Why the Opioid Crisis Affects Us All – And 5 Ways DSGW Is Working to Fight It



By Ryan Turner, AIA, ACHA, EDAC, LEED AP
Principal, Healthcare

In 2016, over 65,000 people died from opioids. In April of 2018, the U.S. Surgeon General released a general advisory to the public — the first of its kind since issuing a warning against drinking during pregnancy a decade ago. This time the advisory urged Americans to carry NARCAN, the brand name for Naloxone, a drug that can counteract the effects of an opioid overdose.

It isn’t just drug addicts who are part of this epidemic; it’s senior citizens with memory loss issues who may forget when they took their last dose, and it’s people with chronic back and knee pain who fill their prescription and wind up addicted. The opioid public health crisis has reached a critical tipping point and all hands are needed on deck.

I attended the American Hospital Association’s Rural Healthcare Conference in Phoenix, Arizona this past February. The presentations were truly eye-opening and highlighted the ways this crisis has become all of our problem to solve. I also saw first-hand how some facilities — like CHI St. Gabriel’s in Little Falls, Minnesota — are implementing new strategies that are yielding incredible results, including reducing the number of opioid prescriptions by over 20%.

DSGW, as well as other architectural firms working in the healthcare field, play a crucial role in the fight against opioid addiction. Here are five ways that collaboration between healthcare facilities and architectural firms can help combat this public health crisis:

Patient Monitoring

  • Spaces need to be designed to handle chain-of-custody types of specimen collection for patient monitoring. These spaces are bare-bones simple and eliminate hiding places.
  • Ceilings should be solid and not a grid with ceiling tiles that can be popped open and removed. There need to be pass-thrus to allow collection directly from the patient. Even the toilet has to have water that can be turned off to prevent patients from falsifying results.
  • These spaces are typically designed for drug testing done by employers or the government. But, these spaces now can be used to safely administer a daily dose of opioid pain medication in a controlled environment that helps reduce the risk of addiction. Our designs ensure there’s no threat to a patient’s privacy while still allowing the space to function in a secure manner.

Infusion Centers

  • While typically designed for the administration of chemotherapy in cancer treatment, these secure yet comforting spaces can also be utilized for the administration of certain types of pain management medication.

Pharmacy Spaces

  • We design “medication safety zones” into all of our pharmacy spaces.
  • These areas are designed so that staff can’t be distracted from their work while still allowing for efficient workflow.
  • These spaces also permit shoulder-to-shoulder verification, where a second pharmacist works directly with the primary pharmacist, double-checking their work.

ERs

  • Nearly every rural facility we work with has an ER that is working with minimal staffing and limited resources. Our design work in these spaces centers on maximizing workflow and efficiency with these small teams.
  • Since the ER team is cross-trained, working daily in different parts of the facility to help each other out, we focus our design on ways to help enhance that cross-training support for when an overdose case is admitted or when an addict enters the facility.

Behavioral Health Spaces

  • Since overdose patients are often treated as behavioral health cases, we make sure our ER spaces are able to convert quickly to a behavioral health treatment positions.
  • A behavioral health space is one where the majority of the elements for a patient to endanger themselves have been removed. That may mean a coiling door to close off outlets and instruments, recessed light fixtures and sprinkler heads, and no outside corners.

We don’t claim to have the silver bullet for fixing the opioid crisis. We know architectural firms like ours are just a piece of the puzzle. But we also recognize that this is a national crisis that impacts all of us, and we all have a role to play in combating it.

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