Designing for Safety and Privacy in New Healthcare Spaces
Designing for Safety and Privacy in New Healthcare Spaces
Healthcare design asks two things of nearly every room that pull in opposite directions. Clinicians need to see patients, often without stepping inside. Patients need to be shielded from the corridor, from other patients, and from anyone who does not need to be part of their care. A wall solves the second problem and creates the first. An open bay solves the first and fails the second.
For years the default answer has been a sheet of clear glass with something soft hung behind it: a fabric curtain, a roller shade, a horizontal blind. That approach works on day one. It tends to work much less well by year five, when the curtain has been laundered (or not), the blind cords have been tied up out of the way, and the infection prevention team has started asking hard questions. This piece looks at what the research says about privacy, visibility, and hygiene in clinical spaces, and how glazing choices made early in design can resolve the tension instead of managing it.
Privacy is part of the care, not an amenity
It is easy to file patient privacy under comfort, alongside nicer finishes and better food. Emergency physicians would put it closer to clinical quality. A 2024 review by the American College of Emergency Physicians Ethics Committee names open ED layouts, patients and visitors in close proximity, and chronic crowding as ongoing obstacles to protecting patient confidentiality (Brenner et al., JACEP Open, 2024).
Patients notice. In a study of 821 emergency department patients in Newfoundland and Labrador surveyed between 2021 and 2023, one in four reported insufficient privacy (Privacy Matters, 2025). Crowding makes it worse. A 2022 review in the Journal of Emergency Medicine notes that patients treated in hallway beds have no verbal or physical privacy at all, which makes an accurate history and a complete exam impossible (Richards et al., 2022).
That matters because privacy and disclosure are linked. Earlier ED research found that some patients in curtained bays withheld part of their history or refused part of an exam because they thought they could be seen or overheard (Barlas et al., 2001). Staff habits play a role, but design sets the baseline, and a fabric curtain does little to block sound or keep a gap from opening.
Visibility is a safety tool
The case for sightlines is just as strong. AHRQ estimates that between 700,000 and 1,000,000 people fall in U.S. hospitals every year, and its fall prevention toolkit names the hospital’s physical design and environment as one of the levers alongside managing each patient’s individual risk (AHRQ). A 2025 ECRI analysis of 71,456 falls found that most happened during transfers, toileting, or walking, which are exactly the moments when a quick look through a door lite can bring a nurse into the room before the patient tries to stand alone (TechTarget summary of ECRI data).
Visibility also lets staff check on a sleeping patient without opening a door, waking them, and resetting the room’s noise and light. In ICUs, step-down units, and behavioral health settings, observation is a care requirement in its own right, often on a set schedule. Every time a clinician has to enter a room just to look, that is time and an interruption the design could have saved.
So the goal is not privacy or visibility. It is control: clear when care calls for it, private when dignity calls for it, and easy for staff to switch between the two dozens of times a shift.
The hygiene cost of soft privacy
The traditional fix for the privacy and visibility problem, a curtain or blind you can pull when needed, introduces a third problem. Anything a hand grabs to open or close is a high-touch surface, and fabric is hard to keep clean.
The concern is not new. A 2012 University of Iowa study found 92% of newly hung privacy curtains in ICUs and a medical ward were contaminated within a week (Ohl et al., American Journal of Infection Control). More than a decade later, hospitals are still working around it. An ICU study published in late 2025 found conventional fabric curtains carried more than ten times the contamination of antimicrobial disposable replacements after 30 days, and that switching cut curtain-related costs by about 59% (Skuntaniyom et al., American Journal of Infection Control, 2025). Treated fabrics, disinfection systems, and replacement schedules all help, but each one is an ongoing cost attached to a soft surface the room could be designed without.
Open blinds carry a related burden. Slats collect dust, cords and wands become touch points, and both need routine cleaning that competes with every other environmental services task on the unit. For designers, the takeaway is that any privacy device the room depends on should either be easy to wipe down as part of normal surface cleaning or be sealed away where hands and dust cannot reach it.
