Even before Covid-19, rates of behavioral health illness were on the rise. In the third year of the pandemic, mental health has accelerated into a crisis, with health care workers in particular facing high levels of stress and burnout. Although mask mandates have been lifted and restrictions have been eased in many areas, caregivers are still in the throes of treating infected patients, while also coping with the fallout of the past two years. This convergence of factors has led to an uptick in mental health issues among health care workers, many of whom report experiencing record-high rates of anxiety and depression compared to the general population.

Previously, designing clinical spaces for well-being was focused primarily on the patient. Now, taking care of patients is table stakes; caring for the people who serve them is crucial to creating and maintaining a high-performing hospital system.

Designing buildings for the well-being of health care staff is not just necessary to curb the mental health crisis among the profession. It’s also critical to buttress the financial fallout that ensues with high turnover, preventing additional strain on a system already taxed from financial losses due to differed treatment during the pandemic.

During Covid, hospitals have seen increased rates of turnover among employees, which is both costly to morale and the bottom line. According to Becker’s Hospital Review, in 2020, the turnover rate for registered nurses increased 2.8 percentage points to 18.7% industry-wide. Each percentage point change translates to approximately $270,000 lost or saved per hospital.

These numbers have prompted hospitals to rethink their approach to the physical environment and incorporate research-based design strategies that improve well-being for both patients and the staff guiding their recovery. Below, we outline three lessons for designing hospitals and clinics based on current projects NBBJ is working on with Massachusetts General Hospital, Atrium Health, Loma Linda University Medical Center, and Montage Health.

Lesson 1: Employee mental health can be part of a building’s identity.

Massachusetts General Hospital (MGH) in Boston is currently building a 482-bed expansion called Cambridge Street that focuses on staff and patient satisfaction, operational efficiency, and environmental stewardship. Several years ago, NBBJ also oversaw the creation of MGH’s 150-bed Lunder Building. Both facilities offer key insights into how seemingly simple design interventions can have a significant impact on the mental well-being of staff members.

It’s important to note that what we recommend are not amenities, even if some may call them that. Rather than focusing on the “nice to have” perks found in tech company headquarters, many of the spaces in MGH’s facility are “must haves” given the fact lives are on the line: stairwells flooded with light, deliberately quiet patient floors, and safer working conditions, for example.

The Lunder building offers plentiful access to daylight through a glass-encased stairwell used only by staff, who have adopted the corridor as a de facto meeting space (nicknamed the “stair conference room”). Staff also use this stairwell as a place to “be alone together” and report that they find comfort watching employees traverse the stairwell while they use the space to think and decompress.

The building further expands staff’s exposure to daylight — which impacts work-related stress and job satisfaction and is found to affect clinician burnout — through corridors that allow staff to access rooms from an exterior wall. Since less noise can reduce stress among caregivers and also help patients recover from illness, the Lunder building uses a variety of sound-absorbing materials and techniques to make the patient floors 35% quieter than typical health care buildings. Other features designed to minimize noise include sliding doors, distributing work zones for clinical staff across the floor rather than in a single location, and elevators and visitor waiting areas located away from patient rooms.

Finally, staff safety is perhaps the most critical “amenity” of all. For example, overexertion — in the form of repetitive routine physical tasks such as bending, stretching, and standing — account for 45.6% of all injuries occurring to nurses, according to a 2018 article published by the U.S. Bureau of Labor Statistics. These injuries can result in musculoskeletal disorders such as sprains and strains that accounted for 8,730 days away from work among nurses in the private industry in 2016. Features such as motorized overhead patient ceiling lifts or full-height glass doors that provide greater situational awareness can help reduce injuries.

Designing buildings in this fashion makes a difference. For example, post-occupancy data from new inpatient units and staff work areas NBBJ designed for Atrium Health indicates that vast majority of employees feel safer and more at ease in the workplace. In the same post-occupancy evaluation, employees mentioned “the collaborative nature of the research floor,” “increased interaction with colleagues,” and “improved team collaboration” as positive aspects of the new building, further illustrating that opportunities for collaboration and interaction improve employee satisfaction.

