere.

So if a proximity card, for example, is required to gain entrance to a ward, the healthcare facility can eliminate obtrusive security devices by using a prox reader built into the hardware trim. The strict security requirements are still in place, but they are now hidden from sight or replaced with decorative trim.

Long-term Care Design Challenges
A rapidly aging population has created greater demand for long-term care facilities. With this demand has come increased need for security products to meet the security and life-safety challenges unique to these facilities. Of all the hardware items used to address access and egress concerns, exit devices are arguably the most versatile and important.

An exit device offers features not possible on other hardware. Exit alarms, dogging functions, egress lighting—the exit device is the Swiss army knife of hardware.

Delayed egress alarms are a must for healthcare facilities that house clients suffering from dementia. A delayed egress exit device sounds an audible alert when the push bar is depressed and then waits a set amount of time—usually 15 seconds—before unlatching the door. This gives the facility staff ample time to check door and prevents clients from wandering out of the building. The exit device can also be tied into the building’s fire alarm system. If the fire alarm is activated, it overrides the delay features and allows immediate egress from the building.

The dogging function allows the latch to be set in a retracted position, enabling silent operation of the door. Electroluminescent and photoluminescent and laser lighting technologies can be incorporated into the rail or push bar, turning a simple exit device into a highly illuminated guide to safety. The inclusion of these features can enhance the functionality of the entire doorway.

Electromechanical Features
Include a few wires and switches on an exit device and its overall value as a security component soars. Because they are found on many perimeter doorways, exit devices can be an integral part of an access control system. Electromechanical versions offer functions that can tie directly into the system to provide monitoring and control of doorways.

Remote latch retraction allows the exit device to be locked or unlocked from a remote location while simultaneously dogging or undogging the push rail.

Latchbolt or push rail monitoring switches allow independent monitoring of the doorway and can be used to detect egress or tampering, sound an alarm, signal a remote location or de-energize an electromagnetic lock.

An Electric latch retraction feature is ideal for high traffic egress doors that require access control. Once retracted, the door functions in a push/pull manner. An exit device equipped with electric latch retraction can be dogged for momentary ingress and egress and is commonly used in conjunction with an automatic door operator. The device can be dogged continuously on fire-rated devices that are tied into the building's fire detection system. When de-energized, the push becomes undogged and re-latches the door.

Design Continuum
Now that durable, commercial-grade locks are becoming increasingly available with stylish accents, architects can easily incorporate hardware into the overall design element of a building.  This makes it possible to have a design continuum throughout the entire structure. So if an executive office or pharmacy suite needs tight access control, the architect can go ahead and use a mortise lock with a credential reader and not have to worry that the hardware used on those particular doors will stand out or look different from those on other openings.

In addition, hardware can also be finished with an antimicrobial coating to improve facility cleanliness by reducing the potential of door handles serving as germ exchange points—yet another important concern for patient safety.

Healthcare facilities have come a long way in functionality and looks. So too has commercial grade hardware. Technological advances have given locks the capability to meet the most diverse security and life-safety needs of a facility. Greater attention to aesthetics has given architects more design options.

All of the features mentioned above make it possible to design a facility that is safe, secure and aesthetically pleasing.