Healthcare facilities have an overriding need to create environments that encourage healthy living. That goal requires products that meet both sustainable-design practices as well as durability standards that let them stand up to repeated heavy-duty cleanings. But administrators also want to avoid the "institutional" look, as they are well aware of the trepidation that many visitors have upon entering their facilities. These factors and others drive specifications for wallcoverings, with some expected to grow in importance as the economy revives. The key trends, according to interior-design

# Cleanability.

The need for clean impacts many wallcovering specifications, as the capability to wash walls to remove dirt and scuffs has become a driving force, says Melissa Surujpaul-Taylor, an interior designer with Perkins Eastman in New York. "Hospitals are finding that they can't clean the walls every day, so when they get an opportunity to do it, they want to do it well and do it quickly, to get as much dirt removed as possible," she says.

Adds Susan DiMotta, principal at Perkins Eastman, "Maintenance is always an issue. Cleaning capabilities and the wallcoverings' ability to stand up to chemicals are important." That can include the need to wipe them down with diluted bleach solutions or other disinfectants.

A key concern is that maintenance personnel don't always follow manufacturers' recommendations, owing to their own procedures or cleaning equipment taking precedence, she says. That mitigates the results administrators want, requiring wallcoverings that are easier to care for in the first place.

A designer in a leading Chicago design firm agrees. "Cleanability is a key requirement," she says. "Clients want vinyl, sturdy designs, and we use wallcoverings that can be cleaned all over the project as a result."

# Durability.

Along with cleanability is the need for wallcoverings to stand up to abuse from gurneys, heavy carts, wheelchairs and other mobile hospital equipment. "Durability is critical today, because healthcare facilities are cleaning walls more often, and they need products that will stand up to that," says Kristin Lopez, vice president and director of interior design at Curtis Groups Architects Ltd. in Dallas.

Vinyl wallcoverings have been the default position when durability becomes the key priority, says Surujpaul-Taylor. "We used to put vinyl wallcoverings everywhere—corridors, exam rooms, patient rooms, etc.—because it was vinyl and provided good impact resistance. But we're looking at other options today."

The best alternatives, she says, provide a fused combination of a rigid layer behind the decorative surfacing layer. That adds durability while ensuring no peeling to mar aesthetics. She also is using darker colors more often, as they can hide dirt and scratches better.

Dents and scuffs can mitigate the efforts the facility puts into creating a high-end look, notes Renaldo C. Pesson, principal and director of interior architecture for healthcare at HOK in New York. "Administrators want to create an upscale look, but it has to be maintained well or it may look worse than if they had used a more heavy-duty design. So they need upscale products that will hold up over time."

To ensure wallcoverings meet these higher standards, administrators are testing samples and creating mock-ups of wall facings. "They try to beat it up or stain it with food or whatever they can to see how it will clean up," says Lopez. "They really try to destroy it and see if it will recover." In a recent presentation by Pesson, the client pulled out a key and tried to scratch the sample provided. Surprising all in attendance, the key simply flowed across the surface.

The mockups also provide a better visual image of how the product will look on a larger scale, Lopez notes. "They want to see as much as they can before making a final decision."

Some clients have performance or specification standards that limit the designers' choices to what the hospital has had success with in the past, notes a Chicago designer. "We still can use whatever we think will work best for the project, and if necessary will try to receive a waiver for them," she says.

Durability has become such an issue that some healthcare facilities are focusing their attention and budgets below the chair-rail, using heavier-duty wainscoting products and eliminating wallcoverings above waist level to minimize maintenance while maximizing protection.

"Some administrators don't want a lot of wallcoverings where they aren't needed for protection, because they worry about being able to repair them or replace portions if they remodel," Lopez explains. "They're concerned that patterns won't be able to be matched, and they don't want to have to store rolls of patterns because they don't have the storage room."

Manufacturers are responding well to these increasing needs, says DiMotta, and designers are looking beyond traditional specs to be more creative. "Rigid wall panels provide good protection, but many of them have proven difficult to clean. New formulations and surface finishes are overcoming that drawback now. When designers think about wallcoverings, we often think only in terms of vinyls and fabrics, but panels offer a lot of potential today. We have to think broader in those terms to meet the durability and cleanability requirements we face."

# Sustainable Design.

Many healthcare facilities are paying more attention to sustainable-design techniques, since a healthy environment is a top priority for facilities involved in restoring patients' health. "Cradle-to-cradle, life-cycle factors and a sharp expectancy for sustainable design have become the leading trends today," says Pesson.

Elimination of high-VOC products to minimize off-gassing provides a key approach to meeting this need for healthcare facilities, he says. "Off-gassing is always an issue, and we are working hard to eliminate that from all of the products we specify."

Because of the strong medicinal odors that permeate a hospital, visitors and patients are constantly reminded of their environment, and it can make them uneasy, he notes. "The aroma often turns people off. By reducing off-gassing from products, it helps control the smell. Once you use sustainable products that are non-emitting, you notice that the only thing missing is the smell, and it's a dramatic difference. Once you use those products, you never want to go back."

Standards set by the Leadership in Energy & Environmental Design (LEED) program offer guidance to administrators and designers in choosing products, says DiMotta. "LEED standards are a more important focus then they used to be," she says. But even if the goal is to meet those standards, not every project aims for certification, owing to the extensive paperwork required. "Unless there is a strong marketing reason to go through the certification process, most want to follow the guidelines but not take it any further."

In some cases, administrators do not push sustainable-design options, owing to the premium that many entail. But designers do present them at every opportunity as part of their own firm philosophy, designers agree. "Healthcare is a large part of our business, and our primary objective is to design space which promotes health and healing in every aspect," Pesson says. "It wouldn't make sense to do otherwise. Sustainable design has become a mantra both with healthcare clients and with HOK overall."

