In the ever-changing realm of healthcare, acute care facilities are undergoing a substantial transformation, gravitating towards more adaptable and resilient spaces that center more holistically on human needs. With the pulse of progress quickening, this evolving design ideology places a heightened emphasis on improving both patient and provider experiences, all while grappling with the challenges associated with the expansion of healthcare infrastructure. The integration of cutting-edge technology, seamlessly woven into the fabric of interior architectural innovation, heralds a new era where the design of healthcare harmonizes with a resolute dedication to human-centric design from inception through execution. We’re now seeing the future of acute care materialize—a vibrant intersection of innovation, compassion, and design.

Benefits of Human-Centric Design

The adoption of human-centered design in acute care facilities affords a multitude of benefits particularly in the reduction of stress for both patients and healthcare providers. Human-Centric Design focuses on building environments that are nurturing, restorative, and responsive to the needs of those who use them. A crucial component to this design strategy, functional floor plans must be implemented to provide caregivers with clear sightlines and close proximity to patients. Additionally, facilities must increasingly prioritize areas for relaxation and respite for healthcare providers themselves. Thoughtful organization of spaces and elements within them significantly reduces professional stress, thereby increasing employee satisfaction and staff retention. The design of patient-dedicated spaces is equally important, with key considerations including minimizing visual clutter, integrating family zones, and incorporating user friendly technology to enhance accessibility and user control. These elements work together to ensure that patients feel connected and supported throughout their stay.

Creating Innovative Facility Layouts

The latest evolution of design layouts in healthcare facilities is characterized by an increased focus on flexibility and efficiency, prioritizing well-being not only for patients, but also for caregivers. Flexible room designs that adapt and respond to fluctuating patient needs have become common and are a critical feature for integrating proactive and preventative measures. Creating rooms that accommodate a wider variety of needs doesn’t necessarily require a physical increase in size; rather designers are working with facility managers to maximize existing layouts, better equipping them to handle both growing volumes and evolving patient requirements. This also ensures sufficient space for larger equipment storage and personal protective equipment, as well as the implementation of staff respite areas. As the current landscape of acute care projects shows an equal focus on constructing new facilities and renovating existing spaces, with many aimed at expanding or enhancing interiors to improve the quality of care and overall experience, designers are cleverly implementing these considerations while adhering to established spatial guidelines.

Key Design Elements

We have seen several factors and specific design considerations increasingly take precedence in the creation of acute care facilities. Biophilic design, which incorporates natural elements like direct access to nature, natural light, and the use of natural forms in furnishings and architecture, is in-demand. This design approach is seen to aid in healing as it creates a more comforting and therapeutic environment for patients and their loved ones. Designers are exploring how to organize and configure spaces to increase direct access and views to nature and natural light (or implement fixtures that mimic this desired lighting), helping patients to better regulate their circadian rhythms.

Acoustics are another vital factor in modern healthcare design. We’re seeing the continued use of acoustic-backed products, particularly in inpatient corridors, highlighting the importance of noise reduction in ensuring greater patient recovery and sleep quality and staff’s ability to focus. There has been a significant increase in the use of resilient acoustic materials as improved patient sleep quality has become a major topic in the healthcare industry. Despite higher upfront costs and potential issues surrounding certain cleaning methods, it’s crucial to consider these elements as we attempt to craft the best experience for patients possible. While cost and maintenance are often a top priority, facilities are increasingly opting to include better acoustics.

Sustainability remains a growing focus, with an emphasis on using eco-friendly materials. Facility managers are now carefully examining options surrounding product sourcing and lifecycles, while material suppliers themselves are establishing sustainability goals that align with these updated expectations. As a whole, this trend also includes a preference for domestic and locally sourced products, which tend to yield less overall carbon emissions from transportation, aligning with broader environmentally conscious objectives.

The Impact of the Pandemic and Rise of Telehealth

The COVID-19 pandemic has had a profound influence on the design of healthcare facilities. The need for spaces to be flexible, adaptable, and resilient has never been more apparent, underscoring the necessity for designs that can accommodate the potential of future public health emergencies. This includes a greater awareness of material selection and sanitation capabilities, including connections and seaming for grout, calking, etc. The connecting seam between hard and soft flooring can be difficult for facilities and their environmental service teams to maintain. As such, decision-makers now prioritize the use of materials that are easier to clean and typically low maintenance, with approximately 95% of surfaces composed of hard materials. Generally, if carpet tile is used, it is limited to a waiting area or inset within a hard surface flooring in a lobby or waiting area.

