Function + form

When it comes to new furnishings in waiting room spaces as well as patient rooms, hospitals tend to want it all.

In general, they seek products that are highly cleanable to support infection control, durable, sustainable and flexible enough to allow for possible space redesigns. Oh, and it needs to look good and meet the budget too.

It's a tall order, but there's a lot at stake, especially with infection control. High-touch areas in patient rooms and waiting areas are potential sources for pathogens that can cause infections. That's a challenge furniture manufacturers continue to address with their designs but without sacrificing cost-effective style.

"One of the things we're seeing, yes, aesthetics are important, but with the focus on infection control and on reducing costs," says Chad Langville, director of business development and head of the health care division at Kwalu, Atlanta. "Hospitals are really more aligned with function over form now. They're looking for something that's going to last — it's a balance."

Debbie Breunig, R.N., vice president of health care, KI, Green Bay, Wis., says that the mandate to get health care-associated infections (HAIs) under control is a key factor in the design of the latest hospital furniture and that makes cleanability critical.

According to the Centers for Disease Control and Prevention, Atlanta, the transfer of microorganisms from environmental surfaces to patients is largely through hand contact with the surface, she notes.

Proper hand hygiene, combined with cleaning and disinfecting surfaces is fundamental to reducing the incidence of health-care associated infection, says Breunig. For those reasons, KI, along with other health care furnishing companies, make ease of rigorous, continual cleaning a design priority.

"I think that the increased awareness about the importance of reducing infections where possible in a hospital has brought forth some attention to furniture design that may not have existed previously," says Jocelyn Stroupe, AAHID, IIDAA, ASID, EDAC, principal and health care interior design practice leader, Cannon Design, Chicago.

Furniture made of materials that are easily and quickly cleanable and with as few crevices as possible are high on manufacturers' hospital design palettes, she says. "Overall, the idea that you can easily wipe surfaces while trying to keep it as simple and straightforward as possible is the overall approach that everyone is taking," she says.

James Owens, national director for health care, Humanscale, New York City, says the company has undergone a "definitive shift in the product development process" so that new offerings are what he calls "infection-control friendly." He believes cleanability is a major factor for hospitals when choosing furniture.

"It's not only the materials utilized in manufacturing a product, but how easily the product can be cleaned, how it withstands robust cleaning solutions and that it has no crevices where fluids can pool," he says.

Simple and smart

A case in point is Nurture by Steelcase, Grand Rapids, Mich., which applied a keep-it-simple design philosophy when it developed Pocket, a line of mobile work stations for use by clinical staff, says Robin Polavin, product manager. The unit's surface is seamless with no crevices and the main work area is powder-coated steel.

"Pocket is simple and what it gives you, from an infection control standpoint, is a surface that's easy to clean," she says. Easy-to-clean design also means it is more likely that the unit will, in fact, be cleaned more frequently and not become a source of pathogens, she explains.

As infection control grows in importance, so do the types of materials used in furnishings, especially as alternatives are developed that offer infection control benefits without sacrificing style.

Langville of Kwalu says more clinical staff are asking for furniture made of non-wood materials, especially in emergency department waiting areas. Because wood is porous, it absorbs bodily fluids; plus, the finish is stripped after multiple cleanings.

To address the demand, Kwalu has developed chair frames made out of a polymer that lasts up to twice as long as wood frames, he says. Also, polymer eliminates the problem of a wood finish being stripped away after multiple cleanings, he adds.

Stroupe agrees that wood-framed chairs are not appropriate for some spaces in hospitals because they are porous and susceptible to degradation from cleaning. "Some of the metal options for arms and arm caps made out of a thermoplastic-type material are more easily cleaned and can withstand a lot of the disinfectants being used," she says.

Kurt Kapp, product manager for the Compass brand of Herman Miller, Zeeland, Mich., also says materials play an increasingly important role in furniture design for hospitals. The Compass modular system of adaptive wall and cabinet components for clinical and other spaces features a Durawrap finish, a 99.9 percent polyvinyl chloride-free material made of polyethylene terephthalate.

