Healthcare facilities are transforming to improve outcomes and lower costs.
Healthcare administrators around the country are facing a dilemma. Occupancy rates are declining, technology is rapidly changing the business and competition is increasing, with smaller hospitals trying to catch up with an ever-evolving healthcare system.
Faced with the shifting landscape, healthcare groups are looking for creative ways to repurpose space that will improve the patient experience, enhance operational efficiencies, increase safety measures and produce better outcomes.
“I think the healthcare industry is finally understanding that they must provide more than just good quality care,” says Sanford Smith, senior vice president of real estate and facilities at Orange County, California-based Hoag Health Network. “They must be cost-effective and consumer centric in order to survive.”
For many healthcare companies, renovating existing facilities is the most efficient way to upgrade and reposition services. In many cases, healthcare facilities have large empty spaces that can be improved and repurposed.
“Many hospitals today are faced with low bed demand and have floors of vacant beds,” says Marcus Thorne, senior medical planner at LPA. “They are looking at opportunities to repurpose these spaces to better serve the community’s needs.”
Redesigning these spaces requires special expertise and a focus on the variety of elements needed by healthcare administrators. Patient room layouts, calming environments, flexible technological spaces and increased energy efficiency are among the key goals. The right mix can reduce operational costs, help retain staff and avoid safety liability issues, as well as create a better environment for patients to heal and feel secure.
Bringing Comfort to Every Space
Smart design can improve the patient experience by providing a comforting and relaxing environment at a time of high stress. Seventy percent of hospital organizations reported that improving the patient experience is one of their top three priorities, according to a survey by the Beryl Institute.
Much like hotels, restaurants and retail chains, the healthcare industry is focusing on delivering spaces where patients feel comfortable and relaxed.
“From entrance to exit, every part of the facility is considered a touch point to the patient,” says LPA project director Gigi Bainbridge. “It is important to pay attention to proper wayfinding, function and finishes to provide a better patient experience.”
An out-patient pavilion—which sits inside a 20-year-old building in Orange, California—recently updated its surgery center. The LPA design team focused on the lobby and registration area to create a comfortable environment. The space includes wood flooring, furniture with calming color hues and a mixture of seating areas, as well as larger windows to let in more sunlight.
Waiting rooms in new centers are a critical point of contact during the patient journey and they often don’t look anything like the waiting rooms of the past. For an imaging center in Long Beach, California, LPA redesigned the waiting area to include a fireplace, coffee station, communal table, a dark blue accent wall and a private seating section.
Consideration of the environment and its impact on patient care goes far beyond the waiting rooms. Even the smallest details must be considered.
“I always think about what the patient is doing in the space,” Bainbridge says. For example, a patient in a labor delivery area is going to spend a lot of time in a bed looking up at the ceiling, she says. “We have to think about keeping that light from shining in the patient’s face and provide something calming to look at.”
Patient rooms should make it easier on the patients and guests by offering more space. As collaboration between healthcare professionals becomes more common, room sizes must be able to accommodate an increasing number of guests, in addition to providing privacy and a comfortable environment.
These rooms are also becoming more integrated with technology. At one healthcare organization, a pilot program put iPads in the rooms, Bainbridge says. Patients can order their meals ahead of time, dim the lights and adjust the shades for a more personalized experience.
In addition to finding new ways to improve the patient experience, healthcare administrators are challenged to create safer, healthier environments. Hospital-acquired infections and injuries are constant challenges for both patients and staff. Smart design can dramatically reduce the amount of medical errors, the spread of infection and patient injuries.
A New Era of Safety
In many cases, handrails, illuminated pathways and non-slip flooring are a starting point. Antimicrobial materials and surfaces as well as strategically located hand washing and sanitizing stations can help prevent the spread of infections.
“Everything that we do in a hospital is related to functionality, not only the aesthetic,” Bainbridge says. All the details must work together. A hands-free entry into a sterile cardiovascular operating room or the well-planned layout for caregiver accessibility into patient rooms can cut down on risks and make a facility more efficient for staff.