The pandemic has also catalyzed ongoing transitions beyond the push for greater flexibility and updated material considerations. Now, designers must increasingly plan for technological integration early in the design process. This integration, which might include elements like smart technology, advanced monitoring, and access to a range of adjustable technology in patient rooms, helps improve communication with patients about their care while offering them greater control of their environment. Outside of these facilities, telehealth has also become prominent, especially as it relates to accessing specialist consultations, indicating a shift towards a more interconnected and digitally advanced healthcare system that acute care facilities must be ready to accommodate.

Overall, the evolution of acute healthcare facilities prioritizes human-centered design and stands as a testament to the healthcare sector’s adaptability and commitment to improving wellbeing for all facility occupants. By embracing innovative layouts, exploring wellness-oriented design elements, and integrating more adaptive means of care, these facilities are poised to provide more effective, efficient, and compassionate healthcare services for years to come.

Beverley Spencer, CID, EDAC, CDT, is a Senior Associate and Interior Designer with FCA.

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BRONX, N.Y. — Simone Healthcare Development, a New York-based hospital construction company, reviews architecture trends that best support the current needs of healthcare as a part of their commitment to supporting the needs of the medical community.

To support optimal patient health, the patient must be cared by a skilled and compassionate medical team — however a team cannot be effective without a quality facility to practice.

Hospital architecture tailored to the needs of the community can improve happiness and health of patients and employees alike.

According to Simone Healthcare Development, following these three key trends in hospital architecture can provide for a better patient experience.

First, hospitals must Focus on Functionality — creating comfort and convenience is essential for patients, their family and employees.

However, hospital construction should support functionality and operations first and foremost. The primary goal of any healthcare facility is to maintain patient health, and any new construction should ensure efficiency and patient care as its first priority.

Having healthy and happy employees means having healthy and happy patients, and it’s the responsibility of hospital leadership to foster a work environment that aids healthcare providers in doing their job as easily as possible.

From easy access to cutting-edge equipment, to layouts that create treatment efficiency, there are various ways that hospital leadership can design a building with effective operation in mind.

The second trend is the integration of Electronic Messaging Boards. 

Messaging boards are able to offer both functionality and comfort to patients, allowing easy access to treatment information in the waiting room, including wait times and the check-in process. This helps to alleviate what is typically a stressful experience for patients and makes it much more manageable.

The third trend is focusing on Patient Experience. During hospital visits, patients and their families may spend a significant amount of time waiting.

Whether it’s waiting to receive treatment or waiting for the doctor in the treatment rooms themselves, even the best-run hospitals have a limited amount of resources and employees that often end up stretched thin.

While the wait may be unavoidable, some simple design choices can make the biggest difference when it comes to the patient experience.

During construction, hospitals must consider easy access to food and beverages as well as having outlets available for patients and their families to plug in their devices.

Even something as simple as providing comfortable seating can make for a more favorable treatment experience.

Reports from Simone Healthcare Development contributed to this story.

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MINNEAPOLIS — Designing for the patient experience in hospitals is a frequent topic of discussion in the industry, but what about designing for community clinics?

Minneapolis-based Associate Vice President and Senior Medical Planner at HGA, Nancy Doyle, has 25 years of experience directing programming and medical planning for a range of healthcare projects, from national and international academic medical centers to community clinics. She holds expertise in directing programming, medical planning, Lean design, Evidence-Based Design and sustainable strategies. She also works with healthcare systems, physician groups and other stakeholders to translate health system goals into planning strategies that improve operational effectiveness, patient satisfaction and clinical outcomes. HC+O spoke with Doyle to discuss the variances, challenges and strategies in designing for the patient experience in community clinics.

Q: What are the specific patient-centric design elements and strategies used in community clinics? How do they help improve the patient experience?

Doyle: Community Clinics are generally a highly visible and integral part of that locale. It’s a symbol of the well-being of the community and often a gathering point in the neighborhood. Anything we can do as designers to gather input from the neighborhood, family and patient advocate groups helps to strengthen the bond between the healthcare facility and the community. Simple gestures such as purposefully incorporating a hitching post in an Amish community and signage in multiple languages will go a long way in fostering community and improved patient experience.

Q: How does designing for patient experience in community clinics differ from larger hospitals?

