Over the last few years, the types of flooring specified and installed in healthcare facilities has evolved in many ways, as product options available from manufacturers grow to answer healthcare’s complex needs. “When you go into a meeting with a hospital system, there are different people who have different priorities,” says Tiana Lemons, healthcare studio leader at Orcutt|Winslow (Nashville, Tenn.). “The environmental services person is concerned about how easy it is to clean, how durable it is. The CEO cares about the visual effect and how beautiful the space is going to look. So what our challenge is as the designer is to meet both of those requirements and give them a product that meets desires for beauty and durability.”

With more options in flooring than ever before, it’s important for interior designers to keep up on the latest trends, initiatives, and materials to provide their clients with the best products for the project at hand. Here’s a look at some of the shifts designers are seeing in demands for hard surface flooring, in particular, and the products available to support them.

Material preferences
One big change in the last five years has been a move away from high-gloss wax finishes on resilient flooring to more no-wax, matte options, as facilities try to save time and cost on upkeep with products that don’t require frequent waxing, says Jennifer Kenson, principal, healthcare interior designer at FCA (Philadelphia). While high gloss was considered the hallmark of clean floors for decades, Kenson says that facilities staff are recognizing the importance of nixing floor sheen in favor of products that will offer the same durability, cleanability, and aesthetic without requiring re-waxing—a process that takes time to complete and dry, which impacts hospitals’ ability to turn over rooms quickly. “It all comes down to cost and operational times. The no-wax flooring is a great lower-maintenance option,” Kenson says. “In the marketplace, there are more options that people like the aesthetics of, so it helps push the pendulum in that way, as well.”

Part of the move away from high-gloss flooring is also a better understanding of materials by the end user, including the environmental services department, says Lemons. “It’s a lot different than it was 10 or 15 years ago,” Lemons says. “They’re concerned about no-wax flooring and they understand what goes into it. And they’re educating the CEOs above them.” There’s also more awareness of the effects of glare on staff and patients, especially older patients, whose eyes may have trouble adjusting to bright spots.

While sheet vinyl was the go-to for hospital floors for years, tiled products like luxury vinyl tile (LVT) and rubber flooring are becoming more popular within the healthcare sector, providing a low-maintenance, durable flooring option for healthcare interiors that’s available in a variety of styles, finishes, and colors. “The surfaces for LVT have improved the product a lot in terms of scratch resistance,” says Stan Spellman, senior vice president, Spellman Brady & Co. (St. Louis). “The wear surface is much better. It tends to not leave marks and it doesn’t telescope imperfections the same way sheet products do.”

Additionally, the thicker composition of LVT compared to sheet flooring helps it withstand the weight of carts and gurneys while providing a bit of cushion for the staff whose feet and legs experience fatigue on hard surfaces—a balancing act that’s important to achieve. “We need softer floors for nurses, but we have to have harder floors for equipment and patients to be able to roll over,” Lemons says. “Softer floors and equipment don’t usually jibe.”

She notes that several flooring companies are trying to find a solution to soft flooring that’s comfortable for staff while providing the sturdiness and abrasiveness needed to withstand equipment loads. In the meantime, she’s found a solution in rubber flooring tiles, which can also help facilities meet in-house environmental design goals. Rubber flooring, most of which is made from recycled rubber, is a more sustainable product option than traditional sheet vinyl.

Jean Hansen, sustainable principal at HDR (San Francisco), says that sustainability is becoming a bigger issue for clients as they become more aware of the environmental impact of their design choices. There’s also a growing list of available certifications in addition to the U.S. Green Building Council’s LEED program that are affecting the industry, such as the Health Product Declaration (HPD) Collaborative’s HPD Open Standard, which reports product content and associated health information, and the International Living Future Institute’s Declare transparency platform and product database. In 2018, Health Care Without Harm announced its Healthy Flooring Initiative, which defines environmental attributes for healthy resilient flooring in healthcare. “We explain to our clients why [these initiatives] were developed, why they’re critical to consider for human and environmental health, and why we recommend we use that same guidance,” Hansen says.

Evolving aesthetics
New material preferences aren’t the only shift in hard surface healthcare flooring; many designers and facilities are also updating their aesthetic preferences, stepping away from natural-looking materials, such as woods and stone, to more neutral options. “We’ve tried to move away from incorporating wood-look floors throughout a project when we can because there are so many other items that end up having a wood-look finish, like the cabinetry and casework … it ends up being too much wood,” Kenson says.

Instead, she tries to steer clients toward something that’s more timeless, such as rubber or linoleum options, rather than something stylistic, especially in more clinical spaces such as the emergency department. Spellman agrees, saying his firm prefers to keep the flooring more neutral. “We’d rather see the color in the walls and the artwork,” he says. “We keep the flooring fairly nondescript.”

In addition to neutral colors, designers are also moving away from a lot of patterning, which was more prominent in the past. “I see designs for floors are more simplistic,” Lemons says. “We now have more products that are visually pleasing.”

When it comes to finding the perfect hard surface flooring for a healthcare interior, the main concern still comes down to budget. But with a wide variety of options available today that are easily cleaned and found in both neutrals and patterns, it’s easier for designers to find products that will fulfill all of a facility’s needs.

Kadie Yale is a freelance writer based in Iowa City, Iowa. She can be reached at kadieyale@gmail.com.