By K.J. Quinn
Healthcare is among the most challenging environments for the A&D community to service, and with good reason. Interior finishes must be hygienic and provide for the health and safety of patients, visitors and staff. The flooring must be tough enough to withstand the daily, around-the-clock pounding from rolling and foot traffic and still be easy to maintain.
“When designing healthcare facilities, we think of safety, function and aesthetics,” said Lyudmyla Matyushko, an interior designer at EwingCole, Philadelphia. “Sterile environments are meant to be safe and germ/bacteria free.”
Linoleum is a floor covering that meets these criteria and is no stranger to designers. Introduced more than a century ago, today’s linoleum is harkening a new generation of specifiers as a durable, all-natural alternative to resilient flooring.
“The major attribute of linoleum that makes it applicable to medical centers and hospitals is its sheet production,” noted James Johnson, commercial segment manager, Armstrong Flooring. “The sheet application allows for minimal seams and, therefore, offers less opportunity for bacteria to hide in grout lines or floor seams. Additionally, this allows for better maintenance options than other flooring.”
Perhaps one of the biggest selling points of linoleum is its ability to meet the rigorous requirements for sterile environments found in intensive care, operating and emergency rooms. Infection control is critical as nearly 100,000 people die annually from HAIs (Hospital Acquired Infections), according to the Centers for Disease Control and Prevention. “Given these factors, we can understand why cleanliness and sanitation are a priority for all types of healing environments,” said Cynthia Hubbel, director of healthcare strategy and development at Tarkett. “Overall, healthcare flooring must be durable to endure high traffic flow and the rigorous maintenance used to combat bacteria and secondary infections.”
Properly selected flooring can not only lower the risk of HAIs, but enhance safety by reducing falls while toning down noise levels in treatment areas. And since linoleum can be flash coved and either heat or chemically welded, it allows for minimal seams and a natural antimicrobial surface healthcare facilities look for. “Seamless floors are certainly better at preventing mold and bacteria growth,” noted Angie Clarkson, LEED AP BD+C, project manager and interior designer, LWPB, Oklahoma City. “And linoleum does not contain any of the potentially dangerous plasticizers and heavy metals that are found in a lot of PVC or other vinyl products.”
Linoleum is made from natural materials such as linseed oil, jute, cork powders and tree resins. The product is antistatic, hypoallergenic and does not emit potentially harmful VOCs, so it contributes to good indoor air quality. “Additionally, the recent trend of phthalate free has many designers changing specifications for these spaces,” Armstrong’s Johnson observed. “Armstrong linoleum offers no ortho-phthalates or heavy metals, low volatile organic compound (VOC) emissions and is FloorScore certified.”
CLEANING AND MAINTENANCE BENEFITS
Following proper guidelines for cleaning and disinfecting is the first and best line of defense against HAIs. But the frequency of cleaning with harsh, complex chemicals to maintain a sterile status can wreak havoc on a floor’s performance. “While hospitals tend to like ‘shiny floors’ linoleum typically has a factory-finished wear layer with a matte sheen that can be maintained without waxing, cutting down on maintenance costs, chemical use and downtime,” noted Amanda Logatto, interior designer, Perkins+Will, Washington.
Vendors do offer proprietary coatings that protect linoleum and make it a more durable material. For example, Forbo reports that its Marmoleum with TopShield2 provides an occupancy ready finish that can be renewed easily and cost effectively, bringing the floor back to its original beauty after years of heavy use.
“This is important to facility managers that are tasked with different cleaning and disinfecting methods needed throughout the facility, from using auto-scrubs in the corridor to microfiber in the patient rooms,” said Casey Johnson, business development manager for Forbo’s Marmoleum, North America. “Forbo works closely with our customers to listen and review cleaning and maintenance procedures with facilities and offer insight and training that meets the facility’s needs and requirements.”
Life cycle costing is another major advantage for linoleum in comparison to other commercial floors as it can wear and look well for considerably longer while requiring less maintenance. “Healthcare facilities are looking for flooring products that offer extended system service life, excellent cost of ownership and minimize environmental harm,” noted Forbo’s Johnson. “The Marmoleum line finds use in ERs, procedure rooms and specialized care/ treatment areas such as blood draw and oncology.”
EXTENDED DESIGN CAPABILITIES
Designers use materials to support the architectural interior design of a building, so patterns and colors are all part of the big picture in the specification process. “The inspiration for pattern can come from the building, function or creating rooms using flooring as a boundary, or transitioning from one type of space to another,” noted Karen Miller, an interior designer at EwingCole. “Inspiration can come from anywhere and is not limited to the healthcare solutions, so a variety of design options is key.”
Similar to other resilient floors, linoleum comes in multiple fresh hues, and the color and pattern extend through the entire thickness of the product. When specified in roll goods, linoleum allows for flowing designs and adds natural influences to otherwise harsh environments. “The beautiful marbleized patterns in linoleum are steadfast and have remained popular with the design community for the last 75 years,” Tarkett’s Hubbel pointed out. “From an installation perspective, it’s easy to create intricate shapes and patterns because the material is flexible.”
Like resilient and rubber, linoleum can be waterjet cut with intricate patterns and inlays. “Borders and fields, medallions, stripes, tiles and planks offer an outstanding range of product application,” said Robin Guenther, principal, FAIA, LEED Fellow, Perkins+Will, New York. “We have even wrapped linoleum up the walls.”
Various industry studies have shown that healthcare design has proven to impact patient care and enhance medical outcomes, in addition to meeting infection control standards. The rise of evidence based design (EBD) is prompting many facilities to move away from stark institutional looks and create atmospheres which are more home-like. “Linoleum has a less institutional aesthetic than other sheet goods, and its color range is both bold and subtle,” Guenther noted. “We use it extensively in outpatient settings.”
As facilities work to provide a space with the look and feel of hospitality, patterns that resemble natural materials are becoming more popular in public and surgical areas, observed Mary Dickinson, regional sustainable design leader, Perkins+Will, Dallas. “With the availability of tile and sheet options with the same wood-look pattern, linoleum now has the unique ability to meet a design aesthetic without changing products.”
Wayfinding also plays an important role in a designer’s decision-making process, and linoleum meets this need within the healthcare segment as well. “Linoleum is a good choice for embedding wayfinding cues in corridors to section the different zones in patient rooms and to create clean/dirty boundaries at labs or pharmacies,” Perkins+Will’s Logatto said.
Regardless of project, healthcare designers concur it’s best to use a balanced choice approach when selecting flooring. While resilient and soft surfaces are proven performers when placed in the appropriate areas, linoleum’s range of colors, patterns and shapes, combined with its cost effectiveness, ease of maintenance and sustainable attributes check many of the healthcare segment’s boxes.