Planning and Design of Behavioral Healthcare Facilities

Behavioral Healthcare Facilities: The Current State of Design

In keeping with most districts of healthcare, the marketplace has seen a boom in the construction of Behavioral Healthcare facilities. Contributing to this increase is the paradigm shift in the way society views mental illness. Society is placing a heavier value on the need to treat people with serious addictions such as alcohol, prescription and elicit drugs. A large percentage of people suffering from behavioral disorders are afflicted with both mental and addictive behaviors, and most will re-enter communities and either become contributors or violators.

These very specialized facilities do not typically yield the attention from today’s top healthcare designers and their quantity accounts for a small fraction of healthcare construction. However, Behavioral Healthcare projects are increasing in number and are being designed by some very prominent architectural firms such as Cannon Design and Architecture Plus. Many are creating state-of-the-art, award-winning contemporary facilities that defy what most of us believe Behavioral Healthcare design to be.

Changing the Way We Design Behavioral Healthcare Facilities

As with all good planners and designers, A+D (along with facility experts) are reviewing the direct needs of patient and staff while reflecting on how new medicine and modern design can foster patient healing rates, reduce environmental stress, and increase safety. This is changing the face of treatment and outcome by giving the practitioner more time to treat because they require less time and resources to “manage” disruptive patient populations.

The face of Behavioral Healthcare is quickly changing. No longer are these facilities designed to warehouse patients indefinitely. And society’s expectations have changed. Patients are often treated with the belief that they can return to their community and be a contributor to society. According to the National Association of Psychiatric Health Systems (NAPHS), depending on the severity of illness, the average length of stay in a Behavioral Healthcare facility is only 9.6 days.

What has changed?

Jaques Laurence Black, AIA, president and principal of New York City-based daSILVA Architects, states that there are two primary reasons for the shortened admission period:

1. Introduction of modern psychotropic drugs that greatly speed recovery

2. Pressures from insurance companies to get patients out of expensive modes of care

To meet these challenges, healthcare professionals are finding it very difficult to effectively treat patients within the walls of antiquated, rapidly deteriorating mental facilities. A great percentage of these facilities were built between 1908 and 1928 and were designed for psychiatric needs that were principled in the belief to “store” not to “rehabilitate.”

Also impacting the need for Behavioral Healthcare construction is the reluctance of acute-care facilities to provide mental health level services for psychiatric or addiction patients. They recognize that patient groups suffering from behavioral disorders have unique health needs, all of which need to be handled and treated only by very experienced healthcare professionals. This patient population also requires a heightened level of security. Self-harm and injuring staff and other patients are major concerns.

The Report of the Surgeon General: “Epidemiology of Mental Illness” also reports that within a given year about 20% of Americans suffer from a diagnosable mental disorder and 5.4% suffer from a serious mental illness (SMI ) – defined as bipolar, panic, obsessive-compulsive, personality, and depression disorders and schizophrenia. It is also believed 6% of Americans suffer from addiction disorders, a statistic that is separate from individuals who suffer from both mental and addiction disorders. Within a given year it is believed that over one-quarter of America’s population warrants levels of mental clinical care. Even if these statistics were cut in half, it cannot be denied as a serious societal issue.

With a growing population, effectively designing in accordance with such measures is at the heart of public health.

Understanding the Complexity of Behavioral Healthcare Design

Therefore, like Corrections, leading planners and designers specializing in Behavioral Healthcare are delving deeper to better understand the complexity of issues and to be the activist to design facilities that promote treatment and healing – and a safer community.

The following is a list of key design variables that are being studied and implemented:

1. Right Sizing

2. Humanizing Materials and Color

3. Staff-Focused Amneties and Happiness

4. Security and Safety

5. Therapeutic Design Tenants

Right-sizing

Today’s Behavioral Healthcare facilities are often one-story single buildings within a campus size. Often debated by Clients due to costs, this design preference is driven by the demand for natural light, window views to nature for all patient areas, and outdoor open-air gardens “wrapped” within. All of this provides soothing qualities to the patient, reduces their anxieties, counteracts disruptive conduct and helps to reduce staff stress.

“When you look at the program mix in these buildings, there’s a high demand for perimeter because there are a lot of rooms that need natural light. Offices, classrooms, dining areas, community rooms, and patient rooms all demand natural light, so you end up with a tremendous amount of exterior wall, and it forces the building to have a very large footprint.” – James Kent Muirhead, AIA, associate principal at Cannon Design in Baltimore

These design principles are also believed to improve staff work conditions. Unlike a multi-story complex, at any moment staff can walk outdoors and access nature, free from visual barriers, and within a building that more accurately reflects building types that both patients and staff would encounter in their communities.

