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New pet Peeve: Do it "the right way"

March 13, 2013
by James M. Hunt, AIA, NCARB
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Lately I have been noticing on several occasions people admonishing others that something is not being done "the right way".  This implies that there is only one way to do that particular thing "right" and that the person speaking is in possession of all possible knowledge about the different ways of doing that "thing" and which is the "right' way in this particular instance.

There is a sign hanging over my desk that contains the "The Fundamentals of Humanics" (by Tom Parker, M.A., M.P. as published in Hospital Topics, May/June 1978).  Number six of the Fundamentals is "A person's way of doing anything is correct as far as he/she is concerned."

I often am asked what is the correct or "right" product or material to use in a general condition.  My standard answer is: it depends on a lot of things.   There truly is no one-size-fits-all solution to anything regarding behavioral health facilities.

Large hospital systems may establish standards that apply to their particular organization and philosophy of treatment.  This is fine for them, but what is "right" for their facilities and patient populations may not be "right" for other organizations whose patient populations or criteria may not be the same.

Determining the "right" way to resolve any question requires information regarding the patient population being served including such things as age, diagnosis, acuity, voluntary or involuntary admission, staffing patterns, culture of facility/unit, and many other considerations.  Some facilities tell me they want a zero risk environment; others are trying to appeal to self-pay patients and want an up-scale look and amenities, and everything in between.

The zero risk environment is not possible to obtain, in my opinion.  My unscientifically reached opinion is that the only way to keep a patient who is determined to commit suicide from being successful is to keep him or her either physically or chemically restrained 24-7-365.  That is not treatment and anything less than that is risk management.  Each facility must determine the right mix of safety and risk that is "right" for its patients.  

Zero risk elements such as toilet fixtures would include a stainless steel toilet fixture with an integral seat, like those used in prisons.  These can result in patients feeling like they are being punished for being ill and may actually delay their recovery.  It is not uncommon to find prison type push button water faucets and shower controls in behavioral health facilities.  These also are carry-overs from the prison type items that do not give the patients control of either water temperature or duration of flow.  So much control is taken away from these patients.  Why not give them the dignity of controlling these things since there are products available that allow for this in a manner that is safe for many patients?

What is the "right" answer for your facility?  The answer will depend on many interrelated factors.

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Jim Hunt

Behavioral Healthcare Design Consultant

Jim Hunt

www.bhfcllc.com

James M. Hunt, AIA, is a practicing architect and facility management professional with over 40...