Design: the ultimate tool for re-inventing high performance facilities

By Janet Lively Heberle

As uncertainty and paralysis continue to pervade the healthcare landscape, high performance healthcare facilities must create dynamic results. We live in a world where innovation drives success, where simply reacting to change is not enough. The key is to re-invent, not respond. Similarly, how you design and develop your facility assets demands innovation and creative strategies.

Traditionally, acute care campuses grow, not surprisingly, out of need. This has led to unrecognizable entries, confusing circulation, remote interrelated departments, staff observation locations that limit productivity, or support services that require extraordinary travel distances. To thrive, facility design strategies that address these issues, must be a priority.

When facilities are maximized, working for you, they:
• Improve care delivery.
• Provide a quality work environment.
• Deliver care efficiently.
• Provide staff productivity enhancements.
• Improve public perception and reduce outmigration.

Collaborative Design Engagement
Design is the ultimate tool for reinventing high performance facilities. Creating efficient facilities, which maximize the return of the investment, while increasing the productivity of every clinician, requires innovative and creative talent, on the part of design firms and clients. That is where collaborative design engagement pays off.

If you can improve productivity, therefore reducing the clinical staff need by one RN and one tech, you can eliminate almost $98,000 in annual payroll cost (not including overtime and benefits). This may seem insignificant, but multiply that across the emergency room, surgery, radiology, medical/surgical units, and it becomes significant – quickly.

Aligning Strategic Initiatives
Where do you begin? Start with a facility master plan that aligns strategic initiatives. The solution to restoring efficiency and productivity to a medical center or health system is to examine every aspect of the patient, staff, physician, logistical and public experience, which occurs thousands of times daily. From there, make changes to improve the experience.

The tangible benefits of a strategic master plan include providing a flexible guide for future capital improvements, and the elimination of inefficient clinical silos built over years of additions and/or renovations. This is an inexpensive process. Quality planning includes demographic composition case mix data and population projections and physician recruitment strategy alignments.

A focused design effort combines predictive analytics, innovation and evidence-based design. Examples of immediate areas of improvement lie within the emergency department and medical/surgical nursing units. When design strategies are implemented it can reduce wait times and length of stay, increase and improve the quality of time and care given to patients, reduce travel distances, staffing and wear and tear on an aging nursing staff.

These design improvements, directly impact the bottom line by improving patient care and satisfaction (potentially outcomes) and improving the work environment, therefore reducing turnover.

Patient Room Improvements
Likewise, in a medical/surgical unit, right-sizing spaces, providing appropriately-located support spaces for clinical staff, reducing noise levels and creating patient-centric rooms with family zones can improve outcomes and efficiency.

The patient room itself must be clinically-focused and patient centric. For example, a high-performance 32-bed nursing unit with an average daily census of 75 percent can cost a hospital approximately $6,000/day in total wages. A less efficient unit lacking adequate, adjacent support, that does not support the current standards of care, can cost an average of $2,000/day more, which annually equates to $766,000, significant savings due to design.

These are just the numbers, which do not account for providing an environment inspiring healing.Incorporating a “family zone” with amenities, such as a mobile charging station and desk, natural or specialty lighting for comfort and safety should all be considerations.

Additionally, patient room design and material selection must address infection control measures, allow ample light for procedures, support multiple/varied medical

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devices and allow care documentation to occur. Each of these can also positively be reflected in scores, revenue, turnover and recruitment.

The objective is to create or re-invent facilities with innovations promoting efficiency and productivity related to staffing, square footage metrics and how design translates positively to a hospital’s profitability and success.

Resultant planning and design strategies involve transitional ideas centered on patient satisfaction and outcomes and how design can improve the care patients receive, while equally focusing on improving staff productivity. Spaces become “right-sized,” travel distances reduced and “frequency of use” determines adjacencies. These environments serve the clinical and social needs of patients and staff while, optimizing efficiency, productivity and facility investments.

Janet Lively Heberle is an associate AIA, vice president – marketing and business development, at TEG Architects.