Holly Ewing

Holly Ewing (Image credit: Meredith Comley)

Pediatric units can be scary places for young patients. There may be unfamiliar adults in the room, bright exam lights, intimidating medical equipment, strange noises, and sterile surfaces.

These factors combined with the disruption to routine and lack of familiar comforts from home, or the very fact that the young patients are ill and potentially medicated, can make these spaces feel very overwhelming to children.

Tackling the emotional realm of care in a pediatric unit is a challenge, one that compounds the already high demands (durability, infection prevention, and efficiency) of a healthcare environment.

Despite these challenges, prioritizing the holistic well-being of pediatric patients remains a worthy challenge.

Pediatric units must be safe and resilient, but they also should be playful.

Lying in a bed away from friends, sick, sad, and dwelling on all the fun they’re missing can be hard on a child. This puts the child’s mental health in a negative place that is not conducive to healing.

Using positive distractions, visual stimulation, and passive play to create a playful experience that lets kids be kids, designers can nurture a more positive mental state that will improve the child’s healing journey and help them feel more normal while in a not-so-normal place.

Visual elements for pediatric units

Pediatric units serve a wide patient population that can range from newborns to teenagers, so project teams need to strive for design strategies that are child friendly without being childish to appeal to everyone, including parents. A theme of Disney cartoon characters or nursery rhymes, for example, may not only alienate older children but also raise doubts in the quality of care being provided. Elevated design implies elevated healthcare.

To uplift everyone within the space and create vibrancy without overstimulating patients, designers can incorporate a variety of visual elements into the environment. Thoughtfully curated art, potentially from a local artist and reflecting the local environment or other familiar scenes, brings benefits like stimulating cognitive function and aiding wayfinding by creating memorable moments.

Imaginative supergraphics can also provide positive distraction with “seek and find” art, for example, and transform a hallway into a friendlier passage. Specialty lighting—twinkle lights are a good example—activates the space and stimulates the viewer without overpowering a room.

Interactive spaces are also beneficial, creating little moments of wonder along a patient corridor. For a recent project with Renown Health Regional Campus in Reno, Nev., Perkins&Will turned a small alcove into a shadow puppet niche, adding silhouettes of native animals and hands showing how to shape them.

With a multicolored light mounted overhead, the niche is mentally stimulating, playful, and colorful without requiring patients to touch a surface or move around too much. Another interactive idea is a themed or decorated reading nook that allows kids to curl up and feel safe. This also provides a photo opportunity to share images with loved ones at home.

Nature-inspired interior design strategies

Research shows that exposure to nature-inspired visuals can reduce stress and anxiety in patients as well. Designers can integrate nature in a variety of ways.

Soft curves and organic patterns can be incorporated into floor patterns and around nurses’ stations. Design teams can select artwork for the walls or create custom graphics of local landscapes for high-impact rigid sheet and glass film. Nature-inspired shapes such as leaves can be cut into solid surfaces or projected onto the ground with lights.

Dynamic and diffuse lighting can also be used to help imitate nature, such as circadian rhythm lighting that can double as a healing tool to help regulate newborns in a neonatal intensive care unit (NICU) or light through a perforated ceiling mimicking dappled sunshine.

For the project in Reno, patient rooms feature sunset gradients in headwalls and twinkling overhead lights that are designed to transport children from a hospital to a campground under the stars at Lake Tahoe. Super-graphic, rigid-sheet murals on the footwalls include images of turtles, rabbits, and owls that patients can look for while lying in bed.

This subdued meadow theme is amped up in the corridors with bright saturated colors, “seek and find” murals with more local animals like foxes and deer, and custom abstract paintings.

Embracing regionalism in this way, with recognizable creatures (avoiding anything frightening), brings comfort to children and parents seeking the familiarity of home, while also sparking their imaginations.

Built-in gaming and music therapy

Alongside the positive distraction and imaginative escape provided by child-oriented visuals, games are also important. Designers can customize wardrobes to fit a video game console, cutting out vents to prevent equipment overheating.

It is prudent in this case to work with the facility’s information technology department to create a separate secure network for game play that doesn’t overload the hospital’s network or potentially expose it to hackers.

Integrating infrastructure for cameras can also serve a dual purpose—allowing in-room medical teleconferencing between patients and specialists or patients and family members, as well as interactive video game play with friends and siblings at home or other patients in the unit.

Music is another therapeutic activity that can be built into pediatric spaces.

Creating a music therapy destination within the hospital can significantly impact the emotional well-being of children, especially those in the unit for a long period of time, by lowering blood pressure, reducing heart rate, relaxing tense muscles, and reducing anxiety and depression.

In these spaces, children can play instruments, record and edit their music in a sound booth, and see others perform. Acoustical panels and angled walls help with acoustics in the recording room.

It’s also desirable to install the room away from the patient floor, ideally off a corridor that’s wide enough to accommodate multiple children arriving at one time, so it can feel like a destination.

Balancing safety and infection prevention needs

Recognizing that children like to touch, pull, and explore, project teams also need to ensure their design prioritizes safety within a pediatric unit, including specifying furniture and millwork with soft edges and properly secured items. It’s also important for spaces to support visibility between staff members and patients.

For example, glass partitions between bays in a NICU and from the corridor to the bays support faster and more coordinated responses from healthcare teams while increasing a general sense of security for the child’s guardians. These glass partitions can be overlaid with colorful graphics—such as meadows, dragonflies, and mountainscapes—to keep the unit from feeling sterile.

In public areas, semi-transparent dividers with openings can create a sense of privacy without giving children a place to hide out of sight.

Playful, interactive spaces and infection prevention are not mutually exclusive, even in this post-pandemic world. As mentioned above, projected light is a great tool for touchless play that captures children’s imaginations without covering toy parts with bacteria.

In addition to universally helpful infection prevention measures including integral blinds and seamless rubber flooring, designers can install art that is engaging but remains clean behind the glass of a shadow box.

Graphics on rigid sheets protect walls with material that is easier and faster to clean. For example, on the Reno project, designers mounted 3-D butterflies, dragonflies, and leaves mounted to the walls in a swirly pattern using screws, so the pieces  can be removed if needed.

Designing to support young patients

A sick kid is still a kid. Supporting a curious and imaginative mind with visual stimulation and passive play opportunities helps soothe and engage without encouraging a spread of germs.

Done right, it also supports parents and staff through difficult times as they care for the littlest of patients.

Holly Ewing is senior interior project designer at Perkins&Will (Dallas) and can be reached at holly.ewing@perkinswill.com