In addition to right-sizing for the overall building footprint, is right-sizing for internal patient and staff support area. Similar to the move we have seen in Corrections to de-centralize support spaces, Behavioral Healthcare is moving to decentralized nursing/patient units called “neighborhoods.” With mental health facilities there is a large concern with distances and space adjacencies in relation to the patient room and patient support areas such as treatment and social spaces. Frank Pitts, AIA, FACHA, OAA president of Architecture Plus, Troy, NY, advocates neighborhoods that average 24-30 beds arranged in sub-clusters, called “houses”, of 8-10 beds. Thus, each neighborhood consists of three houses. Often these layouts will include a common area where patients congregate and socialize, with a separate quiet room so patients can elect to avoid active, crowded areas. In addition Pitts states, “There’s a move away from central dining facilities. So, while facilities will still have a central kitchen, it’s a whole lot easier moving food than it is patients.” However, it is important for the facility to mimic normal outside daily life routines, so patients are encouraged to frequently leave their neighborhoods to attend treatment sessions, and outdoor courtyards.

Humanizing Materials & Color

In all facilities that play a role in rehabilitation, design strives to create spaces that humanize, calm, and relax. Behavioral Healthcare patients need to feel that they are in familiar surroundings; therefore, the architectural vocabulary should feel comfortable and normal. Since these facilities are about rehabilitation (when possible) and encouraging patients to merge back into society, the facility should feel like an extension of the community. Their spaces should reflect the nature and architecture of the surrounding region and thus so, no two facilities should look too much alike.

“Our approach to designing these facilities is to view the facility as an extension of the community where patients will end up when they’re released. Interior finishes also depend on geography because you want to replicate the environment patients are used to. You want to de-stigmatize the facility as much as possible.” – Tim Rommel, AIA, ACHA, OAA, principal with Cannon Design in Buffalo, NY.

Therefore, materials and colors within these spaces want to feel familiar to one’s region and everyday life. To soothe the psyche and rehabilitate, they want to feel soft and comfortable, yet visually stimulating. An interior that is overly neutral or hard in appearance is not appropriate. Materials should reduce noise, and colors should lift the spirit. This can help to create an environment in which the patient can learn, socialize, and be productive while easing anxieties, delivering dignity, and modifying behavior. As stated previously, behavioral studies advise the use of softer interior materials-like carpeting, wood doors and tile. Doing so translates directly to both patient and staff well-being, particularly staff safety, and makes for a nicer place to work. In addition, staff have more resources to “treat” instead of manage heated situations. When staff experiences are eased and satisfied, morale is boosted and life-saving rules and policies are more likely to be enforced.

Staff-Focused Amenities & Happiness

While reducing staff stress and fatigue through a healing supportive environment seems like an obvious goal, there are relatively few studies that have dealt with this issue in any detail. More attention has been given to patient outcomes. However, many leading hospitals that have adopted therapeutic tenants into their newly built environments have seen vast improvement through their “business matrixes” and financial reporting.

In one example, the Mayo Clinic, a national leader in implementing healing design in its facilities, has reported a reduction of nursing turnover from a national annual average of 20% to an annual 3%-4%. In another example, when Bronson Methodist Hospital incorporated evidence-based design into its new 343-bed hospital, they cited their 19%-20% nurse turnover rate dramatically dropped to 5%.

Now, both the Mayo Clinic and Bronson Methodist Hospital have had to initiate a waiting list for nursing staff seeking positions. This converts to better-trained and qualified staff, and a reduced error rate. Therefore, more health facilities are investing in staff support areas such as lounges, changing rooms, and temporary sleep rooms. Within these staff spaces and in the hospital throughout, facilities are also recognizing the need for upgrade materials, better day lighting, and an interesting use of color: One soon realizes that the need of patients and staff are interwoven, each impacting positively or negatively the other.

Security & Safety

Without debate, self harm and harm to staff is one of the biggest concerns mental health facilities manage. Often the biggest safety and security concern is the damage patients can do to themselves. “There are three rules I had drummed in me,” says Mark Hanchar; Director of Preconstruction Services for Gilbane Building Company, Providence, R.I. “First, there can’t be any way for people to hang themselves. Second, there can be no way for them to create weapons. Third, you must eliminate things that can be thrown.” Hanchar says that the typical facility is, “a hospital with medium-security prison construction.” This means shatter proof glass, solid surface countertops (laminate can be peeled apart), stainless steel toilets and sinks (porcelain can shatter), push pull door latches and furniture that cannot be pulled apart and used as a weapon. These are just to name a few.