Lesson 2: Design features can reduce stress in core working spaces.

Many hospitals are embracing support spaces that enable people to choose how they spend their precious break times. These spaces, both “offstage” (where staff can gather or be alone) and “onstage” (where caregivers see patients), allow staff to spend less time navigating a building and more time recharging.

Loma Linda University Medical Center’s expansion in Southern California boasts an open-core design. It features wide corridors, access to daylight, and the distribution of patient and supply rooms along the wings, which allows staff to connect better with each other and patients. In open-core hospitals, major support functions such as staff lockers, break rooms, and conference rooms are in a centralized hub that connects to patient wings along the exterior. This layout reduces the need for staff to travel between patient and supply rooms, the type of inefficient and repetitive physical tasks that can lead to burnout.

In addition to open-core designs, collaborative clinician rooms — such as the new examination rooms at MGH’s Cambridge Street project, which are sized to allow for multidisciplinary consults — reflect the evolving nature of medicine. Collaborative clinician spaces decrease the load on caregivers and their teams while also providing patients with a new, more effective way to navigate their medical journey.

In the future, these recharging spaces could take different forms, which would acknowledge that everyone refuels in a different way. For instance, because the availability of private spaces has been shown to reduce caregiver stress some hospitals are exploring restorative zones with nap areas for their staff that would be located close to the patient unit for ease of use.

Lesson 3: Good design is ultimately good for business.

Health systems such as Montage Health on the Monterey Peninsula are taking advantage of their less-densely-populated location by incorporating nature into the design of their buildings. For example, Montage’s Ohana Center’s garden-like environment and private patios for staff are designed to lower levels of arousal fatigue — the psychological exhaustion that results from sustained stimulation without breaks. Arousal fatigue is one of the key factors contributing to burnout among behavioral health caregivers, who have an annual turnover rate of 40%.

Other organizations are exploring solutions such as satellite food lockers, mobile ordering apps, and meal programs that offer discounts for nutritious food options. These types of design interventions are investments in staff longevity; they help to reduce stress and encourage positive lifestyle choices, ultimately supporting the mental and physical well-being of the people charged with helping others recuperate.

Behavioral health challenges existed before the pandemic and will persist after it’s over. Consequently, as health care systems navigate the lingering impacts of the pandemic, it’s more important than ever that they shift towards a more caregiver-centric mindset. Only by creating spaces and implementing solutions that promote staff well-being and patient healing at the same time can they effectively retain and recruit staff and reduce the financial impact of burnout and turnover. Designing buildings to enhance employees’ well-being will help keep them satisfied and productive.

Are you looking to get out of the daily 9-5 grind that you’re stuck in? Maybe you’re not but better ideas have crossed your mind? Or the idea of being your own boss is simply too tempting to pass up?

Luckily, in a world where tech is at the forefront of a lot of industries, it’s easier than ever to go your own way. You don’t need a premises to open a shop, just the products and a website. You don’t need an office space to be a secretary, just a reliable Wi-Fi connection. You don’t need to move to LA to make music friends, just your home set up.

As the saying goes, restrictions breed creativity, which was proven in the lockdowns. A lot of good ideas came about, and the best stuck. We’re running down a few ideas that could prompt you to get out there on your own and make something of yourself. Read on for all the details of the best industry ideas that came out of lockdown.

Influencer

Don’t scoff. Depending on how you do it, there is a lot of skill and a lot of money in influencing. It’s likely that you are only seeing one side of things, which is usually a well-lit photo of a coffee cup taken in the golden hour. But what if I told you that a lot of skills – creative and business – went into taking that shot. It might feature a product placement for a coffee company, it might be used as a networking opportunity to catch the eye of a brand or generate buzz. It might simply be used to market their own business.

