Considering the healthcare landscape’s uncertain climate, JE Dunn Construction recently partnered with HKS Inc. and the Center for Advanced Design Research and Evaluation (CADRE) to answer one fundamental question: How do we design, not for a faceless future, but for an ever-changing present?
The team specifically delved into what the key drivers of change are in healthcare, then reviewed prevalent trends, assessed the facility implications of those trends, identified innovations through case studies, and filtered their findings into what patients and physicians want—all in order to develop a framework for a change-ready clinic. Healthcare is an ever-changing industry that calls for innovation in the design and construction process. One of CADRE’s many individual projects, Clinic 20XX responds to this call in a study that’s divided into five core components:
- Literature review to identify key drivers of systemic change
- Literature review to identify key trends in response to drivers
- Case study research looking at three clinics that exemplified emerging trends
- Survey distribution to 150 millennials and 150 baby boomers who had visited a clinic for the first time in the previous six months
- Survey distribution to 100 family practice physicians and internal medicine physicians.
All of the information gathered was then put together to develop a framework for the type of spaces that will soon be necessary. Here is a deeper look at the findings from a construction perspective.
Technology takes center stage
Some of the team’s biggest findings were in the arena of technology and its continuing expansion into healthcare facilities. There’s a shift taking place where providers are moving from the standard physical, office-based version of healthcare to a digital, mobile-friendly approach. The clinic now becomes a place where digital information will need to be available, in waiting and exam rooms, staff spaces, and on to billing and accounting. Upgraded technology systems will be necessary to support this.
In line with the expansion of technology across healthcare in general, the expansion of both wired and wireless systems will grow dramatically in the clinic setting. While driving different systems, the degree of wiring will need to be close to current inpatient hospital levels, requiring larger and more cable trays. As much as clash detection is currently used often in hospital projects, cable routing and coordination will become mandatory for effective construction and operations.
Facility owners and designers can also expect the use and quality of flat screens to expand—for example, located in corridors to take the place of the current exam room signal flags, easily allowing patients to navigate from the arrival lobby to the exam room on their own.
Accompanying this rise in the quality and scope of application of technology will come larger and more complex data rooms to support an array of on-site servers. Technology-based care options are supported by separate low-voltage cable and wiring systems. Collectively, the investment can be several million dollars for even a modestly sized clinic. Low-voltage systems expertise will be required, and coordination will become a major part of electrical systems.
With the scale of the investment and need to protect sensitive electronics, clients are looking at non-water-based fire protection for these rooms. Some clinics are budgeting up to double their prior investments in technology and, with that, shifting to fire protection more often seen in corporate data rooms. Large, uninterruptable power systems (UPS) will be deployed to protect data and provide emergency power on-site if outpatient treatments are provided, to ensure patient and data safety in a power emergency. Protecting the patient during treatment is critical and so is the data related to the treatment, making both UPS and emergency power generation increasingly valuable to both patient health and business operations.
Tailoring the workplace to the worker
The research revealed that there’s a significant growth in integrated care teams, increasing the need for more collaborative spaces. It also found that physicians who had worked in an open office before (especially with other physicians) were open to giving up their private physician offices.
Findings also showed a shift toward team-based care, meaning that more providers will be engaged in treatment, both in person and digitally. With data and findings like these, treatment spaces can be expected to have a profound impact on the care provided, such as supporting team members’ investigation of several parallel treatment options.
As technology used by healthcare professionals in their work continues to progress, it may be necessary to consider prominent training rooms for staff with appropriate furniture and technology. Additionally, to improve staff satisfaction, small windowless breakrooms are expected to be replaced by larger and better outfitted rooms, which may double as training rooms.
More hospitality-inspired features
Survey findings show that younger patients, especially millennials, really value a spa-like experience as patients, which indicates a number of things. For example, the arrival experience will be improved, answering higher standards for parking, landscaping, and other initial touches a patient would have with the facility. Once inside, superior interior finishes will be in demand, making quality control in construction more important than ever.
Additionally, music could be more interwoven into the patient experience to make for a more enjoyable experience. Facility owners can expect speakers throughout and volume controls than can be readily accessed by staff, once again leading to an increase in the technology expertise that will be necessary for construction teams.
Evolution of the exam and waiting rooms
One of the major spaces that will likely see an overhaul in the future is the exam room. The key and most visible changes that patients will experience is a more contemporary and much friendlier experience. The exam room will be larger, including space for family and technology. However, with leaner approaches to patient scheduling and faster turn times, facility costs in regard to exam rooms aren’t expected to increase due to fewer, better-equipped rooms doing the work of yesterday’s room. In fact, the researchers suggest that with a growing trend toward group visits and more family included in consults with larger teams, exam rooms are no longer just for examination but rather are a more inclusive care space.
Another room that’s predicted to undergo prominent change is the waiting room. Waiting as we know it is on its way out the door. Additionally, spaces identified for waiting in more public areas may also be repurposed with a “healthcare education” approach. Expect this new waiting room space to contain upgraded furniture and finishes, with multiple flat screens and areas for personal teaching and data entry. A high level of wireless and connected options along with the requisite power outlets will also be prevalent. The terms lounge, concourse, etc., are likely to replace the traditional waiting room.
Smart, Lean, and integrated delivery
Industry-wide the focus on client satisfaction and outcome-based payment is driving a change in the make-up of healthcare systems. Consolidation of independent systems and growth of larger and more diverse organizations are driving new and more patient- and caregiver-responsive facilities. Those changes are driving an imperative for speed to market to capture market share, and this focus is becoming more critical to healthcare systems and providers with each passing day.
With an increasing focus on speed to market, clients are looking for their projects to be built in ever shorter durations. Leading-edge healthcare systems are moving quickly to respond to new care and market opportunities. To survive in this environment, leveraging techniques such as multi-trade prefabrication, bid packaging, modular construction, and more will be needed to compete in the industry.
As facility expectations rise and change for the boomer and millennial healthcare consumers, so too will the expectations of facility owners in order to meet those demands. Design teams and contractors will need to work in a more integrated approach to simultaneously deliver projects faster while introducing better quality materials and more technology in even more accelerated schedules.
Just as leading healthcare practitioners and systems are using diverse teams to address today’s more complex care environments, so too will design and construction teams need to leverage more integrated project delivery models to respond to what’s expected to be a rapidly expanding clinical care market in the coming years.
Philip Macey, AIA, is national director of collaborative project delivery at JE Dunn Construction in Denver. He can be reached at firstname.lastname@example.org.
Produced in collaboration with HKS Architects and the Center for Advanced Design Research and Evaluation (CADRE).