Walls are Moving in Healthcare

by Beth Leibson

When Burnaby Hospital wanted to build maximum flexibility into its newly renovated 7,000-sq.-ft. outpatient arthroplasty clinic, it turned to a mobile wall solution.

The clinic represents a new model for the community-based hospital, in Surrey, British Columbia, Canada. The new model will provide pre-surgical educational counseling and post-surgical physical therapy to patients with hip and knee replacements.

The New York Congregational Clinic uses DIRTT Walls, as installed by Lane Office Furniture.

“Burnaby Hospital’s expansion of hip and knee surgeries supports the action we are taking across the province to invest in greater access to hip and knee surgeries,” said Health Services Minister George Abbott in a prepared statement. “Since 2001, we have performed 118% more knee replacements and 58% more hip replacements in B.C. and cut the provincial median wait time for hip and knee surgeries.”

Not only was the healthcare model new, but so was the approach to design and construction, explains Don Mah, Manager of Capital Projects Implementation at Lower Mainland-Facilities Management Team.

“The modular wall system is the major component of the clinic,” says Mah. “My game plan was to incorporate as much flexibility as possible into the space. Fully 80% of our clinic is the DIRTT wall system.”

A moving trend

Burnaby Hospital is not alone in turning to movable walls. While the construction industry has been hit hard by the recession, movable walls–at least in the healthcare arena–are doing fine.

“In the past, clients have not always used movable walls because of the initial cost factor,” says Mindy Graves-Ajami, IIDA, LEED AP, EDAC, at design/architecture firm Nashville, Tenn.-based Gresham, Smith, and Partners. “But they’ve started to get a little wiser and realize that the upfront cost may be higher, but all they need to do is move one wall and they’re saving money.”

The Queens Hospital in Queens, New York, had DIRTT Walls installed with Lane Office Furniture.

In fact, some manufacturers are seeing a boost in sales. “We’ve seen a 35% increase in activity over the course of 2009,” says Peter Hamm of Calgary, Canada-based manufacturer DIRTT. “We’re not necessarily getting more projects, but we’re getting a larger percentage of the projects,” he adds. “And we expect the growth to continue through the rest of this year.” Other manufacturers are also seeing a boost in healthcare movable walls. “We’ve seen an uptick in interest, response, and application,” says Shawn Green, Vice President of Product Management of Green Bay, Wisconsin-based KI. “There’s been in increase in interest and an increase in sales.” In healthcare facilities, technology is usually the biggest challenge, says Moore. “You don’t know what you will need in one year, much less in five years.” When power, voice, and data needs change, facilities managers may need to cut into a wall to address it. And that approach is much easier with movable walls than with drywall. “Especially if a unit changes functionality or acuity level,” adds Moore. “I know one hospital where they put surgical tape over an obsolete med gas outlet to make sure no one uses it.”

Hospital hospitality

“As the population ages, patients have higher expectations for healthcare facilities,” says Hamm. There is a greater emphasis on hospitality. Hospitals are also placing more emphasis on family visitors, he adds. They want spaces for overnight stays and for family members to use their laptops.

“We’re seeing more private rooms, more of a hospitality esthetic than a clinical environment,” says Hamm. “Hospital rooms feel more like a hotel suite,” he explains. “And that means paying more attention to finishes and wood veneers. People want to feel comfortable in healthcare facilities.” Mah found that movable walls enabled Burnaby Hospital to provide hardwood veneers and warm, natural earth tones. “We wanted an environment conducive to healing and comfort,” he explains.

A hospitality focus does more than just attract patients, says Moore. “In these days of nursing shortages, the interior environment affects staff satisfaction and can help attract talent to the facility.”

But hospitality cannot mean delicate. “Healthcare facilities put a lot of wear and tear on walls,” says Mah. “We have a lot of equipment carts, supply carts, and linen carts going up and down the halls.” The walls have to be tough enough to handle it. “We added a lot of bumper rails and corner guards to the standard walls,” Mah explains.

Speeding it up

In the healthcare arena, design processes are often extended. Between operational and medical personnel, teams are large—and when the goal is saving lives, the stakes are high. Movable walls are easier and faster to install because the product comes ready to install, so multiple trades (such as flooring, ceiling, and HVAC) can work simultaneously. There is no cutting or construction required; many movable wall systems have no more than five to seven parts. These products can also enable companies to respond more quickly to design changes. “During construction of the clinic, we made a programming change to one office,” says Mah. “We had to add an extra door to provide patient access.” Traditionally, that would have involved demolishing a wall, hauling away the debris, and constructing a new door and frame. “But within 24 hours, the door was there,” says Mah. “That flexibility is key—because change is inevitable.”

Lane Office Furniture also installed DIRTT Walls at The New York Eye & Ear Infirmary.

In addition, suggests Moore, because movable walls provide power, voice, and data access in the walls, installing them requires less need to go into the ceiling. By keeping trades people off ladders, she says, there are fewer on-site injuries.

Quality IAQ and sound

Movable walls offer quick changeovers with less disruption to employees and patients and seriously diminish indoor air quality (IAQ) concerns. Building, or renovating, with drywall,  inevitably leads to off-gassing and, even more troublesome, dust and debris.

“It doesn’t matter how large an area you isolate when you’re using drywall,” says Sue Schmidt, Sue Schmidt, CPM, QOE, Facilities at Nashville, Tennessee-based Healthways. “The dust and dirt gets everywhere.” Movable walls, by contrast, are much cleaner.

And movable walls lower the noise level during construction, making the process less disruptive to patient sleep. Recent studies have shown that noise levels in healthcare facilities can affect patient outcomes. “We were able to make a change during construction with no impact on patients or staff,” says Mah.

Niche spaces

Burnaby Hospital is a trend setter; most of the increase in movable walls has been outside of patient rooms. “Most of the increase is in niche spaces,” says Rob Wittl, General Manager, Walls at KI. “Specifically, healthcare institutions are opting for glass doors on patient rooms and alcoves for private spaces.”

KI’s Genius Walls offer a Sound Transmission Class (STC) of 44-48 and have slotted uprights that easily integrate with furniture in healthcare environments and facilities.

Registration areas are another popular use, says designer Graves. “It offers flexibility for future growth.” Some institutions are also using movable walls in imaging areas, “particularly in the read rooms where physicians read imaging on computer monitors,” says Graves. “The technology is constantly changing,” she adds, “so hospitals want flexibility for future growth or new equipment. Often people who consider using movable walls worry about the up-front cost, which can be higher than with traditional drywall. But that is not always the case. “For this specific project, the budget seemed quite good,” says Mah. “It cost marginally more, at best.” And then there is the issue of future savings… “Movable walls are more sustainable from the long-term perspective,” says Mah. “It is definitely a value-add for future projects.”

The verdict is in

“The clinical and operational staff is all very impressed with the system,” says Mah. “It has been very well received by a lot of people in the hospital.” And Mah himself? “I’m considering using the system for another project, which will be about 18,000 sq.ft.”