And then there is the content itself, which encompasses everything from capture to edit. Filming, photography, editing, music, graphic design, and presentational skills are all part of making quality content. There are a lot of transferable skills in both.

You can use influencing to market your own business, or even start your own affiliate blog, which serves as a site where you can showcase your favourite items for commission. A couple of hours’ worth of work a week can gain you a full-time employment salary.

Either way, getting the basics of the role of an influencer down will ensure that you can market just about anything else on your agenda, such as…

Hospitality

The hospitality industry had to go through a lot of changes through lockdown. Closing entirely soon gave way to take-out services, which eventually gave way to social distanced dining, but in that time, a lot of new ideas hit the table on how the food service industry could shake things up.

The most common idea was food through a window. A collection/delivery service where restaurants and cafes couldn’t serve food inside their premises so instead handed them over through a window. When things opened up again, the idea stuck. The roads are full of delivery drivers and cyclists for everything from the mom-and-pop café to the nearest fast-food supplier. It means less of premises and therefore less rent, or you can even do it directly from your home kitchen, making the gap between beginner and business a lot closer.

And then there is the idea of food trucks. You’d be surprised how much a food truck is making during the lunch hour alone. There was a class bias there once, where a food truck meant low quality, “junk” food, but street food is on the rise. It’s usually very high quality, tastes like nothing you’ve tried before since they don’t have to convince investors the masses will eat it, and they go wherever is most popular in the moment. You’ll see food trucks at the park, at festivals, outside clubs, etc. It’s also appealing to the customer because it’s usually more affordable. If you’re worried about menu pricing, take a look at this guide.

Freelancer

When the doors to offices started opening up again, the response was a resounding, “Do we have to?” Middle managers were surprised to find that employees all around the world where in fact enjoying working from home. There was more freedom, whether to work around external obligations like childcare or an exercise regime, or to simply stop for five minutes for a breather without worrying that your boss thinks your slacking off. And we’d be remised to mention that workers were reporting getting more work done at their own pace, because we know managers love productivity.

So, it only makes sense that, while working from home, some employees started wondering why they needed the middleman at all, and suddenly freelance became a viable option again. You can work at your own pace, avoiding all the money spending and polluting that comes with commuting, and be your own boss on top of that.

And it’s easy to apply a freelancing role to almost any skillset. To start, take a look at the role you’re in at the moment. If you can do it from a computer, is there anything stopping you doing it for yourself rather than a company? Think about applying a freelance position to the role you have for an easy transition.

However, if you’re trying to get out of the job, you’re in, there are a lot of options there too. It’s all about matching your skillset to the right freelance job. If you have skills in numbers, you can look into accounting. If you’re handy, you can get a van and get into trades like plumbing, carpentry, DIY, etc. If you have organizational skills, you can look into being a personal assistant to various clients. If you have writing skills you can look into ghost writing, copywriting, journalism, etc.

Teacher

And there is another option if you have all these skills that you can use: teaching. Teaching comes in many capacities. The traditional means of teaching in a school takes a lot of education and internships before you are there in the room, but lockdown has unveiled a lot of ways it can be easier.

If that doesn’t appeal to you, you can use the best lesson of business life in lockdown: use video calls. Sure, traditional teachers and lecturers had to adapt to Zoom, and some didn’t do well there, but you’ve been using Zoom for at least a couple of years now, and you can use it to teach all around the world. Get hired as a personal tutor or put university study groups together to give more personal tutoring to those who are willing to pay for a helping hand.

And, going back to the influencer’s …influence, a lot of online courses are popping up on big social media accounts. You can record a curriculum of your chosen topic and sell access to it for anyone who is interested.

The best part about this is that you can sell courses on just about anything, be it fitness regimes, makeup tutorials, cooking, DIY, or university subjects like social sciences and literature analysis.

If you can market yourself as a reliable source in your field of study, you can record everything you know in some simple, easy to digest content, and put it behind a paywall like Patreon.