Matching the privacy method to the space
Glazing that controls its own privacy removes the soft layer altogether. The privacy mechanism either sits inside the glass assembly or is the glass itself, so the room keeps a smooth surface that cleans like any other. The harder question is which method fits which room, because a corridor door lite, an ICU front, and a family consult room each ask for something different.
| Space | What it usually needs | Approaches that fit |
|---|---|---|
| Patient room doors and observation windows | Quick check-ins, controlled sightlines, nothing added to the cleaning list | Switchable glass; mechanical privacy vision panels; integral blinds |
| Exam and consultation rooms | Privacy for examinations and sensitive conversations | Switchable glass; integral blinds |
| Exterior-facing patient rooms | Daylight, glare and solar control, and darkness for rest | Dynamic glazing; sealed smart shades |
| Imaging and light-sensitive rooms | Full blackout where incoming light must be controlled | Sealed smart shades; dynamic glazing with a shade state |
| Behavioral health rooms | Observation, tamper resistance, and ligature-conscious hardware | Mechanical privacy vision panels; integral blinds; switchable glass for counseling rooms |
| Waiting, pediatric, and family areas | Separation, wayfinding, and color or imagery | Decorative printed glass; dynamic glazing for exterior-facing lounges |
None of these is the right answer everywhere. A behavioral health unit and a cardiac ICU can share a building and need very different glass, and many projects will use two or three approaches across one floor. That is the point of choosing early: the decision follows the care model in each room instead of a single spec carried across the drawings. (For a closer look at observation in behavioral health specifically, see our earlier PGS Perspective, The Behavioral Health Design Mistake Hiding in Plain Sight.)
Questions worth settling in schematic design
Privacy glazing tends to get decided late, often as a substitution during submittals, when framing, power, and door hardware are already locked. Settling a handful of questions during schematic design keeps the options open.
- Who controls privacy in this room, and from which side? Staff only, patient only, or both changes the operator and hardware choice.
- Is power available at the opening, and should it be? Switchable glass needs a low-voltage supply coordinated with the electrical engineer early. Mechanical vision panels need no power, integral blinds come in manual, magnetic, and powered versions, and some sealed shades run on batteries.
- What should the room do if power is lost? PDLC glass is opaque when unpowered, so it defaults to private, but confirm that behavior for any product before specifying it.
- Does the room need to control the view, the light, or both? Switchable glass and vision panels control the view while still passing diffused daylight. Real darkness for sleep or imaging calls for a sealed blackout shade or dynamic glazing with a shade state, and exterior windows may also need solar and glare control.
- What do infection prevention and environmental services need? Bring them in before the spec is written, not after the first cleaning audit. Systems sealed inside the glass leave the operator as the only touch point.
- What are the ligature and tamper requirements? In behavioral health spaces, confirm the hardware and the complete opening, not just the glass.
Designing out the compromise
For a long time, safety and privacy in healthcare rooms were treated as a trade: more of one meant less of the other, with a curtain or blind left to manage the gap. Better glazing changes that math. When privacy lives in the glass, clinicians get the view they need, patients get the dignity they expect, and infection prevention gets one less soft surface to worry about.
PGS offers a product line that supports healthcare projects, from patient rooms and observation areas to imaging suites and family spaces. If you are working through these decisions on a current project, explore our healthcare solutions or call 866.466.9525.
Sources
- Brenner JM, et al. Privacy and confidentiality of emergency department patient information: Contemporary considerations and challenges. JACEP Open, 2024.
- Privacy Matters: Experiences of Rural and Remote Emergency Department Patients. Newfoundland and Labrador, 2025.
- Emergency Department Hallway Care From the Millennium to the Pandemic: A Clear and Present Danger. Journal of Emergency Medicine, 2022.
- Barlas D, et al. Comparison of the auditory and visual privacy of emergency department treatment areas with curtains versus those with solid walls. Annals of Emergency Medicine, 2001.
- Agency for Healthcare Research and Quality. Falls prevention. AHRQ
- ECRI fall analysis, 2025, as reported by TechTarget
- Ohl M, et al. Hospital privacy curtains are frequently and rapidly contaminated with potentially pathogenic bacteria. American Journal of Infection Control, 2012.
- Skuntaniyom S, et al. Assessment of bacterial contamination on antimicrobial disposable curtains compared to fabric curtains in intensive care unit patients. American Journal of Infection Control, 2025. Abstract