Additionally, removing barriers between patients and nursing staff is a safety consideration. Frank Pitts, AIA, FACHA, OAA president of Architecture Plus, says what may be counter-intuitive for safety precautions, “Glass walls around nursing stations just aggravate the patients.” Removing glass or lowering it at nursing stations so patients can feel a more human connection to nurses often calms patients. There is also discussion of removing nursing stations altogether; decentralizing and placing these care needs directly into the clinical neighborhoods and community spaces. Pitt says, “The view is that [nursing staff] need to be out there treating their patients.”

Therapeutic Design Tenants

As medicine is increasingly moving towards “evidence-based” medicine, where clinical choices are informed by research, healthcare design is increasingly guided by research linking the physical environment directly to patient and staff outcomes. Research teams from Texas A&M and Georgia Tech sifted through thousands of scientific articles and identified more than 600 – most from top peer-reviewed journals – to quantify how hospital design can play a direct role in clinical outcomes.

The research teams uncovered a large body of evidence that demonstrates design features such as increased day-lighting, access to nature, reduced noise and increased patient control helped reduce stress, improve sleep, and increase staff effectiveness – all of which promote healing rates and save facilities cost. Therefore, improving physical settings can be a critical tool in making hospitals more safe, more healing, and better places to work.

Today’s therapeutic spaces have been defined to excel in 3 categories:

1. Provide clinical excellence in the treatment of the body

2. Meet the psycho-social needs of patients, families, and staff

3. Produce measurable positive patient outcomes and staff effectiveness

Considering the cost of treating mental illness, which is exceedingly high, and wanting facilities to have effective outcomes, a further practice of incorporating therapeutic design is increasing. The National Institute of Mental Health (NIM H) approximated in 2008 that serious mental illnesses (SMI ), costs the nation $193 billion annually in lost wages. The indirect costs are impossible to estimate.

The estimated direct cost to clinically treat is approximately $70 billion annually and another $12 billion spent towards substance abuse disorders. In addition to the increased need of care and the boom in Behavioral Healthcare construction, it becomes an obligation to make certain that we as facility managers, architects, designers and manufacturers therapeutically plan and design these facilities.

Notably, in 2004, “The Role of the Physical Environment in the Hospital for the 21st Century: A Once-in-a-Lifetime Opportunity,” published by Roger Ulrich P.H.D., of Texas A&M University, was released. In a culmination of evidence-based research, research teams found five design principles that contributed significantly to achieving therapeutic design goals.

The report indicates five key factors that are essential for the psychological well-being of patients, families and staff, including:

1. Access to Nature

2. Provide Positive Distractions

3. Provide Social Support Spaces

4. Give a Sense of Control

5. Reduce or eliminate environmental stress

Access to Nature

Studies indicate that nature might have the most powerful impact to help patient outcomes and staff effectiveness. Nature can be literal or figurative – natural light, water walls, views to nature, large prints of botanicals and geography, materials that indicate nature and most importantly, stimulating color that evokes nature. Several studies strongly support that access to nature such as day-lighting and appropriate colorations can improve health outcomes such as depression, agitation, sleep, circadian rest-activity rhythms, as well as length of stay in demented patients and persons with seasonal affective disorders (SAD).

These and related studies continue to affirm the powerful impact of natural elements on patient recovery and stress reduction. Thus, it is clear that interior designs which integrate natural elements can create a more relaxing, therapeutic environment that benefits both patients and staff.

Positive Distractions

These are a small set of environmental features that provide the patient and family a positive diversion from “the difficult” and, in doing so, also negate an institutional feel. These can be views to nature, water walls, artwork, super imposed graphics, sculpture, music – and ideally all of these want to be focused on nature and, when applicable, an interesting use of color. Therapeutic environments that provide such patient-centered features can empower patients and families, but also increase their confidence in the facility and staff. This helps with open lines of communication between patient and caregiver.

Social Support Spaces

These are spaces designed partially for the patient but mainly for the comfort and socialization of family members and friends of the patient; therefore, family lounges, resource libraries, chapels, sleep rooms and consult rooms all play a role. When family and friends play a key role in a patient’s healing, these spaces encourage families to play an active role in the rehabilitation process.

