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CHRISTUS St. Joseph Villa Marian Center

March 1, 2004
by root
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Salt Lake City
Modern healthcare facility design attempts to create environme nts that are as pleasant and welcoming as possible for patients. Design for a geropsychiatric healthcare facility, however, bears an added b urden of meeting a demand for maximum patient safety. As professionals in the field know all too well, an environment that leaves open the p ossibilities for self-harm can be the patient’s (and administrator’s) worst enemy.

The Marian Center is the licensed gero ntological-psychiatric specialty hospital component of CHRISTUS St. Joseph Villa, a continuing care retirement community offering skilled nu rsing, assisted living, and independent living apartments, as well as a dementia unit, in Salt Lake City. The Marian Center component was co mpleted in 2002. It was a remodeling of the adult day-care spaces of a 1995 main building addition to this 45-year-old facility.

In d esigning the Marian Center, which houses up to 12 private-pay and Medicaid patients needing intensive monitoring for stays lasting up to ten days, our firm incorporated many protective elements in what otherwise appears to be a cozy lodge with a fireplace and reasonably comfortab le rooms. A brief review of these will show why design for mental healthcare facilities, particularly a geropsychiatric hospital such as thi s, might well be an architectural subspecialty unto itself.

In the common room, the faux fireplace (it actually masks a structural co lumn) has real logs and grates inside (not pictured), because families appreciate this visual touch—but they are bolted securely to th e fireplace to ensure complete immobility. The lighting on the high ceiling in the common room has vandal-proof coverings. The kitchen is no t a full-preparation kitchen, and the attractive flooring in the dining area is real wood laminated into resilient flooring.

Just off the common room is a seclusion room—used for the short-term observation and safety of agitated patients—with a 10-foot ceiling, thick plywood walls, wall-mounted fixtures, a low bed, and no chair. A floor drain in the center of the seclusion room allows for easy clea ning with a locked-away hose. One wall of the room contains a safety-glass observation window that can be closed off with a draw curtain. Th e bathroom for occupants is located off the corridor entry so that the patients will have both secure monitoring and privacy.

The fac ility includes four private rooms and four semiprivates, alternated to create small alcoves to encourage patients to come out of their rooms and socialize. Inside the rooms the beds are secured to the floor, and there are no ceiling lights or door hardware that can be looped arou nd with rope or a belt. Draperies are hung with pop-off clips on breakaway curtain rods. The same thought went into designing the wardrobe, which accommodates only folded clothing; hangers and hanging bars pose too great a potential for harm. Likewise, there are no pull cords for nurse call; the facility depends upon the nurses making regular visual observations of the patients.

In the bathroom, grab bars have a solid plate at the bottom, leaving no space between the bar and the wall; the paddle-type hardware is turned down to avoid looping; and t he toilet paper spindle even requires a key for removal. The mirror is stainless steel.

High-strength safety glass is used in all of the window glazing, French doors, and sidelights.

In short, this is a homelike residential facility that is not a typical home. The d esign was intended to help patients reintegrate into society under the safest circumstances possible. BHM
John E. Pace, AIA, ACHA, is a Principal Architect at Pace Pollard Architects, LLC. For more information, call (801 ) 531-1133 or fax (801) 531-1211.