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has new meaning to the facility trying to improve the response to this particular survey question. If we can begin to mea- sure how better acoustical value improves a patient's perception of quality care, we may also fi nd benefi ts in staf -to-staf com- munications and staf -to-patient and fam- ily communications. By using a textile with a higher NRC value, safety concerns can be aligned with benefi ts in communications. How can textile specifi cations of er a greater return on product lifecycle performance? In this new age of af ordable care, many healthcare providers are mindful of chang- ing reimbursement models and there are fewer dollars to keep up with the need for capital improvements. Healthcare is typically a 24/7 environment and many products developed for this sec- tor rarely last the 15-year span between renovations; interior materials, especially textiles, just ugly out. Many commer- cial textile manufacturers are members of the Association of Contract Textiles, which publishes Voluntary Performance Guidelines that make textile specifi cations easier. The ease with which a professional interior designer can qualify a material is in no small measure due to the ef ort this association has made. The set of icons developed by the ACT indicate whether a fabric meets or exceeds guidelines for fl ammability, performance, colorfastness to light, physical properties and abrasion. When specifying product, an interior designer has to consider the conditions for its use and abuse and the performance criteria needed to make the selection a lasting one. In this application the ACT properties of a particular specifi ca- tion become especially important. How can textiles improve the patient experience? As anxious patients try to gauge qual- ity, they often focus on aspects of the experience that they can easily under- stand such as a compassionate nurse or a clean bathroom. In the Harvard Business Review article, "Clueing in Customers," Leonard L. Berry and Neeli Bendapudi advise health organizations to more carefully consider all the environmental clues that factor into a customer experi- ence, especially since the "product" is so dif cult to judge. Often it is the most tangible aspects of the environment such as parking, nursing and housekeeping that leave a lasting impression and infl uence a patron to recommend the facility to family and friends. For example, a patient staring at a stained cubicle curtain begins to question the overall cleanliness of the environment and may report a negative experience despite receiving quality care. Designers focus on creating powerful fi rst impressions to positively infl uence patient satisfaction and emphasize the visual experience over all the other senses. However, the very act of selecting fabrics reminds us of the often overlooked but vital role that tactile experiences play in creating rich interior environments. In his book, The Hidden Dimension, anthro- pologist Edward Hall categorizes the senses into the distance receptors — sight and hearing — and the immediate recep- tors — touch. He of ers an evolution- ary explanation for the development of distance receptors, but laments how environments have become increasingly devoid of interesting tactile experiences. Often an oversight by some designers in other markets, in healthcare, design- ers deliberately limit tactile surfaces and the use of fabrics to facilitate clean- ing and to control the spread of infec- tions. Creative solutions have emerged, however, such as an increase in the use of leather, the further development of antimicrobial topical solutions and even the use of textiles in art installations. Future trends not far to follow Textiles will continue to grow both in terms of possible uses and acceptance of their role in achieving better outcomes in healthcare settings, particularly as elec- tronics become integrated with textiles. Right now, there are personalized and wearable biosensing clothing options for healthcare use that do not require an external power supply. They are able to sense sweat rate, ECG, temperature, respiration and even blood oxygenation. This promises to revolutionize much of healthcare equipment and communication structures. Ongoing research is develop- ing even more cost-ef ective textiles with bio-nanotechnology that can be used on a massive scale. As these future trends become more evident, those using an Evidence-Based Design methodology will be able to continue to use research to in- corporate textiles into design interventions and, one might say, to weave into better environments for quality care delivery. Rosalyn Cama, FASID, EDAC, is president and principal interior designer of CAMA, Inc. A fellow of the American Society of Interior Designers with more than 30 years of experi- ence, she is chair of the board for the Center for Health Design, and serves as a trustee of the ASID Foundation. She also authored Evidence-Based Healthcare Design, John Wiley and Sons, 2009. A Vivika DeNegre quilt on display at Smilow Cancer Hospital at Yale New Haven. Today's trends point toward an increase in the use of leather, the further development of antimicrobial topical solutions and even the use of textiles in art installations. 48 Medical Construction & Design | M AY/ J U N E 2015 | MCDM AG.COM