Recognizing a growing need for behavioral healthcare services, Forbes Hospital in Monroeville, Pa., part of the Allegheny Health Network (AHN; Pittsburgh), had established 2,000 square feet within its emergency department (ED) to help treat the approximately 2,300 behavioral health patients it sees each year in the ED.

The space included three exam rooms and a private consultation room in the interior of the ED. However, the existing space wasn’t purpose-designed to meet the specific needs of behavioral health patients, lacking antiligature fixtures, safe building materials, and adjustable lighting to meet different patients’ sensory needs. Additionally, the layout presented safety and security concerns, making it possible for staff to get backed into corners, and entry/exit doors that were susceptible to patient elopement.

“We really wanted to change the whole nature of the space,” says Dr. Mark Rubino, president and CEO of Forbes Hospital and a physician at the hospital. Specifically, he notes the facility sought a more calming environment designed to help de-escalate potential crises and reduce the use of restraints with behavioral health patients.

That renovation effort received the Innovation and Transformation Award in the International Interior Design Association’s 2024 Healthcare Design Awards.

Balancing staff safety and behavioral health standards

Unable to expand the department, IKM Architecture (Pittsburgh), the architect and interior design firm on the project, instead was tasked with modifying the existing space, including enclosing the behavioral health unit with a sally-port entry/exit to reduce the risk of elopement and minimize the number of staff needed in the suite.

Balancing patient and staff safety while bringing the department up to current standards for behavioral health environments, the project team also retrofitted the three exam rooms with padded walls to create seclusion rooms; repurposed a staff bathroom as a patient bathroom with antiligature fixtures, a shower, and toilet; and modified two existing ED exam rooms near the suite so that they can flex to behavioral patient treatment spaces.

Social and treatment space

One of the biggest changes is the creation of a milieu that can serve as a social and treatment space for groups and patients not requiring seclusion or those waiting for a bed in the hospital’s inpatient unit for behavioral health patients, says John Keelan, IKM’s principal in charge of the project.

Housed at the back of the suite and in full view of the nurses’ station, the calming setting features a floor-to-ceiling wallcovering depicting a lush and flowering Pennsylvania forest, recessed ceiling lights, and ambient sidewall cove lighting that can be adjusted to mimic the sun and sky at different times of the day. To give behavioral health patients a sense of control over their environment, the environment offers a variety of seating options, including an alcove with bench seating and three reclining armchairs.

Keelan says it’s “a space that says ‘you’re going to be OK’ and ‘you’re going to be take care of’ in a social environment, under the watchful eyes of staff, with people who are going through similar things that you’re going through.”

Robert McCune is senior editor of Healthcare Design and can be reached at [email protected].