• Article
  • April 27, 2018

Hospital Room Design Strategies to Keep Behavioral Health Patients Safe

A facilities expert discusses room design strategies to keep behavioral health patients and caregivers safe.

Many children's hospitals report an average of two to three emergency department (ED) visits a day from patients presenting with a behavioral health issue. Making the hospital safer for patients and providers is taking on a new importance. Chet Howard, CHFM, facilities operations director at Arkansas Children's Hospital in Little Rock, discusses how hospitals can minimize risk for pediatric patients and staff members.

What is the one thing hospitals need to know about this topic? General medical/surgical inpatient settings do not need to meet the same standards as inpatient psychiatric centers to be a ligature-resistant environment. Patients with behavioral health-related issues who are admitted to medical/surgical facilities require specialized medical equipment to treat their medical condition, so not all ligature risks can be removed. The idea is to assess and identify the patient's risk of self or staff harm and remove or mitigate as many of those risks as possible.

Why do hospitals need to make rooms safer? Hospitals across the country have seen an increase in patients with behavioral health-related issues. This includes hospitals that do not have a dedicated behavioral health inpatient facilities and staff. This vulnerable population of patients may need additional measures to keep them safe while they are in our care.

Suicide is now the 10th leading cause of death in the United States. While the vast majority occurs outside of health care facilities, many still occur within health care facilities every year. Safer rooms, along with training, are important to keep our caregivers safe, too.

What steps did Arkansas Children's take to create safer rooms? Arkansas Children's recently renovated two inpatient bed spaces designed specifically for general medical/surgical inpatients who also have behavioral health-related issues. These rooms are not intended to be full psychiatric care rooms but are designed to be "safer" rooms where ligature points and other risks of harm have been removed or mitigated to the extent possible.

Some of the features include doors that open into the corridor, ligature alarms on doors, bathrooms that don't lock, ligature-resistant plumbing fixtures, protected medical gas and electrical outlet systems, tamper resistant sprinklers and HVAC vents, 1-to-1 monitoring windows for nursing staff, exterior lighting and water controls, and more. We also have two "safer" exam rooms in our emergency department with similar features.

To learn more about hospital room design strategies, listen to Making rooms safer though facility design. Send questions or comments to magazine@childrenshospitals.org.