Sense of Control

In times when patients and family feel out of control, it is very healing for the facility design and staff to provide it back when appropriate. Although, this cannot always be done suitably in mental healthcare facilities. However, when applicable, these design features include optional lighting choices, architectural way-finding, resource libraries, enhanced food menus, private patient rooms and

optional areas to reside in. A few well-appointed studies in psychiatric wards and nursing homes have found that optional choices of moveable seating in dining areas enhanced social interaction and improved eating disorders. When patients feel partially in control of their healing program and that the building features are focused to them, an increased confidence of the quality of care enters and tensions lower.

As with all therapeutic design, this allows the caregiver to use their resources healing in lieu of “managing” patient populations.

Reduce or Eliminate Environmental Stress

Noise level measurements show that hospital wards can be excessively noisy places resulting in negative effects on patient outcomes. The continuous background noise produced by medical equipment and staff voices often exceeds the level of a busy restaurant. Peak noise periods (shift changes, equipment alarms, paging systems, telephones, bedrails, trolleys, and certain medical equipment like portable xray machines are comparable to walking next to a busy highway when a motorcycle or large truck passes.

Several studies have focused on infants in NIC Us, finding that higher noise levels, for example, decrease oxygen saturation (increasing need for oxygen support therapy), elevate blood pressure, increase heart and respiration rate, and worsen sleep. Research on adults and children show that noise is a major cause of awakening and sleep loss.

In addition to worsening sleep, there is strong evidence that noise increases stress in adult patients, for example, heightening blood pressure and heart rate. Environmental surfaces in hospitals are usually hard and sound-reflecting, not sound-absorbing causing noise to travel down corridors and into patient rooms. Sounds tend to echo, overlap and linger longer.

Interventions that reduce noise have been found to improve sleep and reduce patient stress. Of these, the environmental or design interventions such as changing to sound-absorbing ceiling tiles, are more successful than organizational interventions like establishing “quiet hours.”

Conclusion and Additional Information

The information contained in this excerpted report is intended as a guide for architects, specifiers, designers, facility planners, medical directors, procurers, psychologists and social workers which have a stake in providing improved facilities for behavioral healthcare patients. It is a portion of a report entitled “The Contributions of Color” authored by Tara Hill, of Little Fish Think Tank. Ms. Hill was commissioned by Norix Group Inc., in 2010 to research the role color plays in the safe operation of correctional facilities and behavioral health centers. More in-depth information specifically about the psychological influence of color and behavioral healthcare facility design can be found by reading the full report.

A New Coat For Your House

Are you thinking of painting your house? This may seem like a daunting task and to some extent we cannot deny it but a little amount of knowledge and care can go a long way in making it less tedious. There are several things that are involved in the job of painting. A lot of them like, blasting, scaffolding, etc. are done even before you actually get your house painted. Texas coatings and Texas Scaffolding companies are the best for people living in Texas. However, before you hire people to get your painting done, you will need to know and find out several things. This will help you to get the work done efficiently and within your budget.

One important thing that you need to consider is your budget. You must decide on a budget for painting your house. Next, you must ensure that you do all you can to remain within the budget you have decided. A lot of things influence the cost of your painting job. For instance, it is true that scaffolding is a task that you need to invest in before the painting begins. However, your house may or may not require scaffolding. Do not scaffold your house and spend a fortune on it, if you do not need to. Minor things like the color of your house can also affect the cost. When you are painting the house in a color that is similar to the existing color, you will need less amount of paint. A distinctly different color will need more coats of paint.

The tools you use to get your house painted are also important. The most common tools needed for painting are brushes, rollers, spray guns, etc. Make sure you consult your painter or the painting agency before you buy these things. They will be the best people to guide you on buying the right tools. Alternately, your painter may take the responsibility of buying the tools. Other tools that you may also require are ladders, gloves, pails, rags and so on. Ask your painter for a list of equipment that will be required but ensure that things are not bought unnecessarily.

Take care when you hire a painting company or an individual painter. You certainly want to paint your house to make it look beautiful as well as to maintain it. In the hands of a bad painter, your house may end up looking like a disaster. Hence, get a painter who is highly recommended by friends and family. Check their previous work to see the quality of painting they do. Also, check their rates and compare them with other local painters. Of course, you need to compare the quality of work, as it is difficult to judge a painter on the basis of a single parameter. Do not forget to check the safety policy of the company, too.

Spend some time in research before you get your house painted, There are several things you may try when you paint your house. Look up the Internet for some very interesting and innovative ideas. A well painted house will certainly make you proud.

