Contract - October 2014 - 108

by Jain Malkin
John Wiley & Sons, 2014

A Recipe for a Well-Designed Healthcare Environment
the changes. I interviewed many
Healthcare designer Jain Malkin, CID,
healthcare providers for the book,
AAHID, EDAC, has authored a fourth
both to enable readers to understand
edition of her book Medical and
the issues and to be able to provide
Dental Space Planning: A
new planning solutions.
Comprehensive Guide to Design,
Hutlock: What are other examples
Equipment, and Clinical Procedures
of physical design changes that have
(Wiley, 2014), an essential reference
come because of the ACA?
on medical and dental office design
Malkin: Providers and patients alike
for more than 30 years. The latest
are increasingly embracing mobile
edition-the first update since
healthcare options, including portable
2002-features more than 70
The Capital Oral and Facial Surgery Center, designed by FORMA
and wearable devices that will enable
percent new and revised content.
Design, Inc., is featured in the latest edition of Malkin's book.
patients to remain in their homes for
Malkin is founder of the firm Jain
the types of basic monitoring and
Malkin Inc., a leader in the field of
diagnostic assessment now primarily done in physicians' offices.
evidence-based design for healthcare facilities, and she serves
Exam room design is undergoing major changes both in size
on the board of The Center for Health Design. Malkin spoke with
former Healthcare Design Editor in Chief Todd Hutlock about the and layout. More options are viable now, including some called
"talking rooms" without an exam table. Coupled with these changes is
changes to the book and the healthcare industry as a whole.
the concept of team-based primary care and large multi-disciplinary
Todd Hutlock: So much has changed in healthcare since the previous team stations in the center of a group of 8 to 10 exam rooms. Again,
it is a unified approach to care. The generic exam room and layout is
edition of the book released more than a decade ago. What are the
becoming less prevalent as physicians are thinking about how the
most significant advances?
rooms can be designed and laid out to be more effective during
Jain Malkin: The most significant changes have been to the way care
the patient encounter.
is being delivered. Much of that is due to the Affordable Care Act
Technology continues to change at a lightning pace as well.
(ACA), which has caused hospitals, physicians, and physician groups
As it becomes more digital, medical equipment is often much
to really think about how they provide care. What we call "episodic
smaller-even miniaturized. Therefore, the actual objects and devices
care" has been a problem for many years. Prior to ACA, care was very
typically found in the exam and treatment rooms of practitioners of
fragmented, with little attention given to the big picture. This was a
various medical and dental specialties are different, and the space can
problem for patients, especially those with chronic illnesses. The ACA
be reconfigured accordingly. In the book's latest edition, all of the
now requires a continuity of care so that now, for the first time, we are
space plans and program tables are new because I wanted them
seeing design and procedural changes that allow all members of
a care team-from social workers to nutritionists to psychologists-to to reflect these new options.
Hutlock: Could one read this book to essentially enhance an expertise
truly confer. This unified approach allows for the patient to be treated
in medical and dental office design?
as a whole, rather than episodically from specialist to specialist.
The dramatic increase in the number of insured patients has also Malkin: Yes! The fourth edition is assembled much like a cookbook.
necessitated a new chapter on community health centers, also known Not only covering space planning, the book actually informs the reader
on how to do it, shows the equipment, explains the utility and size
as "safety-net" clinics, and a discussion of alternatives such as direct
care, sometimes referred to as "concierge medicine." The new focus on requirements, and so on. The book is intended to be useful not just
for design professionals, but for medical practitioners as well.
value being linked to reimbursement has spawned a great deal of
process redesign and new metrics to be able to document and analyze

108

contractdesign.com

OCTOBER 2014

PHOTOGRAPHY: GEOFFREY HODGDON, COURTESY FORMA DESIGN, INC.; COVER COURTESY JOHN WILEY & SONS

Medical and Dental Space
Planning: A Comprehensive
Guide to Design, Equipment,
and Clinical Procedures,
Fourth Edition

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Contract - October 2014

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