Lopez agrees. "We push for it ourselves, but there still is a premium for many of these products, and pricing can be a deterrent."

Adds a Chicago-based designer, "We will choose sustainable products above all others, whenever we can, and we will use them unless the client objects. But if they tell us not to, due to budget or other reasons, we won't use them. Administrators often aren't as interested in those factors as they are in ensuring that the products can be cleaned."

# Aesthetics.

Healthcare facilities are aiming for more of a hospitality feel throughout the spaces, with particular attention on main visitor areas, such as lobbies and elevator rooms. But throughout every area, they want to avoid an "institutional" look. What that means varies with each owner's perspective.

"They don't want it to look like a hospital from the 1970s, but how they define 'institutional' otherwise can vary," says Surujpaul-Taylor. "Everyone has their own ideas. Some want no stainless steel, because that looks out of date, but others like that look and want it for bases or corners, because it has a 'contemporary' look to it."

"Administrators are looking for more of a hospitality look overall, using natural patterns and warmer colors," says a Chicago-based designer. "That's especially true in visitor areas, including waiting spaces and corridors. They want the spaces to look more like hotel rooms."

Those goals have led to an increased interest in wood tones, which offer a warmer palette and complement wood veneers on bed headboard and footboards as well as doors. Real wood seldom is used owing to infection-control standards.

"We try to use solids only in back-of-the-house areas and feature more decorative designs, especially woodgrains, in front," says Lopez. "Hospitals like woodgrains because they have a warm, welcoming look." 'Green' decorations, such as leaves and trees, also play off this design philosophy.

Color palettes tend to neutrals, allowing splashes of brighter colors in accents. Those colors tend to the soothing blue/green spectrum, along with warm earthtones, says Pesson. In general, healthcare facilities use about 75% neutrals and 25% saturated colors. "A look and feel more typical of a hotel or a cosmopolitan center is gaining popularity," he says. "They want a look that is more welcoming and less like a hospital is expected to look."

Adds a Chicago-based designer, "Colors can be scary for hospitals. They are renovated only every 20 years or so, so they will have to live with a design for a long time. That's different from other types of clients." As a result, designs tend to be more "transitional," not contemporary (which could become dated) or old-fashioned (which may invoke an "institutional" style).

# Variety.

The variety of functional requirements provides more choices in healthcare facilities than some other projects may offer, designers agree. Lobbies, elevator areas and doctors' offices have more leeway for using high-end products. They set the first impression for visitors and don't have as many demands for durability, expanding the options.

Even patient rooms have zones, says a Chicago-based designer. Different wallcovering treatments can be used to define patient, family and staff zones within the room. "Patient rooms are the most important for achieving a comfortable look, especially as more hospitals move to single-patient rooms," she says.

Typically, neutral-toned spaces are dressed up with furniture or art that adds color, as they can be changed quickly to update the look, Pesson adds. But even wallcoverings can be included in the changes. "They are definitely cheaper than wood panels, stone and tile, and we can get those kinds of textures with wallcoverings if we want."

Textures create the biggest friction, as designers like the visual appeal that dimension provides. But administrators fear the ridges that will allow dirt to accumulate and make the wallcoverings more difficult to clean. "We look for textures without horizontal ridges," Pesson says.

Graphics capabilities are helping negotiate a compromise. Manufacturers are providing more options that are printed with dimensional qualities while remaining flat, Pesson says. That's also an approach being used by Lopez.

DiMotta has been taking a closer look at customizing wallcovering applications, using digital graphics applied with printers, etching or other methods. These techniques allow designs, logos or photographs to be applied to acrylic, glass and other substrates.

Designers also are taking closer looks at tone-on-tone and metallic offerings, which create textural differences without adding dimension. "These options are becoming more popular today, because they add decorative value," Pesson says. "If you're going to use wallcoverings, they should provide a definite upgrade in appearance to paint."

"Clients can be scared off of textures because they fear they will need more cleaning than can be provided," agrees a Chicago-based designer. "We sometimes use a family of designs that communicate a dimensional look without actually providing one, and I see more potential in those."

# Renovations.

With the economy in the doldrums, designers are finding more of their work involves renovations rather than new construction. That adds challenges in complementing existing spaces or covering what had been present. "Renovations require us to look for products that can hide a multitude of sins on the existing walls," says DiMotta. "As a result, rigid wallcoverings have been incorporated into many of our designs to address this issue."

Panelized systems offer added benefits with renovations, adds a Chicago-based designer, as they provide durability, cleanability and clean edges, with simpler appearances that can hide imperfections in the walls that wallcoverings or paint won't cover.

# Spec Restrictions.

In most cases, designers say, they have leeway to present options they think will meet the needs, with few administrators preferring specific brands. So too, while designers prefer a single-source supplier to provide volume benefits and a related family of products, they have no qualms about mixing and matching to achieve the specific goals they need to reach.

The only input administrators typically give is when they want specific products to be eliminated, owing to a past experience. "Many times they know what they don't want to use," DiMotta says. "It's probably because it created a problem; they avoid using that product again." Lopez agrees. "It's usually up to us which wallcoverings to use, unless they say not to use something because it didn't give them the performance they wanted in a past application."

Balancing the needs of hospital administrators creates challenges, with every project offering its unique characteristics. The goal is to find the perfect balance of durability, aesthetics and economy, while providing as many sustainable benefits as possible. "They want all three, which means they want everything," says Lopez. Fortunately, options today are providing more opportunities to find that perfect blend.

For more on designers' perspective on wallcovering trends, see the individual "On The Job" interview reports from each designer at www.nudo.com

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