Doyle: We find that many of these clinics want to use their facilities for community activities after-hours. We’ve seen yoga classes, adult education, farmers markets, community meetings and cooking classes in the café. One clinic we designed will be used as a food shelf for the local community. It’s important to understand the needs of the community this facility serves. For example, in Long Prairie, Minn.,, we participated in a community engagement night about the facility. After a short presentation of the project, the mock-up rooms were open to the public. Armed with post-it notes and pens, community members engaged with healthcare staff and designers in the rooms, and later left comments regarding the room design. The team addressed way-finding and privacy concerns in the design, using large graphics of local photography for wayfinding and an on-stage/off-stage clinic design for privacy.

Q: What are the challenges in designing for the patient experience in community clinics?

Doyle: Smaller clinics have a strong fiscal responsibility to the community. Community members want to know that their tax and donor dollars are being used responsibly. Balancing the budget and patient experience is often a challenge in smaller clinics. For this reason, developing a right-sized program at the beginning of the project is critical. Any resources saved by not over-building can go toward patient amenities. During our 2P Lean events, we pull clinic volumes from patient records to analyze room utilization by session and provider. We collect data by the hour on waiting room use. When possible, we shadow clinicians to understand the movement and collaboration within the clinic. We have the medical staff record patient time in the exam room and average wait times. With this information, and understanding the desired exam room utilization, we brainstorm with clinicians and staff strategies to improve utilization and reduce the overall building area. Strategies we have used include leveling the weekly load, reducing room-to-provider ratio, flexing exam rooms between specialties and reducing the tact time in clinic.

Another challenge we face is the struggle to ensure privacy in an arena where everyone knows each other. In a larger clinic setting, patients are anonymous as they travel through the system. They don’t worry about bumping into their neighbors at the check-out desk. It’s a different story in a community clinic. Smaller groupings in waiting areas and the opportunity to choose where to sit are critical. The ability to make a choice gives the patient control over their situation: choosing whether to watch television, quietly read or work on their laptop gives the patients a sense that this visit is about them. Smaller waiting areas can also mitigate noise with sound-absorbing materials.

Q: What technological or electronic systems are integrated into community clinics and how are they geared toward the patient experience?

Doyle: Some of the new technologies we are seeing such as tracking patients through the clinic process with RFID badges, or checking them in on a kiosk, help maintain patient privacy and move a patient through the system quickly. With the help of an RFID locator, medical assistants can find patients in a sub-divided waiting room without announcing their name to the entire room. There is a strong push toward greater pre-registration and the use of kiosks in both small and large clinics, making the check-in process much simpler and quicker with less information being exchanged at the desk.

Presently, self-rooming is a concept we are seeing more often with our clients on the coasts than in the Midwest, but even those who don’t choose to implement self-rooming initially want to ensure the design will allow it in the future. The next generation expects the convenience of swiping their health card, getting a visit itinerary and moving through the process on their own.

Q: What sustainable strategies are implemented when designing for community clinics and how are they beneficial?

Doyle: Smaller clinics are sometimes subject to higher fluctuations in daily patient volumes and vulnerable to provider changes. If the one OB provider leaves, it may mean the entire program has been eliminated. Clinic rooms need to be flexible and adaptable to remain viable. That means shared workspaces, universal exam rooms and clinic modules that can flex from one specialty to another throughout the day or week. It is often more of a mindset change for the healthcare staff than a physical solution. Facilities can’t afford to dedicate exam room to a provider that may not be in clinic a full 10 sessions. At Unity Point Wellness Center, the center work core supports 12 exam rooms that can be used by various medical and mid-level providers throughout the day and week.

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Senior Principal and Global Healthcare Leader, Phil LiBassi, FAIA, FACHA for global integrated design firm DLR Group, believes in providing comprehensive, innovative solutions that respond to the client’s ethos and needs. While leveraging his significant healthcare design experience, he is committed to offering partnership and consultation, including visioning, process mapping, programming, planning, design, budgeting and technical expertise.

In a recent two-part article he wrote for DLR Group’s website, LiBassi explained designing for the patient experience as well as designing for hospitals into the future. Healthcare Construction + Operations News spoke with him to continue the conversation.

 Q: How does the idea of patient-centered design differ from hospital design from just 10 years ago?

 LiBassi: The idea of patient-centered design has been the focus of our practice for the past 27 years. Over the last decade, however, the advent of the smartphone and an added focus on value-based design has meant greater use of technology within healthcare facilities. As with any change, there are plusses and minuses, but one of the greatest advantages of this development is that it enables us to envision ways we can leverage new technologies to support and improve patient-centered design.

Q: Why has this become such an important focus in just the past 10 years?