Biggest Wins in Next Four 2007 Bowl Games Belong to East Carolina and Texas – Part 2

Here are the next 4 winners of this year’s 2007 college football bowl game results:

Las Vegas Bowl – Brigham Young Nips UCLA 17-16 on a Blocked Field Goal

Brigham Young, which led UCLA 17-13 at the half and went scoreless in the second half, barely managed to hang on to win 17-16 against UCLA in a game the Cougars should have lost.

After allowing the Bruins a 4th quarter field goal to make it 17-16, BYU’s defense went into the dumper behind K-Mart by allowing UCLA to drive 87 yards in the last 2 minutes to give the Bruins a chip-shot field goal on the final play of the game.

Unfortunately for UCLA and fortunately for Brigham Young, a 280-pound Cougar lineman-Eathyn Manumaleuna (I think his last name is Hawaiian and 6 syllables)-who could not jump out of paper sack, got his right mitt up and became an instant hero. He will go into the BYU folklore history if he is not already there.

The win was the 10th straight for the Cougars who finished the season at 11-2, not too shabby by any standard. BYU dodged a bullet earlier this season against Utah, converting on a 4th-and-18 play in their winning drive to seal a 17-10 victory.

The Bruins only lost 2 games in their first 7, one to Utah 44-6 on the road (gag, gag and gag) and the other to Notre Dame 20-6 at home in the Rose Bowl (good grief). UCLA then lost 4 of its last 5 games plus the Las Vegas Bowl to end at 6-7, a losing season. No wonder UCLA coach Karl Dorrell was pushed out the door before the Las Vegas Bowl even started.

Hawaii Bowl – East Carolina Beats Boise State by a Field Goal, 41-38

Speed killed Boise State’s magic this year as East Carolina, which motored to a 38-14 lead early in the 3rd quarter, darn near sent the game into overtime when their star and the game’s Most Valuable Player-Chris Johnson-fumbled while the Pirates were ready to ice the contest.

Johnson’s fumble was picked up and returned for a 47-yard touchdown to tie the game at 38 with 1:25 left to play. East Carolina managed to drive to the Broncos’ 17 yard line and a last play field goal by Ben Hartman sealed the deal.

All Chris Johnson had done up to his inadvertent fumble was set a NCAA bowl record with 408 all-purpose yards for the Pirates. He rushed for 223 yards, caught 3 passes for 32 yards and returned 6 kickoffs for 153 yards. Boise State, a 10.5-point favorite, managed just 3 yards in the 1st quarter while East Carolina racked up 181 yards behind Johnson’s 106 rushing yards.

If you saw this match-up, Chris Johnson ran by Boise State Broncos as if they were standing still. The Broncos looked like they had lost a saddle and were watching their horse run away. It was Don James, the Dawgfather, who said “speed kills” while he built the University of Washington into a powerhouse in the 1980s and early 1990s as the Huskies’ most successful coach.

Boise State had cruised to a 13-0 mark last year and stunned Oklahoma with a miracle 43-42 overtime victory in the Fiesta Bowl. This year was the 6th straight bowl appearance for the Broncos, who dropped to 10-3 while East Carolina rose to 8-5. If Hawaii wins its bowl game against the SEC’s Georgia Bulldogs, Bronco mania could be in trouble. I hear it is cold in the winter in Idaho.

Did I mention that Boise State was ranked 24th in the final AP Top 25 Poll, 24th in the final BCS Standings, and rated 28th by Sagarin? Sagarin rated East Carolina 75th in its final poll; this is why Boise State was a 10.5-point favorite.

Motor City Bowl – Purdue Beats Central Michigan by a Field Goal, 51-48

Purdue was lucky to get out of Dodge a winner when the Boilermakers traveled to Detroit to face the Mid-American Conference champion Central Michigan Chippewas in the Motor City Bowl. Thankfully, the Boilermakers’ Chris Summers put his foot to the pedal to kick a 40-yard, last play field goal as Purdue drove out of town on top, 51-48.

This was an exciting game for fans to watch unless you care about defense. The combined 99 points tied the second-highest total ever for a bowl game in regulation play, topped only by California’s 52-49 victory over Virginia Tech in the 2003 Insight Bowl.

The game showcased the quarterbacks. Purdue’s Curtis Painter set a school-record 546 yards passing on a 35-for-54 effort (65%) with 3 touchdowns and 2 interceptions, both of which went off of receiver Dorien Bryant’s hands. Central Michigan’s Dan LeFevour completed 17 of 34 (50%) for 292 yards and 4 touchdowns, and picked up another 114 yards on 33 carries.

