Healthcare organizations making a capital investment in their physical space have the right idea: good design matters. A growing body of research suggests that the physical environment plays a critical role in driving patient and provider satisfaction, improving care quality, enhancing work flows and patient throughput, and increasing overall productivity. However, good design does not, on its own, ensure a patient-centered practice transformation. Before calling the architect and/or designer, organizations must first lay the groundwork for successful design by thoroughly evaluating their practice operations and culture.
Operations and Culture – Prerequisites for Design Success
Organizations are often eager to move ahead to evaluating floor plans, configuring room layouts, and reviewing interior design ideas. However, conducting an assessment of clinic operations and culture prior to the design phase is a crucial step that should not be overlooked. Assessing operations and culture is essential in laying the foundation for optimal interactions between providers, patients, and the new space. When considering your current operations, ask:
- How do your providers utilize exam, consult, procedure, and office space today? What activities do they conduct in each area and in what sequence? How will that differ in the future? The answers to these questions will allow you to make decisions regarding separating or combining clinical spaces to ensure work flows in your practice are efficient.
- How do your patients, staff, and providers flow through your current space? Are work flows optimal and patient-centered? Assessing patient and provider flow allows your organization to get a strong sense of potential bottleneck areas in your practice. For some organizations, the solution may be repurposing staffing resources to increase patient-centered activities such as proactive outreach and care coordination, adding exam or consult space, or separating patient and practice flow by moving some activities “behind the scenes” in an on-stage/off-stage concept.
- How do the care teams communicate? Is there adequate space for team collaboration? With the rising use of telehealth, group visits, and multidisciplinary team conferencing, more and more organizations need highly versatile team spaces that can be flexed to accommodate a range of practice activities.
- How will your organizational culture be supported and/or promoted through the newly designed space?Organizational culture can also significantly affect work flows and thus should inform planning decisions. Staff input should be elicited and included in the early stages of design planning in order to promote buy-in and gain a clear sense of what an ideal, supportive environment should look like. Organizations run the risk of losing the potential benefits of redesigned spaces if design solutions ignore or overlook staff needs, activities, and culture.
Advancing Patient-Centeredness in Care and Design
A well-designed healthcare space is ultimately one that is created with the patient in mind, be it through providing an aesthetically pleasing, calming environment, extensive wayfinding through the facility, or ample collaborative space for that patient’s care team. With the simultaneous emergence of patient-centered design and the patient-centered medical home (PCMH) as a primary vehicle for care delivery transformation, both healthcare delivery and healthcare design must align to provide the means for continued system transformation. A space designed with these principles in mind, informed by operational and cultural considerations, is a step toward an ideal patient experience.