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  • July 19 2011


    Better Outcomes Through Design: Four Questions to Ask When Designing a New Health Care Facility

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    Have you ever worked in a hospital that was designed and built as a box with smaller boxes inside where patients are located? Or, have you worked in a department where you received new devices and equipment that were placed in an empty location and not where you needed them to provide care? The actual building design was likely completed for the efficiency of the builder, and did not account for clinical workflow, patient comfort or any new technology integration.

    Why does health care facility design matter?

    Current research guides us as we move towards technologically advanced facilities where clinical outcomes can be impacted through enhanced design of workspaces and workflow. We know evidence-based design can positively influence patient care and create improved health care environments. Studies have shown that new designs focused on reducing medical errors, as well as the subsequent costs of care, can help positively impact the bottom line.

    Designs focused on improving satisfaction and efficiency of caregivers, especially those with the most experience, can help in the recruitment and retention of these crucial employees. The design of supportive physical environments for health information technology and reengineered work processes also allow for new technology integration, easing caregiver adoption and increasing clinical efficiencies. Lastly, innovative and adaptable facility design helps build sustainability for hospitals, maximizing responses to the ever-changing healthcare environment.

    In today's world of rapidly changing technology and advanced integration of devices into clinical workflows, it's important to build health care facilities that enable providers and clinicians to take advantage of these technologies. Appropriate designs for rooms and units while incorporating sound wiring and the proper infrastructure are essential for technical growth and optimal patient outcomes, as well as caregiver satisfaction and streamlined care delivery. Device integration is key to obtaining the necessary information required to make sound clinical decisions at the time it is needed. Having that data at the clinician's fingertips in the location needed will reduce delays and error.

    As hospital leaders plan for new builds, they must understand the future of technology and device integration. This will enable them to equip their new facility's future technology roadmap, and help them understand how clinical workflow will be impacted and enhanced.

    What are the consequences of bad facility design?

    After working in hospitals for 25 years and seeing the influx of new devices and technology enter our work areas, I understand that reengineering workflow and, if possible, workspaces to integrate new technology is more important than ever. Over the years, we have seen medical errors rise due to a lack of process development and reengineering after workflows have been altered. While reengineering or redesign might create additional up-front expense for the hospital, it may ultimately cut costs in other areas like clinical efficiencies, liability and human resources.

    How can we design better health care facilities?

    Hospitals of the future need to bring together clinicians, designers, architects and technical experts to provide vision and to strategize the best patient care outcomes when designing new facilities. It's essential to have clinicians at the table during design discussions, as they understand the workflow and what is needed to provide the best care for patients. Clinicians will be able to enhance design features to improve what they do, which may keep them in the workforce longer.

    What questions should I ask before designing a new facility?

    If you are in the planning stages for new facility design, ask yourself these questions:

  • What are the outcomes we want to achieve by designing this new facility or department?
  • Do we believe we can improve patient care outcomes by completing this project?
  • Do we understand where we are today with technology and where will we be 5 years from now?
  • How will this new technology affect workflow, workspaces and information exchange?
  • Asking these questions will help ensure your facility design is more than just a series of boxes within a larger box. The answers to these questions will help you create a facility that improves your caregivers' workflow, integrates technology and provides an healing patient environment.

    Susan Stiles, RN, BSN, MHA, MBA, is the clinical strategist on the FacilityWorks team, which focuses on bringing together expertise in clinical workflow, advanced health care technology, state-of-the-art design and construction practices to create the ideal patient and clinician experience within the walls of a facility when planning for the future. She is responsible for the development and delivery of Cerner's FacilityWorks clinical consulting portfolio. Susan joined Cerner in February 2009 as a strategist for the perioperative business unit, where she led the team in development of software for clinical documentation in surgery venues. She is a former CNO with design build experience and is certified in evidenced-based health care design.

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