Flooring decisions: for the long term; One manufacturer's take on how floorcovering decisions influence facility operations and budgets.

Investors, corporations, and facilities spend billions of dollars today on healthcare construction projects. With every project, measures are taken to maximize limited budgets, staff productivity, and other resources. In both new construction and renovation projects, long-term healthcare decision makers must consider two key factors: design aesthetics and material specifications.

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Flooring decisions represent significant part of the design process, both financially and aesthetically. In a long-term care facility, the unique dynamics of the space and anticipated amount of foot or wheeled traffic must be considered. For instance, an environment in which nursing staff are standing constantly may warrant more cushioning than a corridor where beds and walkers are pushed by staff and residents.

In view of the need for sterile conditions and acceptable indoor air quality, long-term care facilities need floorcoverings that are easily maintained. Since most facilities are constantly in use, floor maintenance and repairs should create as little disruption as possible. When specifying flooring options for areas such as resident rooms where noise reduction is important, maintenance requirements should be fully considered.

Today, a responsible long-term care flooring decision is not driven by price so much as by practicality, purpose, and performance. A careful evaluation of the full life-cycle costs of flooring is the only way to make the best decision that yields the greatest return on investment.

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Life-Cycle Costs

A product that costs less today may cost more in the long term if it is not durable. The total cost of flooring specified today includes more than the initial purchase of flooring material. Additional costs to consider include the cost of installation, installation materials such as glue, and maintenance over the life of the product.

An often forgotten but important cost is the value of the downtime that occurs when flooring is installed, especially during a renovation. Depending on the makeup of the existing flooring to be removed, the area may need to be sealed off during renovation to avoid releasing airborne contaminants. When an operational area is "off the market" during flooring installation, revenue is lost as a result of reduced operating capacity and reduced production from displaced workers.

Staffing "wear-and-tear" costs also are important. The potential cost of worker injury or fatigue from inappropriate floorcoverings can quickly add up, as do costs related to turnover if workers quit because of adverse working conditions.

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Studies in the rapidly growing field of healthcare design show that patients and residents are more comfortable and recover faster when the environment is more conducive to healing. Floorcoverings that reduce noise and foster nurturing feelings can contribute to the healing environment. Furthermore, flooring often is used to create wayfinding through corridors to aid foot traffic through the facility, benefiting both residents and visiting family members.

Still another factor to consider is the cost of flooring removal beyond the sheer time involved. The adhesives and installation methods used for some floorcoverings can make them more difficult to remove. Look for adhesives that are "guaranteed releasable" or installation methods that do not require much glue. Also look for adhesives that do not produce airborne contaminants during the removal process.

While it is true that some hard-surface flooring types may last 20 years or more, they may require frequent stripping, waxing, and/or resurfacing that is labor intensive or requires the use of strong chemicals or other potential irritants.

As for durability being an issue in soft-surface selection, even when administrators and housekeeping staff practice proper maintenance routines, traditional broadloom carpet must typically be replaced every five years. Modular carpet, as an alternative, typically has a life span of 10 to 15 years. It also offers individual tiles that can be easily and quickly replaced when worn or damaged, making repairs less disruptive. In many cases, repairs can be performed by staff rather than by costly labor.

Considerations With Renovation

Consider how flooring might affect a renovation in terms of cost savings. Typically, most of the wear on a floor occurs on only 20% of the surface, especially in high-traffic areas such as corridors and cafeterias. Solutions that avoid having to replace the entire floor during renovation can obviously reduce cost.

Floorcovering Myths

Many people believe carpet is more likely to hold mold or bacteria than hard-surface flooring. It is worth remembering that carpet, when properly maintained, can keep contaminants out of the air because particles are retained in it until it is cleaned. Floorcoverings also should be specified with antimicrobial properties and moisture barriers to prevent the growth of mold and bacteria. However, make sure that the antimicrobial is environmentally safe, meets EPA requirements, and will not wash out or leach to other surfaces.

Some say that hard-surface floors are preferable because they don't hold moisture. That is true, but that assertion is balanced by the consideration that hard-surface floors can harbor various particles that can be passed into the air by foot traffic or improper cleaning methods. As for user practicality, denser commercial carpets with lower face weights can provide the cushioning properties of residential carpet along with some of the hard-surface advantages, such as rollability. Also, for settings where acoustics, slip-and-fall, or worker fatigue and injury are of utmost importance, soft-surface floorcoverings may be the best option.

The key is to properly maintain the flooring you select for maximum use and long-term benefits. Follow the manufacturer's recommendations for cleaning and maintenance, even if that means purchasing new floor maintenance equipment or using sophisticated cleaning methods. The return on investment on such items is much higher when flooring is well maintained.

The Issue of Sustainability

Environmental considerations also should be factored into flooring decisions. This pertains to all product elements, including raw materials used, manufacturing methods, potential installation waste products, and postremoval recycling possibilities.

For questions about the product's raw material components or its manufacturing processes, ask the flooring vendor to supply research-based responses to your concerns. There has been some dialogue, for example, over the use of polyvinyl chloride (PVC) in healthcare flooring. Nevertheless, PVC continues to be one of the most efficient and safest options for producing durable floorcoverings for healthcare. If PVC is of concern, inquire about products containing recycled PVC, which offers two main benefits: superior performance, and the closed-loop recycling and manufacturing process in which PVC is reconstructed into a usable product, eliminating the potential health concerns of "virgin" PVC.

Look for flooring manufacturers whose products use the most sustainable processes (in terms of resource use) possible. Also consider manufacturers' options for recycling or "down-cycling" your used floorcoverings to create other useful products.

It is also worth obtaining data from third-party organizations that provide certified information on sustainable products. Look for organizations that utilize stringent criteria addressing an array of issues. For example, Scientific Certification Systems certifies its Environmentally Preferable Products based on a rigorous evaluation process that examines each phase of the products' life cycle, including resource consumption and other product manufacturing considerations, product use, and end-of-life disposal (www.scscertified.com).

Conclusion

The total long-term cost of flooring for your facility can be far greater than the amount invested in preparing for opening day. However, thorough research combined with proper and consistent maintenance can result in a floor that is beautiful and health-sustaining for your residents, practical for your maintenance staff, and cost-effective for your budget.

Gail Nash is Vice-President of Healthcare Strategy for Interface Flooring Systems, manufacturer of high-performance modular carpet with award-winning designs and a construction featuring the company's patented, permanent antimicrobial preservative, Intersept[R]. In 2003, Interface introduced the new i2[TM] collection of flooring that offers creative design options and flexibility and is designed for nondirectional installation without concern for pattern or dye lot. For additional information, call [phone], ext. 6511. To send your comments to the author and editors, e-mail [e-mail]. To order reprints in quantities of 100 or more, call [phone].