Digital technology is transforming the healthcare industry—from electronic medical records to wearables that monitor patients’ vitals—but the basic design of most hospitals hasn’t changed since World War II.
A growing number of healthcare facilities are partnering with real estate and architecture firms in an effort to change that—by creating built environments that combine patient needs with smart design.
The desired result: a better patient experience, which can yield happier and healthier outcomes overall for patients as well as providers.
“The wartime hospitals that came out of the Hill-Burton Act in the U.S. can sometimes be drab and dreary,” says Lora Schwartz, principal in CBRE Healthcare’s Capital Projects Solutions team. “There’s so much more we can do to improve these spaces and create an inspiring, uplifting, multisensory experience that’s better for the patient and for the staff.”
“It’s Time for an Upgrade”
In the years after World War II, the strategy for building healthcare facilities—particularly in small towns—was shaped by the Hill-Burton Act, landmark U.S. legislation passed in 1946, which provided billions of dollars in federal grants to build public hospitals and outpatient clinics.
That means many facilities have had the same basic look for upwards of 50 years. Those that were renovated in the last few decades are now sorely in need of a refresh.
“Hospitals are operating on finite resources and have to do more with less.”
“There’s definitely a move towards renewal of facility assets in healthcare, and things are changing at an ever-increasing pace,” says Curtis Skolnick, managing director, Capital Projects Solutions, at CBRE Healthcare. “Many of those buildings are going on 40, 50 years, so it’s certainly time for an upgrade.”
But with massive bills, waning resources and changing reimbursement models, hospitals today are faced with a host of challenges, and a design overhaul is often not an immediate concern.
“Hospitals are operating on finite resources and have to do more with less—meaning more patient care with less reimbursement—so they’re trying to figure out how they can get the most bang out of their buck from their facilities,” Skolnick says.
The best way to do that, experts say, is to create a thoughtfully designed environment that can have a significant impact on patients’ experience, and ultimately, their health.
Good Design = Good Business
Innovative hospital renovations, including the Mayo Clinic’s Jack and Jill rooms, which separate the exam space from a more soothing conversation space for patients and doctors, and the Boston Children’s Hospital’s customized pediatric unit, are major contributors to a seismic shift toward patient-focused healthcare.
Many of these patients are in the most fragile and vulnerable state of their lives. How can we use real estate, architecture and design to communicate thoughtfulness, support and convenience?
Many of the spaces are created using an architectural, research-based model known as design thinking or evidence-based design—a problem-solving approach that strives to improve consumer healthcare experience and delivery.
“Design thinking can be described as a discipline that uses the designer’s sensibility and methods to match people’s needs with what is technologically feasible and what a viable business strategy can convert into customer value and market opportunity,” Tim Brown, CEO of IDEO, told the Harvard Business Review.
In healthcare, that translates to spaces that are designed with patients’ specific needs in mind.
“If we can show through the design environment that there are improved patient outcomes, fewer hospital-acquired infections, shorter lengths of stay, improved health status, that’s what we are trying to achieve,” Skolnick says.
The first step to achieving those goals is working closely with architects and planners to determine which portion of the patient population is being served—pediatrics, women, patients that require long-term care versus short-term, etc.—so spaces can be customized accordingly.
“Many of these patients are in the most fragile and vulnerable state of their lives. How can we use real estate, architecture and design to communicate thoughtfulness, support and convenience? What can we do to make this a better experience?” says Schwartz.
Schwartz says there are three key areas where architecture can have a tangible impact on the patient experience: communication, support for caregivers, and design that enables a more efficient, happier staff.
Communication Via Design
Spaces should communicate calm and warmth, and be welcoming and accessible to patients and caregivers. Parking should be easy and accessible. Extended-care rooms should be filled with daylight and include natural palettes and organic materials and textures with soothing colors, Schwartz says.
Scott Rawlings, a principal and healthcare practice leader at architectural design firm Payette, says adaptability can also go a long way toward lowering patient stress. Customizing a room, down to the lighting, artwork and room color, has shown to be beneficial, particularly for children.
“Kids return frequently in major pediatric care, and customization can make them more comfortable by lowering the stress of being in a hospital,” says Rawlings. “Imagine, a child presses his thumb on a print reader at the door, and the room turns into his room.”
Similarly, erasing “equipment fear” by removing unnecessary medical equipment—particularly in rooms that are not set up for urgent care—can help lower stress.
Among the emerging trends in healthcare design is creating a comfortable space for caregivers, complete with all the necessary amenities to ensure they can stay around the clock: a laptop station, WiFi access, a place to comfortably sit and work or read, and a space carved out in the room for sleeping, Rawlings says.
“In many cultures, particularly in the Middle East or China, patients’ families are expected to help care for the patient on a daily basis, so hospitals have to offer a space where three or four family members can sit, eat and maintain some sense of a daily routine,” Rawlings says.
Schwartz believes a well-thought out design should ensure that parking, 24-hour food options and even mailboxes are accessible to caregivers.
Maintaining a Happy, Productive Staff
When we talk about patient experience, we want to make sure the staff experience as well is optimal.
“When we talk about patient experience, we want to make sure the staff experience as well is optimal, because if the staff is having a negative experience, it can affect the patient,” Schwartz says.
A design that optimizes the flow for both patients and staff is the best way to create a positive experience for both, she adds.
“Chaos and business and work mentality doesn’t need to be in the space of our visitors, so separate them,” says Schwartz.
Hospitals should be designed so that business operations take place out of public view, without “trash carts running across you in the elevators,” says Schwartz.
As the population continues to live longer and the focus on health becomes more preventative, healthcare facilities with a huge footprint will likely shift to smaller, acute, specialized care centers that will serve sicker, older patients, Rawlings says.
Skolnick agrees, adding that the outpatient space is the next untapped opportunity in healthcare.
“If we’re going to truly manage the health of our population—eradicating diabetes and other diseases—we need to challenge ourselves as an industry to better design the outpatient space,” Skolnick says.