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A New Hospital for Modern-Day Psychiatric Care

March 1, 2004
by Richard Abbott, AIA
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Patient privacy was an impo rtant design consideration for Sheppard Pratt’s new hospital
by Richard Abbott, AIA
Sheppard Pratt Health System, Maryland’s largest behav ioral health services provider, is constructing a new psychiatric hospital with 192 all-private rooms—perhaps the first of its kind in the nation—to replace its existing acute inpatient hospital located on its 110-acre campus in Towson, Maryland. Sheppard Pratt’ s goal is to build a state-of-the-art hospital that supports and facilitates the modern-day practice of psychiatry. To achieve this, the new Towson hospital was designed to convey the institution’s reputation as one of the nation’s top psychiatric facilities, expresse d both in its patient care and in a new physical environment dedicated to patient privacy and healing.

Scheduled for completion in De cember, the new structure will complement the historic hospital’s Victorian architectural character and provide patients the utmost pr ivacy and quality. It will be connected to the current hospital, which will be renovated for administrative, clinical, and residential progr ams. The hospital complex, including the new structure and renovated buildings, will total 240,000 square feet.

This project just did n’t develop out of thin air. Sheppard Pratt conducted an assessment process and identified design objectives to meet its goal of build ing a hospital that supports and facilitates modern-day psychiatry.

Psychiatry’s Changing Environment
Sheppard Pratt’s existing hospital was founded 112 years ago following in the tradition of the nation’s first freestandi ng private psychiatric hospital, Friends Hospital, started in 1813 by Quakers. The spirit of social responsibility in providing behavioral h ealth treatment infused Sheppard Pratt as it grew into a large system operating two psychiatric hospitals, as well as special education scho ols, residential treatment centers, day hospital programs, outpatient mental health centers, and other related facilities.

The origin al 322-bed Towson hospital, Sheppard and Enoch Pratt Hospital, has been dedicated to providing intense therapeutic assessment, intervention, and treatment for patients of all ages whose symptoms of mental illness meet the criteria for inpatient hospital care. Specialized care uni ts include adult crisis stabilization, short-term treatment, addictions, psychiatric disorders, trauma, geriatric, and pediatric.

As the practice of psychiatry has been forced to change in the face of low health insurance reimbursements, hospital beds for behavioral health patients have been disappearing throughout the nation. Psychiatric and chemical dependency patients and their families are finding it incre asingly difficult to find centers for acute care. In assessing the existing hospital, Sheppard Pratt made a commitment to expand the availab ility of private acute care for behavioral health patients: The new facility will serve more than 6,000 patients annually. Respite care beds will be available in the renovated facility.

Design Objectives
With numerous areas for improvement i n mind, Sheppard Pratt and its architects (HDR Architects, Inc., and Robert A.M. Stern Architects) planned the new private hospital as the c onsummate setting for the humane treatment of mental illnesses. The primary goal was to continue Sheppard Pratt’s tradition of providi ng quality care to patients afflicted by behavioral health problems.

In the existing hospital, shared patient rooms are compounded by circulation patterns that allow traffic to pass through some units to reach others, as is the case in most aging psychiatric facilities. Ro om visibility is also lacking; some patient rooms are not easily monitored. Visitors and patients share the same circulation routes, potenti ally hindering the confidentiality of health treatments.

The new design creates one of the nation’s first—if not the first—all-private-room psychiatric hospitals. The patient admissions process will be separated from family and visitor access and u se private rooms for physical and psychiatric evaluations. Family members will enter the hospital and access a waiting area outside of the p atient unit. Patients and family will be reunited before entering the patient’s unit. A dual corridor system will serve all units so s taff and services can circulate without encountering public traffic. Each unit will be set up so that staff have clear visibility of all pat ient rooms from the nurses’ station, visibility into the next nursing unit if doors are opened, and visibility of the entrance to the unit. Sight lines from the nurses’ station also will be established to common areas and seclusion rooms.

Each private patient r oom is designed for comfort and livability, sized approximately 10 × 14 feet, plus an adjoining individual bathroom and shower. Each ro om will have a 10-foot ceiling and a 3 × 7-foot window to allow for panoramic views and ample daylight. Furnishings and finishes were s elected to create a residential atmosphere in the patient rooms, in balance with the safety of patients and staff. Safety features will incl ude breakaway shower curtains to deter suicide attempts, card access controls, egress controls, electronic locking mechanisms, and intrusion detection devices. The overall result is aimed to be an environment that encourages healing and good mental health.

The new hospital will have 11 different units of patient care, ranging from seniors to children. Each dedicated area will offer the most appropriate treatme nt of a wide range of behavioral disorders.