 LiBassi: On the plus side, technology allows for greater access to healthcare in the realm of information, self-monitoring and treatment (e.g., e-clinics). Healthcare providers have greater access to data and information, which increases the support for diagnoses and treatments. Patients have convenient access to care and medical information, allowing them greater control over lifestyle management and the ability to engage in “well management” as opposed to “sick care.” Access to information, both inside and outside the hospital, can support shorter lengths of stay and improved outcomes. Acute care patients and caregivers — who often experience challenging health decisions — are armed with the important information necessary to make these health decisions.

Q: Can you provide examples of how you, as a designer, use empathy to influence design? How exactly do you “put yourself in the patient’s shoes”?

 LiBassi: On a personal level, nothing tops immersion. Whether we’re shadowing physicians, surgeons or nurses as they work, or spending time with family members or loved ones as part of a caregiver team, we can only understand from the hands-on experience. In my case, my passion for healthcare design began over 30 years ago following my role as a caregiver for my nephew. The experience left me with a desire to improve what I viewed as obstacles to a positive patient experience through enhanced design. I’m glad I had the opportunity to experience that —  it changed my life and how I approach my practice of architecture.

Q: What are some of the key factors when considering “simplicity” in a patient-focused hospital design?

 LiBassi: Less is more: Eliminate clutter and organize the necessities. Create simple, intuitive paths of travel, and create an excellent workplace for the medical and support staff.

 Q: Can you speak to some of the unique challenges in healthcare design and expand upon how you work to overcome those challenges?

 LiBassi: Healthcare design is technically complex at every level — design, regulatory, physical. The challenge is to not lose sight of design while still focusing on solutions to technical challenges. The balance of the answer would require a book.

Q: As patient-centered design becomes more common, what other trends do you see on the horizon for healthcare design?

 LiBassi: I would like to think patient-centered design is common, and as I look at the landscape of healthcare design, I see a great many firms doing excellent work. The industry has come a long way. I’m always cautious to suggest trends, but I can foresee an increased focus of balancing value and design as the cost of healthcare continues to climb. Perhaps the most important trend should have nothing to do with the hospital, but more a focus on wellness as an attitude and a lifestyle.

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As health care continues to undergo significant change, health care organizations are looking for innovative solutions, new approaches, proven processes and best practices that mirror their increasing focus on the patient-caregiver experience. There is growing interest in anything that can enhance patient and caregiver experiences and improve the quality of ambulatory medical care.

Most health care organizations understand that the patient-caregiver interaction at the point of care is a foundational element of effective health care. However, many organizations fail to fully recognize how the point of care ecosystem affects the overall experience, including clinical outcomes.

Traditionally, caregivers viewed a patient visit as everything that happened during the direct patient-caregiver interaction. While the interaction in the exam room is a focal point, the point of care ecosystem actually encompasses everything that happens within the practice or clinic, as well as experiences that occur outside of this environment.

As engaged health care organizations work to better understand the point of care ecosystem through the lens of a complex integrated system, they quickly realize just how disconnected some of these processes and components truly are.

Seamless Patient Experience

A fully connected point of care ecosystem is becoming more of a reality as new technologies with greater connectivity are introduced to the industry. This connected ecosystem integrates processes, equipment and caregivers at the point of care to significantly enhance the patient and caregiver experience and improve the quality of ambulatory care. It also ensures a more satisfying and seamless patient experience by providing a platform where organizations can leverage new technologies, incorporate best practices and employ greater standardization to improve care and outcomes.

1. Greater Visibility

Today’s medical practices are complex organisms, often featuring many disconnected processes, devices and components. Most health care organizations find it difficult to determine exactly how their practices are performing and where opportunities exist for improvements or efficiency gains.

However, new technologies and tools are helping bring visibility to existing processes, giving organizations the insight they need to make data-driven business decisions. As organizations gain greater awareness of the entire ecosystem, they are better positioned to make additional optimizations to ultimately enhance patient care.

For instance, real-time locating systems (RTLS), which have been used in hospitals for many years, are quickly becoming a key component of a connected point of care ecosystem in outpatient facilities.

This data-driven understanding of workflows provides in-the-moment situational awareness of the ecosystem. This allows healthcare professionals to proactively escalate responses to problem areas and monitor key performance indicators in real time.

2. Standardized Approach

The continuing consolidation of medical practices is occurring at such a pace that many organizations are finding it difficult to establish network-wide operational and clinical standards. Many health systems simply tolerate the variability in outpatient environments, not realizing the costs associated with having little to no key performance metrics in place.

