October 2019
Tool

Overview

Healthcare is moving beyond the walls of the hospital. This is partially due to a growing population of patients who require medical care but are stable enough to be treated at home (including older adults with acute and chronic conditions). Caring for these populations in their own home is more convenient and cost effective than providing that same care in a traditional medical setting. Home environments that support medical care can reduce unnecessary hospitalization, influence health and wellbeing, and help to maintain a person's independence.

The majority of design strategies in the Healthcare at Home diagrams apply to Universal Design U, Aging in Place A, and Healthcare at Home H. Strategies associated with only one or two of these approaches are indicated as such with icons.

Click on one of the dots or the thumbnails below to learn more

  • Pathways

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Smooth, level floor surfaces with minimal variations that allow freedom of movement, especially when navigating with mobility assistance or medical equipment citation
    • Minimize thresholds (less than ¼ inch vertical, or up to ½ inch beveled) citation
    • Avoid glare and excessive contrast and patterns on floors, which can be perceived as or conceal actual changes in level which pose a potential trip hazard. citation
    • Provide wainscot trim that protrudes from the wall and is securely fastened to offer a frame of reference and a touchstone for balance for level surfaces. citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Smooth, level floor surfaces with minimal variations that allow freedom of movement, especially when navigating with mobility assistance or medical equipment citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Smooth, level floor surfaces with minimal variations that allow freedom of movement, especially when navigating with mobility assistance or medical equipment citation
    • Minimize thresholds (less than ¼ inch vertical, or up to ½ inch beveled) citation
    • Avoid glare and excessive contrast and patterns on floors, which can be perceived as or conceal actual changes in level which pose a potential trip hazard. citation
    • Provide wainscot trim that protrudes from the wall and is securely fastened to offer a frame of reference and a touchstone for balance for level surfaces. citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid glare and excessive contrast and patterns on floors, which can be perceived as or conceal actual changes in level which pose a potential trip hazard. citation
    • Provide wainscot trim that protrudes from the wall and is securely fastened to offer a frame of reference and a touchstone for balance for level surfaces. citation

  • Layout - Overall

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    • Clear/turn space at least 5-foot by 5-foot citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Layout that allows for reorganization of space (e.g., easily movable furniture, modular elements) to accommodate changing needs
    • Clear/turn space at least 5-foot by 5-foot citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Layout that allows for reorganization of space (e.g., easily movable furniture, modular elements) to accommodate changing needs
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    Desirable Outcome
    minimize undue strain during recovery
    Design Strategies
    • Layout that allows for reorganization of space (e.g., easily movable furniture, modular elements) to accommodate changing needs
    • Clear/turn space at least 5-foot by 5-foot citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    • Clear/turn space at least 5-foot by 5-foot citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Layout that allows for reorganization of space (e.g., easily movable furniture, modular elements) to accommodate changing needs
    • Clear/turn space at least 5-foot by 5-foot citation

  • Caregiver/Clinical Staff Workspace

    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Designated well-lit clean workstation (e.g., a desk) located in a quiet area away from distractions (e.g., pets, children, visitors) for procedures using sharps or medication preparation A H citation
    • Safe, easily accessible storage for medications (refrigerated, if needed), supplies, and medical equipment A H citation
    Desirable Outcome
    Safety; infection control
    Design Strategies
    • Designated well-lit clean workstation (e.g., a desk) located in a quiet area away from distractions (e.g., pets, children, visitors) for procedures using sharps or medication preparation A H citation
    • Safe, easily accessible storage for medications (refrigerated, if needed), supplies, and medical equipment A H citation
    • Large sharps containers with leak-proof covers H citation
    Desirable Outcome
    Safety; medication safety
    Design Strategies
    • Large sharps containers with leak-proof covers H citation
    Desirable Outcome
    Safety; medication safety
    Design Strategies
    • Designated well-lit clean workstation (e.g., a desk) located in a quiet area away from distractions (e.g., pets, children, visitors) for procedures using sharps or medication preparation A H citation
    • Safe, easily accessible storage for medications (refrigerated, if needed), supplies, and medical equipment A H citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Keep defibrillator(s) close to a telephone in a convenient, central and temperature controlled area, where the visual or auditory "ready" indicators can be seen or heard. A H citation

