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Is there anything you can think of where one size fits all? Certainly not in clothing or footwear. Not in sports equipment or eyewear. Not in wedding rings or activity trackers.

Then why are we designing one size fits all patient rooms in hospitals?

A Story

My 82-year old mother, who has dementia, was hospitalized this past week for a chronic condition that flares up every once and a while. When I got to the hospital the second day, she was sitting in the room's patient chair.

Except that this particular chair was a bariatric sized patient chair. My 5'2" mother's feet didn't even touch the ground.

Completely mobile, Mom had difficulty moving herself back in the chair to raise the footrest and sit in a reclining position. Once in that position, she didn't look comfortable, because her back wasn't being supported by the chair.

Maybe that's part of the reason she kept wanting to get out of the chair to go to the bathroom. And every time my mother did that, my father and I had to call the nurse, who then had to help Mom get out of the chair.

The hospital my mother was in is part of a large, well-respected healthcare system in Illinois. But, the unit she was on probably hadn't been renovated in more than 10 years. There was a tiny flat screen television on the wall that you could barely see from the bed or chair, and no artwork.

Most likely, a designer or the facility management team had chosen that bariatric chair based on information about increasing obesity rates.

Not once during the six hours I was with my mother in the hospital, did any of the nurses observe that my mother was uncomfortable in the chair. That it didn't fit her petite frame.

Maybe they did, but chose to ignore it.  Or, they are so used to the chair that they are immune to its design flaws.

How do hospital administrators get past that inertia in their attempts to improve the patient experience? Susan E. Mazer's blog post this week has some ideas about that.

Not Just the Chair

Most hospital beds are designed as one size fits all. But they have features that allow you to adjust the height and incline of the bed. Not ideal for every body type, but better than nothing.

Also, one size fits all doesn't work in patient room bathrooms. My mother's feet did not touch the floor when she sat on the toilet either.

How about if hospitals offered patients their choice of chair when they are admitted? So that if there is a bariatric chair in your room and you're not obese, you have the option of getting another chair.

Wouldn't that not only make it easier on patients, but also the staff?

Or how about designing a bariatric patient chair that has accessories, like extra cushions for the back and side, to support smaller patients' bodies? Has anybody done this?

Okay, I can hear all you designers and facility managers thinking, "That would be a storage and cleaning nightmare." So, operationally, these ideas may be impractical for patient rooms.

But let's be more creative about this. One size fits all patient rooms just don't work in hospitals anymore. What do you think?

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Leave a comment

Bruce Komiske

8 years ago

Love your Blog and look forwarward to reading it!
Thanks for taking the time to share your thoughts,

Sara Marberry

8 years ago

Thanks, Bruce!

Marjorie Serrano

8 years ago

You're absolutely right Sara. "One size fits all patient rooms just don’t work in hospitals anymore." And they never did!
We can be more creative in all we that we do. It often just takes someone to highlight the problem so we can develop a solution. There is nothing like a personal experience to shed light on needed changes. We must ask (and listen closely!) to our users.

Sara Marberry

8 years ago

Completely agree! Thanks for your comment.

Kristin Ellingsen

8 years ago

Sara - you hit it spot on. One size doesn't fit all, and demographics should play a part in the research of the client base.

I do enjoy your blog - thanks for the posts!

Dean Russell

8 years ago

Creating choice is an admirable goal. Unfortunately the cost of building and designing healthcare facilities is astronomical; how do you propose creating a more tailored experience without adding cost? As a designer I would argue this isn't a design issue its a financial issue. Sure with more money it's easy. Cash fixes lots of design problems.

Sara Marberry

8 years ago

It always comes down to money, doesn't it? If only hospital leaders would look at the longer-term ROI of investing in good design. If patients have chairs they are comfortable in, maybe they don't call the nurse every 10 minutes, and maybe that lowers the nurse's stress (and number of steps he/she takes in a day), increases his/her productivity, and reduces turnover.


8 years ago

Along these same lines, I think it would be wise for the FGI to examine the SF recommendations for different parts of the patient room and their function. If space was determined/ allocated, similar to the required bed clearances, for the care team work zone (sink, PPE, supplies) and the storage needs for linen and waste, as an example, then the patient room would most likely remain "right sized" and not squeezed down during a VE process. This would allow for proper furniture perhaps as well, or at least the storage for needed pillows to prop up a smaller patient using that bariatric chair. There is not one single project I have worked on recently where the owner hasn't asked "how small can the room be by code?"
Unfortunately, "by code" doesn't mean it functions very well.

Sara Marberry

8 years ago

Good point! Thanks for sharing your thoughts.

Cathy Dolan-Schweitzer

8 years ago

Sara you bring up a very good point here " it always coming down to money" the ROI needs to accommodate the new delivery of care compensation in the future. We need to wrap our minds around the hard fact that we are being compensated for quality not quantity. This supports investing in good design based on the sharing of wisdom and experience of teams that are on the frontline taking care of the patients.


8 years ago

Thank God you have noticed. True no one size fits all but in addressing cost, there must be some degree of customisation or provide range of sizes. Perhaps that may help in sizing patient's room, bed or anything requiring flexibility. As architect and researcher I work on critical size based on norms derived from previous similar researched. However cultural,human behaviour, change of use and adopted standard operating procedure (SOP) do influence use of space. Just sharing.

What's the ROI for Designing Choice into Patient Rooms? - Sara Marberry Sara Marberry

8 years ago

[…] Why One Size Fits All Patient Rooms Don’t Work […]

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7 years ago

[…] Is there anything you can think of where one size fits all? Certainly not in clothing or footwear. Not in sports equipment or eyewear. Not in wedding rings or activity trackers. Then why are we designing one size fits all patient rooms in hospitals? Read the post>> […]

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What's my story? I'm a healthcare and senior living design knowledge expert who writes and speaks frequently about trends and issues affecting these two industries. I'm also a strategic marketing consultant and content creator, working with companies and organizations who want to improve the quality of healthcare and senior living through the design of the physical environment. You can reach me at .

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