Standardization helps organizations develop clinical protocols that drive better outcomes. It can also create efficiencies and cost savings, as well as minimize human variables that increase the likelihood of errors that can contribute to inaccurate diagnoses. One area where this is evident is blood pressure (BP) measurement, which continues to be one of the most inconsistently performed tests in a clinical environment. But, it also has perhaps the strongest connection to point of care diagnosis, patient risk stratification and medication dosing.

A fully connected point of care ecosystem helps facilitate and ensure a level of standardization to minimize human variables and maximize consistency and data accuracy. Connected diagnostic devices used in conjunction with a connected exam table that automatically positions the patient to achieve an accurate reading allow caregivers to measure blood pressure more consistently through established electronic checklists. It can also directly import patient data into electronic medical records (EMR) and help facilitate the adherence to a health system’s clinical guidelines for proper technique in achieving BP readings.

3. Greater Efficiency

A fully connected point of care ecosystem allows caregivers to not only identify opportunities to improve efficiencies, but to also more easily and accurately measure progress and success.

For example, one area where efficiency gains can be realized is vital signs acquisition. The vital signs process hasn’t changed significantly in the last 30 years, and today’s processes often include multiple stopping points in a facility to capture base vital signs (height, weight, pulse, temperature and blood pressure). Some of these locations are in semi-public spaces. These disconnected processes result in significant inefficiencies and lost patient and caregiver time.

A Midmark study examined potential workflow efficiencies during the acquisition of vital signs, as well as the interaction between patients and caregivers, in an effort to identify near-and long-term implications for efficiency. Care interaction was observed from the time the patient was called from the waiting room, through vital signs acquisition, to the time the patient was ready to see the physician. The average time was five minutes, seven seconds.

Results of the Midmark study indicated that minor changes in workflow and design, such as collecting vital signs in the exam room and implementing automated vital signs connected directly to an EMR, could reduce conveyance and acquisition time by as much as 36 percent per patient.

4. Enhanced Patient-Caregiver Interaction

Patient-caregiver interaction in the exam space is a foundational element in the continuum of care. Traditionally, the face-to-face exam was seen as the only significant interaction between the patient and the primary care provider. However, growing focus on population health is encouraging health care organizations to think in broader terms. With the advent of the patient-centered medical home, care is often delivered by care teams that can include providers, nurses, ancillary staff and care coordinators.

When viewed from the lens of a point of care ecosystem, the patient-caregiver interaction becomes every touch point that the patient has with the health care organization, including, but not limited to, face-to-face time in the exam room. For instance, consider the waiting room. While traditionally not viewed as part of the patient-caregiver interaction, it could potentially have a negative impact on the patient experience — especially if the patient wait time is perceived to be too long or the room is not seen as being comfortable or inviting.

As workflow software continues to advance, health care organizations are gaining a better understanding of how rooms and equipment are being utilized and the amount of time patients and staff spend with specific processes. New technologies, such as RTLS, can tell health care organizations how much time a patient spent in the waiting room before being called to an examination. It can also provide visibility into the patient experience when they leave the waiting room and are taken to the exam room.

Jon Wells is responsible for driving product strategy, product development and marketing efforts within Midmark’s medical division. He is a supporter of patient accessibility standards in medical facilities and has testified regarding accessibility requirements for medical devices to the United States Access Board.

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The crown jewel of the project was an emergency critical power system that will support the entire 664-bed, 27-building campus, which covers seven square blocks. The project consolidated separate backup generators, previously stored throughout the campus, into one connected system with most of the infrastructure contained in a new central energy plant. Jake Ring, chief marketing officer at GE energy management, explained the system would drastically improve the reboot time for returning power to the entire campus in the event of an outage.

“In Illinois, it’s mandated that medical facilities have to restore power in the instance of an outage within 10 seconds,” Ring explained.

The new system dropped the delay in restoring power to 8.3 seconds for the entire campus. Although that is a staggeringly fast response to a power outage, it wasn’t fast enough for some systems, like MRI machines and data centers that store electronic medical records (EMR). Ring explained that some sensitive equipment should never be without power, so his company installed uninterruptible power supply systems at these locations, utilizing backup batteries.

Ring explained this need for uninterruptible power supply systems was becoming more prevalent in health care as electronic medical records became more ubiquitous throughout the industry. He said a 10 millisecond power flicker could cause a server to go down, disabling a hospital’s EMR system, which could take hours to get up and running again, meaning the only option is for the power to never go off.

The MRI machines and other sensitive imaging equipment are protected by surge protectors that shield them from damage resulting from lighting strikes and other surges, along with an uninterruptible power supply battery system. This ensures the expensive and important medical equipment will never get too much or too little power, either of which could damage it severely.

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