LeFevour’s 19-yard scoring pass to Bryan Anderson with 1:09 remaining tied the game at 48. LeFevour, a sophomore, finished the year with 27 passing touchdowns and 19 rushing touchdowns, almost matching Heisman Trophy winner Tim Tebow of Florida as the only major college player to have 20 each in a season.

Purdue, which has risen folding in important games to an art form, blew no less than three 21-point leads before Summers decided to win one for a change. The Boilermakers were favored to win by 9 points. Purdue finishes the year at 8-5 and Central Michigan dropped to 8-6.

Holiday Bowl – Texas Beats Arizona State 53-34 for 4th Straight Bowl Victory

Texas quarterback Colt McCoy fumbled 4 times but it was still not enough to slow down his Longhorn teammates as they outlasted Arizona State 53-34 to win the Holiday Bowl. McCoy was helped by the Sun Devils committing 5 turnovers.

Arizona State quarterback Rudy Carpenter had a horrible night, going 18-of-32 for 187 yards and being sacked 4 times. McCoy threw for one score, ran for another and fumbled into the end zone and his teammate Jermichal Finley recovered for another score. McCoy was 21-of-31 (67%) for 174 yards and ran for 84 yards on 16 carries.

A stupid mistake by Texas coach Mark Brown’s stepson, Chris Jessie, marred the game but did not affect the outcome. Jessie touched an errant fumble by Arizona State that was a live ball and the Sun Devils capitalized on the error to score a touchdown. “That’s the most unusual play I’ve ever seen in college football,” ASU coach Dennis Erickson said.

Texas led 28-10 at the half and was not about to be denied a victory. The win by Texas was its 4th straight in bowl competition and lifted its final record to 10-3 as Arizona State dropped to 10-3.

(Editor’s Note: This is the 2nd article of a series on the 2007 bowl game results.)

Copyright © 2008 Ed Bagley

6 Clever Interior Design Ideas Using eBay Finds

As a decorator I get paid to shop. That sounds like a dream job! The downside is that searching for interesting pieces within a set price range can be time consuming. With the price of gas, it can also be expensive to drive all over town. For me, online shopping becomes very appealing as well as practical.

One of my favorite places to shop for interesting and unique items is eBay. I remember the night I first discovered this wonderful site. I spent hours thinking up things to find. Need an Elvis suit? An original Pac Man game? A discontinued fragrance? Someone is probably trying to sell it and eBay will connect you with them.

This is a great site for decorating your home. Make a list of accessories you need to pull your rooms theme together and start shopping. Once you open an account with eBay, you can create a wish list so that you will be alerted when something you want is placed on the market.

Here are some interesting items that I found online:

1. Are you trying to create a vintage bathroom? Hang a glass front cabinet on the wall and fill it with old medicine bottles. A quick eBay search found a variety available for a few dollars. Add to this talcum powder tins and antique razors and you will feel like you are in your great grandmothers bathroom. Nostalgic touches can be very creative decorating.

2. Pottery and glassware are plentiful on eBay. This the fastest way to start a collection that would look great on top of your kitchen cabinets or on your bookshelves. Usually they will draw nice comments from your guests.

3. Cast iron doorstops are another collectible that can easily be bought. Dogs, floral arrangements and even the state of Texas are represented in these decorative pieces. Use them as a door stop or display them along the baseboard of a hallway to create floor art.

4. To add a focal point to a stone floor or wall, check out the marble stone mosaics available. They are hand cut and mesh mounted for easy installation when you are laying tile work. This category also has listings for colorful hand painted pieces that would look wonderful in a backsplash, tabletop or around the edge of a swimming pool.

5. I love the little details in a room. The light pulls that you can buy for less than $5 are a perfect way to add fun to your ceiling fan. I found whales, dragonflies, geckos and billiard balls to buy. I also searched and found great finials that you can also purchase for your lights. These little touches make a big difference.

6. It would be great fun to use the toys you grew up with to decorate a childs playroom? If your beloved items have been given away, you can buy new memories on eBay. Type in vintage toys and see what comes up. It is so much fun to go back in time in this category. I even found a set of 1968 Play-Doh Cans ( empty, thankfully!)

Grab a glass of lemonade and go shopping online this week. You will find things you may have never thought of to buy for your home and it will add to your creative arsenal that will have your guests raving about your decorating abilities.