Behavioral health settings guided by strict safety design measures often result in spaces that are stark, plain, and isolated-potentially exacerbating environmental stressors and escalating already difficult patient situations. Acute care emergency settings have a particular set of challenges as EDs are predicting increased visits from behavioral health patients. As a result, designers and caregivers are challenged at providing solutions that meet the needs of a diverse behavioral health patient mix, while designing a space that is non-institutional and calming to patients.

Faced with the challenge of designing a behavioral health care setting in the Emergency Department at UnityPoint Health in Rock Island, IL, the project team hypothesized that the creation of a Crisis Stabilization Unit (CSU) with a “Living Room Concept” would provide a higher quality of care to patients while assisting in the staff’s ability to quickly consult and treat a diverse set of patients entering the ED. The CSU was created for the purpose of separating the escalated behavioral health patients from the main Emergency Department in order to better address their unique needs and avoid unnecessary inpatient admissions to the hospital. The “Living Room” is a large consultation room within the CSU that looks similar to a home living room --complete with wood millwork, comfortable seating, artwork, a dining room table, and a large salt water fish tank to promote relaxation. The design was intended to be a space where patient peer counseling can occur when appropriate, along with simultaneous caregiver and family care. As part of this project, a multiyear research study will develop and test a synergistic theoretical model for how structure and process determinants are linked to improvements in patient and staff satisfaction, quality of care, safety and legal and financial targets. Data will be compared pre- and post-occupancy through paired t-test analysis of hospital metrics, observation, and qualitative analysis of staff and patient focus groups.