By Marcus Terry, AIA, Project Manager
One of the many changes that came out of 2020 was the comfort of moving into the virtual world. Many of us were able to collaborate with our teams from home, and we were even able to conduct site visits virtually.
Even before virtual work became so common we were giving our clients the opportunity to interact with designs using virtual reality. But for parts of a hospital that will be replicated multiple times – such as inpatient rooms and prep recovery bays – building a mockup room can be the best way for staff to experience how the room and its features affect patient care and their ability to do their jobs.
As designers, the challenge that we often face is that owners and health practitioners might struggle to interpret the drawings on the page as a physical space. This disconnect can lead to situations where spaces are constructed and clinicians are surprised by the outcome because they didn’t quite understand what they had agreed to.
The patient room mockup is a collaboration between the design team, the contractor, the owner, and the clinicians who will be using the space. There are many forms of mockup rooms with varying levels of detail. The more robust option is to have the contractor construct a true-to-scale patient room to design parameters provided by the architect where certain elements – like outlets – can be represented by sticky notes or pieces of cardboard that can be moved around as necessary and to suit staff and clinicians’ preferences. A simpler and faster option is to build the room with foam boards and cardboard or perhaps even just print out the headwall design to full scale and tape it on the wall. Anything to bring the design to a 1:1 scale for the user brings significant value to the process. After the room is built, nurses, physicians, facilities personnel, infection control, and others are brought in to see the room, interact with the space, and test how the many details that make up a patient care space actually work together. If a full buildout is performed, there is the added value of being able to review installed finish materials with the client and make adjustments, establish levels of construction quality, refine complicated details, and test fit equipment in the space all before the space is replicated 100 times in the field.
This exercise can focus on aspects of the staff experience and identify elements that can then be adjusted to desired configurations before all patient rooms are built. For example, in a recent visit to a mockup patient room, clinicians debated where suction bottles were mounted relative to the vacuum outlets and how high they needed to be off the floor. Some preferred they be lower to permit a better gravity assist, while others preferred they be higher and more visible so they could avoid being bumped into. To provide the group with a clear visual of the options, the actual outlets and suction bottles were brought to the room and hung in various positions on the patient headwall, giving the team a chance to move things around and experience the pros and cons of each arrangement firsthand.
During this process, the design team will take note of any changes, capturing the consensus and how and why that consensus was reached. If questions arise later in construction, the mockup process and changes that came from it will be fully documented. We also recommend leaving the mockup room in place for the duration of construction, updating it as necessary, as a reference for design, construction, and staff. In many instances these mockup rooms are also used to train staff members to acclimate to the new space and reduce opportunities for clinical errors.
Building patient room mockups does come with a time and monetary investment, but those are minuscule compared to delays and costs associated with redesign or moving features – especially across many rooms. Owners are always concerned about the schedule and budget, and rightfully so. It is easy to move at such a rapid pace during these phases of design that owners forgo processes like this to meet an established deadline and budget. But we’ve found that it’s more cost- and time-effective to spend the time and money upfront so these rooms are constructed to the client’s satisfaction the first time. It’s much less expensive to move pieces of cardboard and sticky notes around than it is to tear apart a wall and redo piping, medical gas outlets, power outlets, and data outlets.
Assuming all materials can be procured under normal circumstances, within a few weeks a construction crew could have something mocked up that is to scale and with the same materials that will be used. The mockup construction can be integrated into the design schedule, mitigating to some extent additional time to the schedule. As for costs, a patient room mockup could cost $10,000-$15,000, but a change order to correct a previously unidentified issue can easily be 10 times that amount. For the most part, clients are more inclined to invest in a mockup room when their projects cost more than $50 million. However, our experience tells us that they can be valuable and cost-effective for smaller projects too. Our team recently completed a $2.5 million med-surg renovation that contained 10 existing med-surg patient rooms to be renovated as private rooms. With speed to market in mind for these revenue-generating spaces, the owner opted to move through the design process at an accelerated pace. A physical mockup was not done for the new patient headwalls and, unfortunately, once construction was finished the staff felt the final configuration and height of the devices needed to be adjusted. This adjustment was performed in the field toward the end of the construction phase and added a week to the schedule and a cost of approximately $10,000.
In the example above, the design team did in fact construct a virtual computer simulation of the space and shared it with end-users using virtual reality technology. While virtual reality is a great way to interact with a space, there’s something about physically being there that’s hard to replicate. In a facility with dozens of identical patient rooms that each contains hundreds of different features, a good rule is to do a mockup. You won’t regret it when you end up saving time and money from fixes that happen in the mockup stage rather than at the end of construction.