  • Flooring

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Smooth, level floor surfaces with minimal variations that allow freedom of movement, especially when navigating with mobility assistance or medical equipment citation
    • Minimize thresholds (less than ¼ inch vertical, or up to ½ inch beveled) citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Smooth, level floor surfaces with minimal variations that allow freedom of movement, especially when navigating with mobility assistance or medical equipment citation
    • Avoid deep pile carpet or loose/worn carpet; tack down edges of carpets and rugs; remove loose rugs/mats citation
    Desirable Outcome
    Minimize undue strain during recovery
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Smooth, level floor surfaces with minimal variations that allow freedom of movement, especially when navigating with mobility assistance or medical equipment citation
    • Minimize thresholds (less than ¼ inch vertical, or up to ½ inch beveled) citation
    • Smooth, non-glare, non-slip or slip-resistant flooring citation
    • Avoid deep pile carpet or loose/worn carpet; tack down edges of carpets and rugs; remove loose rugs/mats citation
    • Avoid flooring materials with intricate high-contrast patterns (especially for patients with impaired vision) citation
    • Install soft, resilient interior flooring materials (e.g., cork, rubber, or linoleum) that are gentler under foot than harder materials and can lessen the impact of falls. citation
    • Avoid glare and excessive contrast and patterns on floors, which can be perceived as or conceal actual changes in level which pose a potential trip hazard. citation
    Desirable Outcome
    Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Install soft, resilient interior flooring materials (e.g., cork, rubber, or linoleum) that are gentler under foot than harder materials and can lessen the impact of falls. citation
    • Avoid glare and excessive contrast and patterns on floors, which can be perceived as or conceal actual changes in level which pose a potential trip hazard. citation

  • Walls

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    • Wall support and provision for adjustable and/or varied height counters and removable base cabinets for wheelchair accessibility/roll-under counters citation
    • Provide wainscot trim that protrudes from the wall and is securely fastened to offer a frame of reference and a touchstone for balance for level surfaces. citation
    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Intercom system and/or voice-activated smartphone technology. citation
    • Wall support and provision for adjustable and/or varied height counters and removable base cabinets for wheelchair accessibility/roll-under counters citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • Intercom system and/or voice-activated smartphone technology. citation
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Intercom system and/or voice-activated smartphone technology. citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination citation
    Desirable Outcome
    Patient control and independence
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    • Wall support and provision for adjustable and/or varied height counters and removable base cabinets for wheelchair accessibility/roll-under counters citation
    Desirable Outcome
    Patient satisfaction and comfort
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Intercom system and/or voice-activated smartphone technology. citation
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    • Wall support and provision for adjustable and/or varied height counters and removable base cabinets for wheelchair accessibility/roll-under counters citation
    • Provide wainscot trim that protrudes from the wall and is securely fastened to offer a frame of reference and a touchstone for balance for level surfaces. citation
    Desirable Outcome
    Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination citation
    • Multiple storage locations for gloves and other personal protective equipment throughout the occupied space, especially in care areas, to facilitate proper safety protocols (e.g. in the event of exposure to blood and other bodily fluids) A H citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Keep defibrillator(s) close to a telephone in a convenient, central and temperature controlled area, where the visual or auditory "ready" indicators can be seen or heard. A H citation
    • Small, easy-to-use ABC fire extinguishers mounted in easily accessible locations citation
    • Install smoke detectors throughout the occupied living areas citation
    • Carbon monoxide detectors citation
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    • Provide wainscot trim that protrudes from the wall and is securely fastened to offer a frame of reference and a touchstone for balance for level surfaces. citation

  • Ceiling

    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Install smoke detectors throughout the occupied living areas citation
    • Carbon monoxide detectors citation

  • Windows

    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • View of outdoor nature/garden
    • Window treatments that allow natural light to be blocked/reduced during the day if needed
    Desirable Outcome
    Patient satisfaction and comfort
    Design Strategies
    • View of outdoor nature/garden
    • Window treatments that allow natural light to be blocked/reduced during the day if needed

  • Doors

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Easy-to-open doors (consider handle grip, mechanics, and weight of door)
    • Minimize thresholds (less than ¼ inch vertical, or up to ½ inch beveled) citation
    • Minimum 36-inch doors citation
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    • Efficient ventilation to minimize unpleasant smells A H
    Desirable Outcome
    Patient satisfaction and comfort
    Design Strategies
    • Efficient ventilation to minimize unpleasant smells A H
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Easy-to-open doors (consider handle grip, mechanics, and weight of door)
    • Minimize thresholds (less than ¼ inch vertical, or up to ½ inch beveled) citation
    • Minimum 36-inch doors citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Efficient ventilation to minimize unpleasant smells A H

  • HVAC

    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Efficient ventilation to minimize unpleasant smells A H
    Desirable Outcome
    Patient satisfaction and comfort
    Design Strategies
    • Efficient ventilation to minimize unpleasant smells A H
    Desirable Outcome
    Safety; infection control
    Design Strategies
    • Ventilation system with features such as HEPA filters or 100% outside air to minimize air contamination H
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Efficient ventilation to minimize unpleasant smells A H

  • Electrical

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    Desirable Outcome
    Patient control and independence
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    Desirable Outcome
    Patient satisfaction and comfort
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Electric and internet outlets located at 24-inches (min) above floor [48-inchs (max) above the floor when located above countertops] and in close proximity to locations where telemedicine equipment will be used to ensure that cords will not obstruct walking paths citation

