Contract - October 2015 - 102

BOOK REVI EW

Modern Clinic Design:
Strategies for an Era of Change
by Christine Guzzo Vickery,
Gary Nyberg, and Douglas
Whiteaker (Wiley, 2015)

Architects and Designers at HGA Coauthor
Authoritative Book on the Design of Clinics
By Sara O. Marberry, EDAC

Keeping up with changes in healthcare delivery is not easy. Social,
economic, and political forces are constantly reshaping the healthcare
"landscape" and challenging design professionals to find new solutions
for delivering quality care environments. That's why "Modern Clinic
Design: Strategies for an Era of Change" (Wiley, 2015) by Christine
Guzzo Vickery, Gary Nyberg, and Douglas Whiteaker is timely.
Those who have Jain Malkin's classic, "Medical and Dental Space
Planning" (Wiley, fourth edition, 2014), on their shelves may not think
they need another book on this subject. And the detail in Malkin's
688-page volume is more comprehensive than any other book about
healthcare design. But the 336-page "Modern Clinic Design" offers
a fresh, condensed look at ambulatory care design and the trends
shaping it now and in the future.
A collaborative process, this book was written by a team
of veteran healthcare interior designers and architects with HGA
Architects and Engineers, with colleagues as contributors. So, most
of the many project examples and diagrams in the book are HGA's
work, but the book is not about HGA.
From clinic planning to lean design
Organized into 10 chapters, the book is a thoughtful exploration
of topics such as the patient experience, lean design, designing
for flexibility, clinic planning concepts, exam room design, politics
and healthcare, retail healthcare, medical home model, and nontraditional clinic models. The impact of evolving legislation, changing
technologies, aging populations in the U.S., and other cultural factors
are thread throughout the book, with each contributing author offering
his or her perspective on how those forces are shaping clinic design.
In his introduction, healthcare design expert Frank Zilm
describes the design of clinics as the "heart of ambulatory care."
The heart of the book itself may be the chapter on exam room design
written by retired HGA Healthcare Principal Gary Nyberg, who points
out that "who does what, when, and where" in the clinic environment
is changing. "As more health services flow toward the point-of-care,
the exam room is becoming the place where most of the work

102

is accomplished," Nyberg writes. The chapter also includes 10 exam
room prototypes with diagrams and a very useful comparison table.
Notably, the authors include a whole chapter devoted to politics
and healthcare. Written by HGA Healthcare Principal Douglas Whiteaker,
the chapter is a fascinating analysis of how politics and healthcare
influence each other in the U.S., starting with the Pilgrims of Plymouth
colony that provided care for wounded soldiers in the 1600s. Whiteaker
frames the description by era, providing an overview of major political
and medical events that shaped U.S. healthcare, from Typhoid Mary to
Florence Nightingale, Medicare and Medicaid, COBRA, HMOs, and more.
In this chapter, Whiteaker discusses how design professionals
have "addressed the constantly changing challenges presented
by political forces and other factors." Suggestions for how designers
act on new opportunities and "maintain and enhance their valued
position as trusted advisors for their clients" can also be found within
the chapter. But placing this information at the front of the book
instead of the seventh chapter would have been more impactful.
Readers will learn from HGA Principal Jennifer Klund's description
of the history of the medical home model and the challenges facing
it today. She explores the seven key characteristics of medical homes-
continuity, team-based care, whole-person orientation, coordination,
quality and safety, enhanced access, and payment reform-and the
trends influencing design. A strong section on the impact of technology
and its use in the medical home model is included. The chapter
ends, as many in the book do, with project examples accompanied
by detailed floor plans.
Seasoned healthcare design professionals may learn a thing
or two from the book, and mid-career designers, students, and healthcare
managers will find it to be a very useful resource.
Sara O. Marberry, EDAC, is a healthcare design writer, blogger,
speaker, and strategic marketing and business consultant
in Evanston, Illinois.

contractdesign.com

OCTOBER 2015

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Contract - October 2015

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