Creating a Healthcare Facility that Supports thePatient-Centered Medical Home

Cindy Barr RN, EDACOperations & Facilities PlannerMay 2011

.2010 Guidelines for Design and Construction

of Health Care FacilitiesFacility Guidelines Institute

“The physical environment shall be

designed to support the intended

delivery of care model …”

“… where patients could receive care in a truly

healing environment

that would also provide them with

access to the information needed to become

active participants

in their own care and wellbeing.”

www.planetree.org

What is a Patient–Centered Environment?

What is a Patient–Centered Environment?

Setting the Stage for Effective Interaction

Designing for Continuous Stress Reduction

Optimizing a Sense of PlaceSharing Control

Creating a Patient-Centered Environment of Care

Accommodate Persons Accompanying the Patient

Supportive Waiting Create multiple comfortable “drop-offs” to give the patient control over the level of involvement of family and friends.

Age-Specific Waiting Accommodate children in adult waiting areas and adults in children’s waiting areas.

Stress-Free Waiting Maximize the visitor’s experience by offering positive distraction within a healing environment.

Toddler play zones, beverage bars, free wireless internet, library lounges, interactive education kiosks.

Creating a Patient-Centered Environment of Care

Communicate a Message of Welcoming Inclusion

Me … and also You Offer subtle cultural cues which are not exclusionary:

•Incorporate colors, symbols, graphics which have cultural meaning to your target population

•Define movement through the facility using flow patterns reminiscent of significant cultural events and local natural spaces

•Share natural light

Mannington Website

Creating Public Light

Creating a Patient-Centered Environment of Care

Communicate a Message of Welcoming Inclusion

Familiar … but Better Integrate community norms while exceeding expectations:

•Accommodate multiple methods of transportation

•Address personal care needs immediately upon arrival

•Create orientation space between entry and interaction zones

Profit by Design website

Offers Privacy for OrientationAddresses Personal Care Needs

Creating a Patient-Centered Environment of Care

Communicate a Message of Welcoming InclusionFamiliar … but Better Integrate community norms while exceeding expectations:

•Feed all five senses – lightly!

•Integrate security measures appropriately

•Utilize exterior finishes commonly found on public buildings in your community

Creating a Patient-Centered Environment of Care

Create a System of Intuitive Wayfinding

Effective Signage:

Efficient Movement:

One Message, Multiple Methods:

Creating a Patient-Centered Environment of CareCreate a System of Intuitive Wayfinding

Effective Signage • Incorporate Universal Symbols

www.hablamosjuntos.org

•Monitor ADA Compliance

www.ada.gov/2010ADAstandards_index.htm

•Facilitate continuous movement using meaningful shapes, lay language and consistent placement

•Develop universally effective color ways

www.colorschemedesigner.com (Vision Tab)

Creating a Patient-Centered Environment of Care

Create a System of Intuitive WayfindingEfficient Movement •Invite movement with architectural curves

•Invite interaction with open areas

•Check sight planes to insure patients can always visualize a staff member

•Create corridors of appropriate width

Develop a “Road System”

•Accommodate personal needs in private alcoves along primary routes

Profit by Design website

Staff VisualizationPersonal Care Needs Intuitive Interaction

Creating a Patient-Centered Environment of Care

Create a System of Intuitive Wayfinding

One Message, Multiple Methods:

•Utilize technology creatively, yet comfortably

•Reinforce all verbal communication with narrative and pictorial documentation

•Offer personal escorts

.

The “Medical Home” as defined by AAP

Facilitating “accessible, continuous,

comprehensive, family-centered, coordinated,

compassionate, and culturally effective care”.

Creating a Place to Call Our Medical Home

Creating a Place to Call Our Medical Home

Foster Personal Identification

Personal Connection

•Facilitate the development of a relationship between each patient and at least one staff person whom the patient will identify as a point-of-contact.

Design common passageways with consultation alcoves.

Incorporate multiple access points to phone and computer.

Consistent Follow-up

•Encourage post- and inter-visit follow-up utilizing visual reminders and convenient access

Locate lab, eligibility and education near the main entry

Creating a Place to Call Our Medical Home

Foster Personal Identification

Effective Teamwork

•Incorporate zones which accommodate “warm handoffs” between staff/providers and patient

•Build on the power of co-location to encourage coordination - Remember!

Out of Sight, Out of Mind!

Create Swing Suites, Team rooms and Talking Rooms

Spaces for Effective Teams …

Facilitate Interaction Accommodate Focused Work

Incorporate Flexibility

Utilize Calming Design ElementsIncorporate Natural Light

Provide Sound Absorption

Creating a Place to Call Our Medical Home

Create New Spaces for the Redefined Patient Visit

Family Visit •Expand the exam room width by at least 2 ft

•Strategically locate seating alcoves

Multi-Disciplinary Visit •Incorporate visual and architectural cues to create task zones for education, examination, consultation and therapy

•Adapt finishes and furnishings of select rooms to facilitate hand-offs

•Facilitate timely multi-provider encounters

Explore the Possibilities

What does Integrated Behavioral Health mean?

www.milbank.org

Location, Location, Location

Integrate Education & Behavioral Health

PROCEDURE

EXAM

EXAM

EXAM

EXAM

EXAM

EXAM

CONSULT

FAMILY EXAM

PROCEDURE

EXAM

EXAM

EXAM

FAMILY EXAM

FAMILY EXAM

EXAM

EXAM

EXAM

NURSING BHS

RD

PROCEDURE

ON-DECK--FAMILY

INTEGRATED EXAM

INTEGRATED EXAM

INTEGRATED EXAM

INTEGRATED EXAM

FAMILY EXAM

STORAGE

FAMILY EXAM

FAMILY EXAM

FAMILY EXAM

55’

10’

Creating a Place to Call Our Medical Home

Create New Spaces for the Redefined Patient Visit

Group Medical Visit •Space and Location Requirements

•Pre-Construction Pilots

•Multi-Functional Suites in New Construction

Group Education Visit •Front and Center Location

•Target: 80% Utilization

Provide for internal storage, presentation options, seating options, refreshment staging, restroom access

Convert Medical Records to Group Medical Visit Space

Convert Offices to Group Medical Visit Space

Convert / Create Exam Module to Group Medical Visit Space

Create Flexible Group Spaces

Going Beyond the Conference Table

StorageCloset

Demonstration Kitchen(ette)

Create Multi-Functional Group Spaces

Exam Suite?

Main EntryArea

Natural Light Source

Creating a Place to Call Our Medical Home

Create New Spaces for the Redefined Patient Visit

Technology-Enhanced Visit •Monitors:The Third Person in the Room

• Designing for Telemedicine: Consultation and Examination

• Staff-to-Staff Communication

•Security

•Kiosks:Where and When

What is Wrong With This Picture?

The Third Person in the Room

Effective Zoning

Form Function

Option A Option B

120 Sq Ft of

Storage

Remember …

Your facility will either support or hinder the understanding of your words and the

effectiveness of your actions.

To talk further…

304-876-6996 (office)304-283-7863 (cell)cbarr@caplink.org