The unusual layout of this clinic is designed to help children with chronic pain

[ResidentialBusiness]

Everyone knows pain. It’s the most common ailment people experience, from a headache to a stubbed toe to a sore back. Treating pain can be as straightforward as popping a pill. But for people experiencing chronic pain—like the lingering aftereffects of chemotherapy or the slow rehabilitation after a major car accident—medication is rarely enough to fully erase the pain. When the patient experiencing chronic pain is a child, the stakes can feel even higher.

To help children experiencing chronic pain, a new kind of clinical space has been created that goes way beyond handing out medication. The Stad Center for Pediatric Pain, Palliative and Integrative Medicine is a holistic clinic that combines Western medicine, rehabilitation, psychological care, and less conventional forms of pain management, including hypnotherapy, acupuncture, and meditation. In its newest location, designed by the architecture firm NBBJ and opening next month in San Francisco, the architecture of the clinic plays a significant role in this multifaceted approach to treating pain.

[Photo: NBBJ/courtesy UCSF]

“It was specifically designed in a way to start the healing before children even see the first doctor,” says Dr. Stefan Friedrichsdorf, medical director of the Stad Center.

The clinic features nature-inspired decor, alcoves, and furnishings. Two themes, underwater and redwood forest, appear throughout the clinic and are given playful, almost interactive elements to encourage engagement among younger patients. One wall in the lobby features a projected digital waterfall over a forest scene, and its flowing water responds to the movement and touch of children who come near it. Natural-looking materials, abundant daylight, and spacious common areas are intended to exude calm.

“We’re one of the very few places that really show that our goal is to help children and adolescents and young adults to get back to normal life and get rid of the pain,” Friedrichsdorf says.

[Photo: NBBJ/courtesy UCSF]

Rethinking the waiting room

Part of the University of California San Francisco Benioff Children’s Hospitals system, the Stad Center is a five-year-old clinic that builds off Friedrichsdorf’s previous working building a similar pain center in Minneapolis. When the opportunity arose to build a brand new space at UCSF, Friedrichsdorf flew the NBBJ design team out to Minneapolis to see how this holistic approach to treating pain works. In addition to its inclusion of non-Western medical and healing modalities, Friedrichsdorf’s multidisciplinary approach avoids some of the spatial separations that can slow the delivery of care.

[Photo: NBBJ/courtesy UCSF]

The biggest difference between this new clinic and most health care spaces is that it does not have a formal waiting room. To reduce the anxiety that young patients can experience in hospital settings, the clinic was designed to make a smooth transition from the outside to a consultation area, exam room, or therapy space. The lobby is one point of a circular pathway that leads to sitting areas, treatment rooms, and rehabilitation spaces. There are almost no right angles, and the designers used natural curves to inform its layout.

[Photo: NBBJ/courtesy UCSF]

Another major focus of the design was creating a space where the center’s team of multidisciplinary practitioners can meet with new patients, all together, to understand the pain conditions and plan out a course of treatment. “That intake can take a long time, because we really want to spend the time to understand what brought the child to the clinic and then really think about what we would recommend for them,” says Dr. Karen Sun, a hospitalist at the Stad Center.

Friedrichsdorf explains that chronic pain can often be hard to detect, which leads many doctors to either ignore it or over-medicate it. “Kids have often heard ‘well, we don’t see anything on the imagery, therefore the pain is not real, therefore you’re crazy or you’re making this up,’” he says. “I always tell my kids your pain is real, you’re not crazy, you’re not making this up. I see this all the time. Now, what do we need to do to make sure that this pain goes away?”

[Photo: NBBJ/courtesy UCSF]

A new approach to chronic pain

The intake meeting with the clinic’s various practitioners helps the team understand the pain and identify the best interventions, be they medical, rehabilitative, or less conventional forms of healing. “It feels very cohesive. It feels very much like things flow. And they leave with a really strong sense of what’s going to happen,” Sun says. “There’s none of this, ‘Oh, we’re going to refer you to physical therapy and then you have to wait for three months.‘”

[Photo: NBBJ/courtesy UCSF]

That physical therapist is typically in the room for that intake meeting, and the physical therapy gym is right down the hall. Same with the acupuncture and acupressure studios, meditation spaces, and more conventional medical exam and treatment rooms. One feature patients have responded to well in early testing is the multisensory room, which features dimmable lights, speakers built into chairs, a hanging swing, a climbing wall, and other interactive elements meant to help calm children with particular sensitivities. “This is something quite fabulous and originally meant for children who have impairment of the brain or other senses,” Friedrichsdorf says. “However, we found that otherwise healthy kids and teenagers really, really enjoy this room.”

Pulling all these treatment types into one center means that patients can easily access whatever will help address their specific type of pain.

“We have found if we combine the best Western medicine and medications, interventions, surgery, rehabilitation, and psychology with those integrative modalities, that kids heal much faster and get back to life earlier,” Friedrichsdorf says.

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