  • Lighting

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Sufficient illumination level for medication dispensing to minimize errors (for any places where medication dispensing is performed by caregiver or patient) citation
    Desirable Outcome
    Patient control and independence
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    Desirable Outcome
    Patient satisfaction and comfort
    Design Strategies
    • Light switches lowered to 44-inches off the floor citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Night lighting system that provides both horizontal and vertical cues (e.g., under bed and around doorways) to support postural control and stability A H citation
    • Avoid glare and excessive contrast and patterns on floors, which can be perceived as or conceal actual changes in level which pose a potential trip hazard. citation
    Desirable Outcome
    Safety; medication safety
    Design Strategies
    • Sufficient illumination level for medication dispensing to minimize errors (for any places where medication dispensing is performed by caregiver or patient) citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Avoid glare and excessive contrast and patterns on floors, which can be perceived as or conceal actual changes in level which pose a potential trip hazard. citation

  • Fixtures/Furnishings/ Appliances/Equipment/ Accessories

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Lever handles or pedal-controlled faucets with hand-held sprayer citation
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    • Low cook top with leg room U citation
    • Shallow sink with leg room U citation
    • Oven with side-opening door U
    • Raised dishwasher U A
    • Front-loading washing machine and dryer raised 12 to 15 inches off the floor citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    Desirable Outcome
    Minimize undue strain during recovery
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination citation
    Desirable Outcome
    Psychosocial support
    Design Strategies
    • Designated space and provisions for pets (bed, built-in feeding system, outdoor access, fenced in yard, self-cleaning litter box), if appropriate citation
    Desirable Outcome
    Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination citation
    Desirable Outcome
    Safety; minimize risk of injury
    Design Strategies
    • Install anti-scald water devices that limit the temperature to 120 degrees Fahrenheit maximum. citation

  • Casework/ Storage

    Desirable Outcome
    Accessibility; ease of use
    Design Strategies
    • Varied height counters and removable base cabinets for wheelchair accessibility/roll-under counters citation
    • Counters 25-inches deep (max) to maximize reachable distance for persons in wheelchairs, with clear knee space as deep as the reach distance U citation
    • Upper wall cabinetry three inches lower than conventional height citation
    • Open shelving for easy access to frequently used items citation
    • Pull-down cabinet shelves A
    • Pulls (rather than knobs) on cabinets and drawers
    • Maximize drawer space and pull-out shelves/drawers in base cabinets citation
    Desirable Outcome
    Efficient delivery of care
    Design Strategies
    • Easy-to-access storage for first-aid supplies
    • Safe, easily accessible storage for medications (refrigerated, if needed), supplies, and medical equipment A H citation
    • Adequate storage space (e.g., cabinet that conceals medical equipment) to efficiently store items, reduce clutter, and maintain domestic aesthetic. citation
    • Maximize space for medical supplies when needed A H citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Adequate storage space (e.g., cabinet that conceals medical equipment) to efficiently store items, reduce clutter, and maintain domestic aesthetic. citation
    Desirable Outcome
    Minimize undue strain during recovery
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Easy-to-access storage for first-aid supplies
    • Adequate storage space (e.g., cabinet that conceals medical equipment) to efficiently store items, reduce clutter, and maintain domestic aesthetic. citation
    • Maximize space for medical supplies when needed A H citation
    Desirable Outcome
    Safety; infection control
    Design Strategies
    • Safe, easily accessible storage for medications (refrigerated, if needed), supplies, and medical equipment A H citation
    • Easy-to-clean materials to reduce surface contamination citation
    • Multiple storage locations for gloves and other personal protective equipment throughout the occupied space, especially in care areas, to facilitate proper safety protocols (e.g. in the event of exposure to blood and other bodily fluids) A H citation
    • Large sharps containers with leak-proof covers H citation
    Desirable Outcome
    Safety; medication safety
    Design Strategies
    • Safe, easily accessible storage for medications (refrigerated, if needed), supplies, and medical equipment A H citation

  • Patient Handling/Movement Equipment

    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Avoid deep pile carpet or loose/worn carpet; tack down edges of carpets and rugs; remove loose rugs/mats citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Avoid deep pile carpet or loose/worn carpet; tack down edges of carpets and rugs; remove loose rugs/mats citation

  • Technology/Monitoring Equipment/Internet

    Desirable Outcome
    Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Intercom system and/or voice-activated smartphone technology. citation
    Desirable Outcome
    Communication/ interaction with care provider/ emergency care
    Design Strategies
    • Intercom system and/or voice-activated smartphone technology. citation
    Desirable Outcome
    Minimize patient stress/anxiety
    Design Strategies
    • Intercom system and/or voice-activated smartphone technology. citation
    Desirable Outcome
    Patient control and independence
    Design Strategies
    • Timed medication dispensing system with built in reminders for patients and alerts (email/text) to physician and caregivers if a dose is missed A H citation
    Desirable Outcome
    Safety; fall/injury prevention
    Design Strategies
    • Intercom system and/or voice-activated smartphone technology. citation
    Desirable Outcome
    Safety; medication safety
    Design Strategies
    • Timed medication dispensing system with built in reminders for patients and alerts (email/text) to physician and caregivers if a dose is missed A H citation