“We’re strategically thinking about where things are located, how the staff uses a space and the interaction with patients in each space,” Bainbridge says.
Indoor air quality is another issue impacting building performance to improve infection control. Proper design, construction and maintenance of mechanical systems—heating, ventilation and air conditioning—are essential to the health of a hospital. These systems are also a major energy draw for a building and when efficiently designed, can significantly reduce energy consumption.
Amenities for Engagement
Patients are becoming more engaged with their care choices, forcing facilities to stay competitive by redesigning spaces to include amenities that will set them apart.
“In the past amenities were not factored into a hospital design. It was more clinical and institutional,” says Thorne. “It’s really been shifting and both patients and staff are demanding these types of spaces.” For a hospital in Irvine, California, LPA turned the landscape into a peaceful healing garden with drought-tolerant plants, a variety of seating areas and walking paths. Research shows these types of gardens can help speed healing, as well as reduce stress for patients, family members and staff.
In the new healthcare environment, amenities play a key role in a facility’s bottom line, according to report by the National Bureau of Economic Research. An increase in amenities typically raised a hospital’s demand by 38 percent, while a similar increase in the clinical quality measure only increased demand by 13 percent, the authors found.
Massage and relaxation spaces, gardens and family lounges in surgical zones can be important additions to a facility. These areas can impact staff retention and contribute to a positive patient experience, which can result in better health outcomes.
Creating Better Efficiency
Renovating healthcare facilities comes with many complex variables not found in other building types. Hospitals are one of the most regulated facilities in the country, with new building codes, particularly in California, constantly calling for improvements to seismic safety and sustainability.
Designers must also account for new technologies, which change the way facilities operate. One LPA client wanted to install a robotic drug distribution system as part of its makeover.
“The one thing we know with certainty, is that we must find ways to deliver more healthcare value for the dollars spent,” Smith says. “We must improve the experience of our ‘customers’ to be in line with other industries and we must utilize technology to provide convenience and access.”
Energy efficiency needs to be a key priority in any retrofit, the one area where a redesign can have an immediate impact on cash flow. Hospitals in the U.S. spend an average of $1.67 on electricity per square foot annually, according to a study by National Grid, a multi-national energy company. Some hospitals spend between 40 percent to 60 percent of their total energy budget on lighting alone, according to industry estimates.
“Many healthcare facilities operate 24/7, meaning that small improvements can have nearly three times the benefit and payback than a normal office building might have,” Smith says.
Changing the lighting systems or switching to LED bulbs will not only provide energy-savings but also help the staff, says LPA principal Rick Wood. “Nurses are working 12-hour shifts three to four days a week,” he says. “How the lighting affects the staff has been ignored for a long time.” By changing out the lumen levels of light and allowing the light color to adjust according to the time of day, you can impact the natural circadian rhythms of staff while allowing the patients to rest and heal faster, Wood says.
When possible, using natural daylight is always better, both in terms of a welcoming environment and energy conservation. On a hospital renovation in Newport Beach, California, LPA’s research found sunshades were a viable, cost-efficient option for reducing energy costs for the 10-story building.
The design team worked on both the exteriors and interiors, creating the opportunity for a holistic approach to addressing the issues. “We approached it initially as an exterior design project,” Wood says. “But we said, wait a minute, let’s see what it looks like from the inside out.”
For healthcare administrators, a renovation can be the first step in modernizing and refocusing business plans. New spaces and environments can cut costs while improving a facility’s performance.
“We must challenge ourselves to really understand our value streams to remove waste and non-value added processes,” Smith says. “When we design new facilities, it gives us a unique opportunity to assess our current state and make modifications that can result in both better outcomes and lower costs.”
This story originally appeared in the latest edition of Catalyst, a quarterly publication that takes a deep dive into the new ideas, industry leaders and cutting-edge initiatives changing lives by design.