Creating greater functionality and upscaling amenities in patient restrooms is critical.

As with many commercial buildings, hospitals are finding they must improve their restrooms to meet staff needs and users' expectations. With hospital entrances looking more like tranquil spas and patient rooms like hotel suites, washrooms are being upgraded to be less institutional and fit within the overall facility design. Another key trend is that many hospitals are eliminating patient restrooms where space is at a premium, instead installing modular patient care lavatory units.

While some hospitals on the ultra-high end are adding touches like custom wood cabinetry in patient bathrooms, there are a number of design elements that can be incorporated within a more modest budget.

Sometimes just making a few improvements can make patient washrooms more inviting. Before making any changes, however, be sure to check local building codes and ADA requirements for healthcare facilities. Often toilets need to be raised or additional grab bars mounted, so it's a good idea to plan for these compliance issues upfront.

Cleaning and maintenance should be a primary focus during the design process. Shower stalls and sinks will be cleaned frequently and must be durable enough to stand up to disinfectants. Along those same lines, keep nooks and crannies where mildew can accumulate to a minimum. Curved tiles or seamless integral sinks, for example, are easier to keep clean. Products with antimicrobial agents can help reduce the number of germs.

A few simple touches also can make a patient's stay more comfortable. Shelves near the sink are helpful for keeping toiletries handy. Softer overhead lighting is a better alternative to harsh florescent strips.

Replacing Restrooms

While upgrades are being made in some patient areas, in others the trend is to forgo the restroom altogether. Higher revenues generated by critical care and intensive care units are the driving force behind this change at many hospitals. Older hospitals are converting traditional patient rooms into critical care wings to create more space and save money. Other hospitals are building new "replacement" facilities where they can offer more specialized intensive care services.

Patient care units, which are combination lavatory and water closet modules, are a good solution to meet these space limitations. Traditional bathrooms may not even be an option for many facilities. The space-saving patient care fixtures have a fully functional sink and toilet, and give the room a tidy appearance with plenty of room for patients and medical staff.

These compact units are economical because oftentimes patients in critical areas are unable to use the facilities, and the staff simply needs to wash their hands or rinse bedpans. Critical care nurses say these units are beneficial because they increase efficiency - there's no need to leave a patient's room to take care of sanitary tasks. Moreover, having a handwashing station close by reduces the spread of germs.

Another key benefit is that patient care units are easy to install and cost-effective to maintain. There are only a few plumbing hook-ups and generally ICU areas are designed so the fixtures can be installed back-to-back. In terms of placement, it is important to be sure the units are not too close to obstacles, such as where a patient bed or closet will be located, or tucked into a corner where getting to the fixture could be a problem. This can and does happen.

Fixture Design

Frank Gardner, a senior plumbing designer in the healthcare group of Tilden Lobnitz Cooper, Orlando, Fla., sees a key product design trend for fixtures used in healthcare facilities. "There's a demand for patient care units and other fixtures that meet the special needs of larger patients," says Gardner. "Manufacturers are offering more options, and it's important for contractors and engineers to consider specifying things like sturdier stainless-steel water closets, rather than china. We're also seeing a need for floor-mounted installation on patient care units for added strength."

Look for other handy features, such as a built-in bedpan washer and spray attachments. Solid surface countertops resist germs and are available with integrated backsplashes and no-drip edges, which help to keep floors clean and dry. A deeper 9-inch bowl depth can help prevent splashes and allows for easy IV-bag draining.

Upgrading Public Washrooms

In addition to patient facilities, public washrooms in hospitals are getting face lifts. While cleanliness is critical, sterile-looking lavatories and all white walls are out. In their place are warm shades and residential-inspired handwashing fixtures. As in other areas, attention to detail is key. For public restrooms it means textured floor tiles, attractive light fixtures and better finishes throughout - even the old sink is out.

"More upscale-looking wall-hung lavatories with granite or solid-surface countertops are what we're installing," notes Gardner. "From public areas to family waiting rooms and even nourishment rooms where nurses fill ice cups for patients, everyone is moving away from white china lavs."

Multiheight lavatory systems that are ADA-compliant and can be used by children, their parents and the physically disabled should be a consideration for unisex washrooms. These innovative new fixtures save space and come in a range of configurations for design flexibility. Group handwashing fixtures with multiple sink stations are another option for busy restroom areas near entrances. Both of these styles are made of seamless solid surface materials, and some are available with interesting curves and fluid shapes for added visual interest.

Finishing Touches

According to a 2003 survey of International Facility Management Association members commissioned by Bradley Corp., the "must have" design feature for restrooms is hands-free or touchless fixtures. Hospitals are adopting this technology which has been used for some time in other public washrooms. Infrared, sensor-controlled faucets, soap dispensers and paper towels are becoming the norm and are helping in the fight against germs.

As far as the style of accessories, toilet partitions and towel dispensers can be coordinated to match lavatories. Materials such as phenolic composite plastic are attractive yet durable enough for high-traffic washrooms. Most architects and designers are selecting neutral-colored fixtures and accessories, bringing in color on the walls. Beyond paint or wall coverings, making restrooms seem more like home also can be as simple as adding artwork, plants and cushy seating.

The line between residential and commercial design will continue to blur in the coming years. Consumers are becoming more interested and attuned to design in their homes, and are turned off by public places that don't adhere to the same standards. For hospitals, creating greater functionality and incorporating more upscale amenities is critical. Product manufacturers, architects and engineers are all good resources for learning more about innovative new products and key elements that can take restrooms into the next level.