Healthcare Design - January/February 2016 - 30
Emerging outpatient concepts
Reducing hospital readmissions is on the minds
of designers, operators, and owners across the
healthcare design spectrum-and rightfully so, as
penalties for these continue to take effect.
During her conference session, speaker Natalie
Abell, a senior associate for the applied solutions
group at the ECRI Institute, identified two emerging
specialty outpatient concepts and how they could
help address this issue. The two concepts-postdischarge clinics and adolescent and young adult
(AYA) cancer centers-present opportunities to
intervene with a vulnerable population's care routine
and improve outcomes and results.
Starting with post-discharge clinics, Abell said
that for patients leaving a hospital or healthcare
facility, "80 percent of discharge instructions are
forgotten by the time they hit the parking lot."
Some potential reasons for this: Patients might
still be under the influence of medication; they don't
have an established relationship with a primary
care physician with whom to schedule follow-ups;
they have difficulties filling prescriptions; or their
test results and medical records don't always get
transferred into their electronic health record.
To facilitate better post-discharge care and patient education, several operators have implemented these after-care clinics where staff can check
a patient's health, assist with making follow-up
appointments, review test results, and help regulate
medications. Abell said that while the concept is still
too new to have much design evidence backing it,
studies have started to show a correlation between
timely follow-up visits and reduced readmissions.
Turning her focus to cancer centers for patients
caught between young pediatric and adult oncology services, Abell said that cancer clinics aren't
designed to address the specific needs of these
patients (such as ongoing education and fertility and
family planning services). These patients, Abell said,
may also be more emotionally and financially vulnerable than other patient populations.
AYA cancer centers should focus on specialized
services, programs, and built environments that
provide separate spaces for infusions/clinical care
and zones for rest and socializing. "Peer interaction
is extremely important to them," she said.
They also seek bright, colorful, homelike setting with lots of windows and that are outfitted with
computers and gaming equipment. "They want to be
distracted," Abell said. "It's an important part of their
Abell said many of these units originate in
children's hospitals and traditionally are supported
by charitable organizations, such as Teen Cancer
America. In addition to improving outcomes and
access to educational resources, AYA cancer clinics
can also promote more participation in clinical trials
to help advance care. "Only 14 percent of [young
cancer patients] enroll in trials compared to 60 percent in pediatrics," she said.-AD
FROM OUR KEYNOTES
"There's truth beyond the data when you go into the
-Deborah Adler, founder of Adler Design (New York). The gemba, she explained, is a Japanese
term that translates into "the real work"; by getting up close to the places where healthcare-related
activities occur (the supply closet, at the patient bedside), our industry has the best chance of
solving real problems with smart, specific design.