Rx for Success

Feb. 3, 2005
What the experts have to say about today’s healthcare facilities
You've most likely heard the reports about how exposure to daylighting, excellent indoor air quality, and soothing colors can aid in patient rehabilitation: Providing healthcare consumers with healing environments isn't necessarily a new concept. Although it's still top-of-mind, other recent advances in healthcare facility design and management have surfaced. While early detection and intervention techniques (such as new drugs, virtual imaging, etc.) may reduce the demand on conventional healthcare facilities, the number of satellite healthcare locations, specialty clinics, and ambulatory hospitals is growing. With the largest group of consumers in history going through the healthcare system today, some economists and financial experts expect healthcare to stimulate the U.S. economy much like the IT explosion of the 1990s. So, if you have an upcoming healthcare modernization, renovation, or new construction project, keep the following points in mind to ensure that your facility is a strong competitor.Consumers Take ControlToday's patients are accustomed to environments where the consumer is king, and they're making choices based upon individual desires and requirements. With easy access to a wealth of information, healthcare consumers are savvier than ever: Surveys, Internet research, word of mouth “even looming healthcare facility rating systems “can impact decisions. Healthcare facilities are competing for customers, and these potential patients want to get in, get out, and get on with their lives. Today, we really have a far more empowered consumer,” explains Phil Tobey, senior vice president and national health practice leader for Los Angeles-based SmithGroup. That empowerment is encouraging the consumer to demand choices and options. Facilities are responding to that.” They're responding by providing consumers with choices regarding everything from lighting levels to room temperature to cooking their own meals. Patients want to spend recovery time in a facility that allows them to make their surroundings as comfortable and as home-like as possible.Making Room for the FamilyFor many healthcare consumers, an important factor in providing a relaxed environment is the option of a single-patient room “a trend becoming more prevalent. Most all facilities that we're doing today are 100-percent private rooms,” says Dallas-based RTKL's Brad Barker, senior vice president of the healthcare sector. But, single rooms don't mean that patients want to recover alone; facilities with accommodations for family members are gaining in popularity. Since many friends and relatives today are part of a patient's healing process, it only makes sense that the design of a healthcare facility (including patient rooms) incorporates space for them as well. Traditionally, patient rooms haven't been easy places for family members to spend time; however, new facilities have planned spaces intended specifically for family members. In these buildings, visitors won't have to leave a patient's room when a nurse or doctor needs to conduct an evaluation “in-room or floor lounges provide an area for family members to spread out, take a quick break, or catch up on daily news and events. On-site amenities (such as kitchen space and Internet access) allow visitors to keep up with work and everyday routines at the hospital instead of at home or at the office, allowing them more time with loved ones. Some healthcare facilities also offer business centers” for visitors “quiet places to access computer equipment and respond to e-mail, search the Web, etc.Minimizing Patient FrustrationReducing the chance of consumer frustration is also an essential consideration for healthcare facility projects. Instead of forcing patients to find the services they need within a facility, many hospitals are choosing to bring necessary services to their patients. A one-stop shopping” approach is how Tobey explains this trend. Traditionally, patients moved from place to place to register, [for] preliminary work-ups, for the diagnostic testing, and for treatment. There's a desire now to make this a cohesive, single-stop kind of process. [Not everything can literally] come to just one spot, but we try to make it easier on the patient and the family in terms of the entire process by bringing services to the bedside wherever possible.”The concept of new-market” hospitals is also a movement emerging to help eliminate confusion for the consumer. Where there were once cornfields, there are now communities,” says Barker. Those communities were underserved “they didn't have hospitals. This whole trend of a ˜new-market' hospital came about.” Providing healthcare serv-ices to the Baby Boomers, Gen-X, and Gen-Y crowds that live in these areas means providing convenience. A lot has been learned from retail: The ability to park conveniently, identify where the front door is, and to have a short travel distance,” Barker explains. He indicates that designing entrances as public concourses is helpful to modern-day healthcare consumers: A public concourse is similar to a mall. When the consumer comes in, [he/she can say], I understand this, I know where I am, I can figure this out.” When