by Anthony Cavallaro
Designers of healthcare facilities must consider the needs of both the patients and the healthcare providers who will live and work within the surroundings. Healthcare designers can couple the level of aesthetic comfort offered throughout the environment while integrating design strategies that lead to improved patient safety, reduced staff fatigue, increased effectiveness in delivering care, and improved overall healthcare quality.
The outcomes needed in healthcare design must also be balanced with the financial limitations that many healthcare organizations face. The U.S. healthcare system is under constant pressure to deliver optimal care with the latest technologies for less money. With the costs of certain aspects of the industry rising along with shrinking reimbursement allowances, the need to operate as efficiently as possible has never been more important.
Lean initiatives and new technologies such as advances in CAD software and building
information modeling (BIM) increase efficiency in the design and construction process and avoid spiraling construction costs. BIM technology enables an integrated design process in which architects, consultants, general contractors, subcontractors, and vendors can participate in the design and construction arena. This approach also offers previews of equipment and furniture layout in 3D BIM modeling; walk-through animations and renderings; daylight simulations and energy analysis; high quality construction documentation; and accurate estimates of quantities and cost, to name a few. Likewise, the Lean design and construction process complements a method that allows for total collaboration of all disciplines with impeccable coordination, and targets areas such as waiting, inefficient conveyance, excess inventory, unnecessary motion (such as lengthy walking distances for nursing staff or excessive patient transport), and repeat of processes.
Sometimes selecting to renovate existing space over adding a new building can meet the needs of the healthcare facility. The decision is based on a multitude of considerations such as adaptability of existing space and savings in time and/or money. Reconfiguring space can allow for less-used facilities to provide much-needed use of more revenue-generating programs, and also typically allows for upgrades to equipment as needed, keeping all materials at state-of-the-art levels.
Placement of functions is an important consideration in healthcare design. For example, imaging departments can consider separate areas for ambulatory patients and in-patients waiting for testing. It is important that adjacencies of patient, staff, and material flows always provide for efficient use of time for patients and staff. Clinics that offer multiple services in the same area also help to reduce patient travel time and stress.
Similarly, placement of crucial areas of operation can greatly enhance several outcomes at once. For example, selecting a panoptical layout of a central nurses’ station can allow for oversight of the waiting room, changing room, pre- and post-operative bays, and the restricted sterile core, allowing healthcare providers better vision to anticipate any issues or problems. Expanding well-used work areas also typically leads to improved staff productivity.
Aesthetic decisions are also important. Selecting finishes that exude a comfortable and welcoming feel may positively impact patients and providers alike. Using glass whenever possible to bring natural light into a space also promotes a sense of welcome and well-being. Healthcare environments that incorporate some of the comforting environs more commonly found in spas can be transformed into serene spaces that augment treatment
outcomes, especially in outpatient cancer treatment centers.
Enhancing the quality of the care experience, along with providing staff and operational efficiencies, is the foundation of a proper design process for healthcare. Healthcare design can offer thoughtful care environments that provide improved efficiency and productivity for staff members as well as overall wellness for patients and providers.
Anthony Cavallaro is the CEO of JACA Architects in Boston.