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At Boys Town Hospital, experience aids design

November 1, 2013
by Shannon Brys, Associate Editor
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As experiences are had and shortfalls are noticed, lessons are learned for future mistakes to be prevented. This is true in life, but also more specifically, in facility design. The staff at Boys Town Hospital had been in the planning stages for about seven years for the new residential facility that opened mid-September.

The plan was originally to have this facility replace the existing facility, but after evaluating and finding that the new facility has 34 beds, and there were 45 children in the existing program with a large waiting list, the decision was made to open the new facility and continue the older facility at a smaller census.

Art Smith, senior project manager at Leo A Daly, the architecture/engineering firm that designed the new 32,000 square foot facility, says that although there is plenty of information available on construction techniques and design for behavioral health facilities, the most helpful part of the process is staff input.

“There are a lot of tried-and-true building systems out there, but I think what really helped us as designers was the fact that the Boys Town Hospital staff has had so much experience with their existing facilities. They were just a wealth of information as far as how they wanted to see the structural and physical components come together,” Smith explains.

Throughout their years working with children 5-18 years old with severe behavioral and mental health problems, the staff at Boys Town Hospital realized that the following areas were requirements for the new facility:

  • Durable, vandal resistant systems
  • Easy to maintain features
  • Patient safety/security
  • Space for play/activity
  • Natural light
  • Flexibility for current and future uses

Vandal-resistant design

In the past, program staff experienced a consistent problem with patients causing damage to facilities. For example, children found ways to hit and break sprinkler heads, releasing water and sometimes flooding areas. So, the new residential facility was built with a two-stage sprinkler system: If one of the heads does get broken off, the water doesn’t release until the system receives a second signal from a fire or smoke detector.

Dennis Vollmer, director of the Boys Town Hospital, explains that protecting other facility plumbing from vandalism was a major concern for his. All of the plumbing is locked tight and not exposed or available to children—only maintenance. Additionally, children in facilities like this often try to vandalize facilities by plugging up toilets or sinks and flooding the facility so the design team added an extra drain in the bathroom floor in addition to the shower drain.

There was also a hook of sorts installed in the plumbing of every bathroom so if a child tries to stuff a towel or piece of clothing down the toilet, staff have access via a trap door to pull out a chain that would catch that towel or clothing before it is able to plug up the entire system.

The ceilings in the previous facility were also an area for improvement. From experience seeing children climb up into the tile ceilings, wreck the tiles, and mess with the wiring, the ceilings in the new facility are all at least nine feet tall. 

Because children tend to slam doors which can cause a great deal of maintenance problems, installed in the new facility were 3 to 4 inch rubber bumper guards behind all of the doors. Additionally, behind every wall in areas where children are present, there is ¾ inch plywood from floor to ceiling. This prevents the children from being able to punch holes in the walls. Although the cost is certainly more up front to install thick plywood behind all the walls, Vollmer says the long-term benefit of providing a more maintenance-free environment is worth it.

All of the doors are piano-hinged – having hinges run the full length of the door. “Typically when a door has 3 or 4 hinges, eventually they wear out because there’s a lot of weight bearing on a hinge. Now, the entire hinge is supporting the entire door. This is very durable and minimizes maintenance costs,” Vollmer explains.

Safety first

As the safety of the building is important, even more so is the safety of those inside the building. Staff at LEO A DALY and Boys Town Hospital worked tirelessly to come up with ways to make the new environment as safe to the children as possible.

Bedrooms. All bedroom furniture is bolted down the floor to prevent children from barricading themselves into the room. There is also no access under the beds and motion detectors between the beds so that if someone is moving around at night, the staff is aware and is able to immediately to address any of the issues. Each youth in the program has his or her own wardrobe, but the units have no drawers or doors and have been retrofitted with sloped tops so children cannot climb.

Showers. Vollmer explains that “all handles and showerheads in the bathroom are sloped and stub-nosed so if you attempted to tie something on them it would simply slide off.” The shower curtains have Velcro at the top so it releases easily if an individual tries to use it as a means of strangulation or injury. Also, the towel hooks in the bathrooms can support the weight of towels or clothing, but rotates down if something heavier is attached.