The material wraps around tiles seamlessly, thus eliminating the need for edge banding. "Anywhere you can eliminate seams helps because you stop the places where germs and bacteria grow and this helps in the fight for infection prevention," he says.

Stroupe says the use of upholstery materials like vinyl for furniture in waiting areas and patient rooms is on the rise due to its infection control benefits. "Vinyl is impervious; it's nonporous. Any kind of fluids that will collect will sit on the surface and not seep in, as it might with a textile or woven product," she says.

Woven solution-dyed nylon is making a comeback thanks to improvements in the quality of the material, giving designers another upholstery option that is stylish yet sturdy, she notes.

While the use of antimicrobials embedded in the finish or furniture material itself continues to grow as a potential aid against fighting pathogens, its ultimate value is still questioned by Stroupe and others.

"I think the jury is still undecided on whether antimicrobials are a good practice or not," says Stroupe.

Antimicrobials have become more pervasive in furnishings ranging from wood materials to vinyl upholstery, says Stroupe, who believes they may kill bacteria on surfaces that are not cleaned as quickly as would be ideal.

Stroupe cautions that antimicrobials can supplement good old-fashioned elbow grease, but not replace it, something infection-prevention experts strongly advocate. "I don't think they are the end all, be all of infection control," she says of antimicrobials. "It's just one additional thing that can be used as a safeguard. You can't replace good cleaning practices."

Choices galore

Proven or not, antimicrobials — along with other features — are a selling point for a variety of furniture manufacturers.

The patent-pending Miller Expanding Bariatric Recliner from Haworth Inc.'s Legacy Furniture Group of Holland, Mich., has been designed to meet infection-prevention needs, say company officials. The recliner expands from 22 inches in width to 28 inches, which allows for better access to the chair and a complete cleaning. Wood-finished arm caps contain an antimicrobial finish, which inhibits the growth of bacteria, fungi or algae that may cause decay, according to Haworth.

Interlude from Carolina Business Furniture, Archdale, N.C., is available in a variety of design materials, including multiple metal and wood finishes, top surface materials and knit/upholstery materials. Several arm styles provide varying levels of support to users.

Euroluxe with SilverBan comes standard on all wood finishes in the Interlude collection. SilverBan technology is infused into the Euroluxe wood finish, providing antimicrobial protection on all exposed wood surfaces. Interlude also offers silver ion powder coat finish for metal surfaces.

Antimicrobial Lockers from Lyon Workspace Products, Aurora, Ill., are finished in an advanced powder-coat technology with Agion antimicrobial that inhibits the growth of mold and bacteria on locker surfaces. Moisture triggers the controlled release of silver ions to provide antimicrobial protection for decades, according to the company.

Additionally, ergonomics and safety are important features that furniture manufacturers continue to offer in their latest products as evidenced by a new offering from GLOBALcare. The company offers Nourish, a patient chair developed in consultation with health care pro­fessionals. The chair accommodates a variety of body types, sizes and mobility issues.

The T7 is the latest addition to the TouchPoint series of mobile technology carts from Humanscale. The T7's auto fit technology instantly adjusts the unit to the caregiver's entered height and allows users to work in an optimized ergonomic position with minimal effort. Power track steering enables caregivers to maneuver easily in tight spaces and corridors.

Style is still desirable, but not at the expense of infection control and durability. Carrara seating from Kwalu is a "blend of contemporary design elements, stylish sophistication and durability," state company officials. The patented finish is scuff-, scratch- and water-resistant and engineered to withstand stringent infection control protocols.

Finally, KI also is committed to selecting materials that support the cleaning standards within health care, according to the company. The Soltíce Collection features a new arm design with sweeping angles and modern style. The collection is built to withstand stringent cleaning practices.

Jeff Ferenc is senior editor for Health Facilities Management magazine.