Healthcare Design - June/July 2020 - 34

configured to provide a functional layout. By using existing space, the
$1.1 million UIHC CSU was completed in only eight months after the design process began, opening in October 2018.
D E S I G N D E TA I L S

Prior to opening the unit, the only two options for behavioral health
patients seeking care in the ED were early and immediate discharge or
inpatient admission. Additionally, there was no dedicated psychiatrist
and the ED didn't include ligature-resistant furniture, fixtures, equipment, or spatial considerations to accommodate these patients' safety.
Now, when behavioral health patients arrive in the ED, they receive any
necessary stabilization and can then be taken directly to the CSU, which
is designed with features to address the safety needs of both patients
and staff.
Located on the seventh floor, the 3,185-square-foot unit is organized
with spaces identified into three risk occupant zones, each with appropriate design features. For example, high-risk areas comprise spaces
where patients can be alone, such as a calming room or bathroom, and
are built to the maximum level of safety with inaccessible ceilings and
ligature-resistant fixtures and furniture. Areas of medium risk, including
the open treatment area and interview rooms, are where patients are always under observation of staff. Here, furniture is weighted and fixtures
are tamper resistant, but ceilings are accessible and not all items are necessarily ligature resistant. Staff-only areas are deemed low risk and are
built with typical construction methods.
The main treatment room features 12 recliners with 110 square feet of
clear area dedicated to each recliner in a communal setting, providing patients with the freedom to move about the room and interact without confinement or restraint. An open provider station helps the staff and patients
feel unified and partnered rather than separated during treatment. Furthermore, to encourage socialization and avoid patient degradation that's

34

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2/9

The University of Iowa
Hospitals and Clinics'
behavioral health crisis
stabilization unit features calming graphics
on the walls, windows
controlled by integral
shades to bring in natural daylight, and dimmable lighting to create
a calming and inviting
setting for patients.

often related to isolation, care is delivered in
the open treatment area instead of assigned patient rooms.
The unit also has two calming rooms where
distraught patients can be isolated at will or with
intervention. Although the goal is not to have
patients deteriorate to the point of needing an
isolated calming room, these rooms are imperative to help de-stimulate an individual patient or
to settle situational escalation that could be triggered by social conflict.
By providing an openly social platform with
opportunities for games, television, and puzzles, the CSU maximizes patient choices and
welcoming inclusive interactions. Other patient amenities, such as a washer/dryer, shower, personal storage lockers, toilets, and activity
areas, are located off the open treatment area to
give patients a sense of independence and normality while they're in the unit, a critical step in
quicker stabilization and recovery. Additionally, the open design features calming wall graphics, soft pastel colors, and views to the exterior
to sooth patients and reduce anxiety or a sense
of confinement.
Many safety considerations are integrated
into the behavioral health CSU design, as well.
The unit is fully separated from other areas of
the hospital by a secured vestibule, and patients
are brought to the unit from the ED triage area
by hospital staff. Patients are then evaluated and
processed in the interview/intake rooms prior to
being received into the CSU.
Private conversations about patient treatments can occur in a team workroom located
behind the provider station, while still allowing
staff to maintain visual observation of the unit
through a window. Additional design features
include pick-proof sealant, weighted furniture,
secure TV enclosures, and exterior windows
with acrylic shatterproof protection. Ligatureresistant grab bars and fixtures, nonbreakable
mirrors, and the elimination of cords or pull devices that could be used as weapons or for selfharm are also integrated into the design.
LESSONS LEARNED

After opening its CSU, UIHC saw a 25 percent
decrease in behavioral health inpatient admissions, based on the unit's ability to buffer
patients needing more extended stabilization
time. The CSU also decreased behavioral health
inpatient boarding time from 28 hours to six
hours due to fewer patients being admitted. Additionally, UIHC saw a universal decrease in the
number of transfers and in the number of emer-

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Healthcare Design - June/July 2020

Table of Contents for the Digital Edition of Healthcare Design - June/July 2020

Healthcare Design - June/july 2020
Editorial
Show Talk
Homeward Bound
Take Five With Tammy Felker
First Look
Into the Light
Difference Maker
Planning and Operations Decompression Space
Staff Spaces Building Alignment
Productspotlight Behavioral Health
Product Spotlight Artwork
The Center
Face Time
Healthcare Design - June/July 2020 - Healthcare Design - June/july 2020
Healthcare Design - June/July 2020 - Cover2
Healthcare Design - June/July 2020 - 1
Healthcare Design - June/July 2020 - 2
Healthcare Design - June/July 2020 - 3
Healthcare Design - June/July 2020 - 4
Healthcare Design - June/July 2020 - 5
Healthcare Design - June/July 2020 - 6
Healthcare Design - June/July 2020 - 7
Healthcare Design - June/July 2020 - 8
Healthcare Design - June/July 2020 - Editorial
Healthcare Design - June/July 2020 - Show Talk
Healthcare Design - June/July 2020 - 11
Healthcare Design - June/July 2020 - 12
Healthcare Design - June/July 2020 - Homeward Bound
Healthcare Design - June/July 2020 - 14
Healthcare Design - June/July 2020 - 15
Healthcare Design - June/July 2020 - First Look
Healthcare Design - June/July 2020 - 17
Healthcare Design - June/July 2020 - Into the Light
Healthcare Design - June/July 2020 - 19
Healthcare Design - June/July 2020 - 20
Healthcare Design - June/July 2020 - 21
Healthcare Design - June/July 2020 - 22
Healthcare Design - June/July 2020 - 23
Healthcare Design - June/July 2020 - 24
Healthcare Design - June/July 2020 - 25
Healthcare Design - June/July 2020 - Difference Maker
Healthcare Design - June/July 2020 - 27
Healthcare Design - June/July 2020 - 28
Healthcare Design - June/July 2020 - 29
Healthcare Design - June/July 2020 - 30
Healthcare Design - June/July 2020 - 31
Healthcare Design - June/July 2020 - 32
Healthcare Design - June/July 2020 - Planning and Operations Decompression Space
Healthcare Design - June/July 2020 - 34
Healthcare Design - June/July 2020 - 35
Healthcare Design - June/July 2020 - Staff Spaces Building Alignment
Healthcare Design - June/July 2020 - 37
Healthcare Design - June/July 2020 - Productspotlight Behavioral Health
Healthcare Design - June/July 2020 - 39
Healthcare Design - June/July 2020 - 40
Healthcare Design - June/July 2020 - 41
Healthcare Design - June/July 2020 - Product Spotlight Artwork
Healthcare Design - June/July 2020 - 43
Healthcare Design - June/July 2020 - 44
Healthcare Design - June/July 2020 - 45
Healthcare Design - June/July 2020 - 46
Healthcare Design - June/July 2020 - The Center
Healthcare Design - June/July 2020 - Face Time
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