hospitals are designed with this feature, reception/concierge areas are located in the public concourse; individual points of services stem off of that main area. Patients work their way back for treatment or diagnostic services, and then end up back at the concourse (where they started) to exit.Ease of Outpatient ServicesWith outpatient practices continuing to grow, finding economical and efficient ways to manage the outpatient proc-ess is vital. Barker explains that one of his recent projects “Tenet HealthSystem's Centennial Medical Center in Frisco, TX “involved the creation of a separate waiting space where customers with outpatient appointments are received (complete with coffee areas and personal lounges). Patients are welcomed into this separate lounge area, and private dressing areas with personal lockers are provided to store clothes, bags, and purses brought into the facility. Patients remain there until the appointment. Once the procedure is finished, they enter another lounge, access their personal lockers from the other side, and are free to change and leave. [This is] a new consumer-oriented trend; we're doing that in most all of our facilities now. It's very ˜treat the consumer special' instead of the old ˜take a number' days,” says Barker.Keeping Up with TechnologyAs with almost any industry today, the role technology plays in healthcare facility design and management is always changing. For this reason, experts emphasize the importance of hospitals being accommodating and adaptable “ready for technological change. [You] have to provide a platform or an infrastructure that is flexible to allow hospitals to respond to the changes in technology when they come along,” says Tobey.The digital age is big. [The days of] standing at the end of the bed with a metal clipboard are coming to an end. Everything is going to go digital,” says Barker. The need for filing rooms and storage warehouses is already decreasing due to the option of storing data and other notes electronically. In newer hospitals, centralized nurses' stations are no more: The purpose of the nurses' station is diminishing as more charting and other patient care work is being done via wireless technology, better communications technology, and PACS (picture archival and communications systems) for image retrieval and review, explains Richard Niemi, a senior medical planner at Chicago-based Loebl Schlossman & Hackl. Care is going to the bedside; substations are being utilized instead, providing Internet access for laptops and allowing doctors/nurses to digitally view and document information.Greg Stringer, senior vice president at Houston-based Tellepsen, has seen technology pay off for patients as well. Instead of traditional televisions in patient rooms, some hospitals now offer patient stations.” These computer-screen devices offer bedside television, Internet and e-mail access, music, electronic gaming, and healthcare education information.Stringer has also seen nurse call systems advance. The nurse call systems we see going into hospitals today are very sophisticated; it's more than just being able to push a button in your room. For patients, that's maybe all they see, but the new systems literally track doctors and nurses all over the hospital. If there's an emergency, [it's] tracking the doctors and nurses and knows where they're at. Those systems are very sophisticated compared to what they used to be,” he says.Your Next MoveAs you make determinations about how your facility will compete, remember that professionals agree: You need to develop and stick to a master plan. SmithGroup's Tobey says: The last thing you should do is just react to the latest crisis “simply attempting to put out that fire and then put out the next fire and put out the next fire without having an overall concept about where you're going with your existing facility. The risk is that you'll invest in some specific initiative and find out two initiatives later that you invested in the wrong place, or you can't expand logically, or there is no long-range plan. You really need to clearly understand what [your building's] opportunities and constraints are. It's critical to understand where you want to go “to make sure you're investing in the right places, and not forgetting the larger picture.”To make sure your solutions are in sync with how hospital employees work, become involved in the healthcare industry, not just the facilities management industry. Join organizations, check out online forums, talk to other professionals “learn what's happening in the medical field and consider how those changes will impact your facilities and how they operate.Lastly “communicate, communicate, communicate: Tellepsen's Stringer points out that there's nothing more fundamental than communication if you want your healthcare projects to go well. It sounds simple, but one of the biggest problems I've seen come out of [hospital renovations] is lack of communication. I believe that at least once a week, [everyone involved] needs to sit across the table, have an agenda and a list of items you've been talking about, and review those agenda items.”Leah B. Garris ([email protected]) is associate editor at Buildings magazine.

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