Healthcare Design - December 2015 - 51


WILL HERNANDEZ, CLEVELAND CLINIC

a waiting area might have on patients' perception of a
physician's bedside manner or the location of a team
station on care coordination.
The elusive connections between design and
patient experience can be sought out when design
research aggregates a broader spectrum of observed
behaviors and outcomes in healthcare settings.
Fortunately, a mixture of new and old techniques is
helping design researchers revamp the data-gathering
process, making it easier to discover more complicated and unexpected patterns.
The two case studies that follow are illustrations of
how advances in design research are powerful tools
to identify challenges, target real value (whether that's
patient satisfaction or something else), and ultimately
prioritize design and operational solutions so they're
aligned with building project goals.
Cleveland Clinic
In planning an inpatient and outpatient facility, Cleveland Clinic set out to explore the ways in which the
design for an acute care patient room might improve
empathic relationships and the patient experience.
Cleveland Clinic worked with BBH Design (Raleigh,
N.C.) to conduct the design research and WRL Architects (Cleveland) for the design during 2014 and early
2015.
More than 600 Cleveland Clinic patients provided input through an online patient panel survey, while others
completed written questionnaires during their hospital
stay. Patients and caregivers also took part in a series
of mock-up experiments that incorporated multiple
and subtle manipulations of room configuration. Finally,
the team undertook behavioral observations that were
collected from patients, visitors, and clinicians on three
existing inpatient units, accounting for the roles of
nearly everyone on the units and their activities.
The findings converged on a key theme: Patients
appreciated the value of improved design while they
also recognized that quality of care was distinguishable from room aesthetics. This echoed the study by
the Johns Hopkins team; however, the study also revealed a picture of patients who valued room designs
that supported opportunities for more control over the
patient room environment, responsiveness by frontline
caregivers, and family presence.
Results indicated that patient loyalty improved and
anxiety decreased when the patients felt and had
more control over room conditions (such as lighting
levels). Patient-centric amenities that boosted this
sense of control included reading lights, accessible
outlets for personal devices, in-room accommodations
for family members, opportunities for room personalization, as well as views of artwork and the outdoors.
Many of the patients recognized and valued room

features that helped caregivers respond to their
security and comfort needs. Keeping this in mind,
experiments with a same-handed room mock-up
demonstrated improved rounding, better visibility, and
more reliable knowledge about the location of supplies
and equipment.
Similarly, an idea for in-room docking stations for
workstations-on-wheels created win-win situations
for the patients and caregivers. The orientation of
the docking stations encouraged more satisfying
face-to-face interactions between patients/family and
caregivers, and caregivers could be more efficient by
not having to power up their workstations or find a
place for documentation in busy corridors.
The design research redefined project assumptions
by revealing the underlying issues and aligning design
decisions to what patients and their caregivers actually
value. An important takeaway for everyone involved
was that the design research created opportunities to advance Cleveland Clinic's facility design that
may have not been considered without the design
research.

A two-stage mock-up process was used at Cleveland
Clinic to run experiments
with patients, family
members, and caregivers.
The primary goal was to
compare the performance
of a same-handed room to
a mirrored room by using
side-by-side mock-ups.
Between sessions with
participants, room orientation, charting solutions,
caregiver work zone, lighting, and other conditions
were switched out without
the participants' knowledge
so the conditions could be
compared on measures of
performance.

New Parkland Hospital
With an FKP-designed clinic underway for its new
campus, the New Parkland Hospital in Dallas conducted a study to explore how clinic design and layout can
influence communication and collaboration among patients and caregivers. The hospital partnered with BBH
Design (New York and Raleigh, N.C.) and KI (Green
Bay, Wis.) to conduct five days of behavioral observations, ethnographic observations, and team interviews
on two existing outpatient clinics in spring 2014.
The behavioral observations found some meaningful relationships between design and caregivers'
communications with patients. For example, one
challenge found in the existing space was that physicians and nurses spent much of their day in front of
computers-even in the exam rooms-which limited
face-to-face communication with patients and fellow
team members. Also, nurses were the "glue" to the
clinics, searching for others and resources and relaying information between physicians and patients.
Location, accessibility, visibility, and team composition also came into play. Interdisciplinary team stations
boosted collaboration and opportunities for nurses to
interact with and find physicians, particularly in one
HCDmagazine.com 12.15

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Table of Contents for the Digital Edition of Healthcare Design - December 2015

Healthcare Design - December 2015
Contents
HCDmagazine.com
Editorial
Show Talk
Monitor
The Center
The Inside Story
Hitting the Mark
View From the Top
Echoing the Landscape
Master Class
Research
Special Supplement: 2015 Remodel/Renovation Competition
Remodel/renovation Competition
Special Advertising Section: Remodel/Renovation Directory
Special Supplement: 2015 Product Innovation Awards
Product Innovation Awards
Special Advertising Section: Product Innovation Gallery
First Look
Healthcare Design - December 2015 - Healthcare Design - December 2015
Healthcare Design - December 2015 - Cover2
Healthcare Design - December 2015 - 1
Healthcare Design - December 2015 - Contents
Healthcare Design - December 2015 - 3
Healthcare Design - December 2015 - HCDmagazine.com
Healthcare Design - December 2015 - 5
Healthcare Design - December 2015 - Editorial
Healthcare Design - December 2015 - 7
Healthcare Design - December 2015 - Show Talk
Healthcare Design - December 2015 - 9
Healthcare Design - December 2015 - Monitor
Healthcare Design - December 2015 - 11
Healthcare Design - December 2015 - 12
Healthcare Design - December 2015 - 13
Healthcare Design - December 2015 - 14
Healthcare Design - December 2015 - 15
Healthcare Design - December 2015 - The Center
Healthcare Design - December 2015 - 17
Healthcare Design - December 2015 - The Inside Story
Healthcare Design - December 2015 - 19
Healthcare Design - December 2015 - 20
Healthcare Design - December 2015 - 21
Healthcare Design - December 2015 - 22
Healthcare Design - December 2015 - 23
Healthcare Design - December 2015 - 24
Healthcare Design - December 2015 - 25
Healthcare Design - December 2015 - Hitting the Mark
Healthcare Design - December 2015 - 27
Healthcare Design - December 2015 - 28
Healthcare Design - December 2015 - 29
Healthcare Design - December 2015 - 30
Healthcare Design - December 2015 - 31
Healthcare Design - December 2015 - View From the Top
Healthcare Design - December 2015 - 33
Healthcare Design - December 2015 - 34
Healthcare Design - December 2015 - 35
Healthcare Design - December 2015 - 36
Healthcare Design - December 2015 - 37
Healthcare Design - December 2015 - Echoing the Landscape
Healthcare Design - December 2015 - 39
Healthcare Design - December 2015 - 40
Healthcare Design - December 2015 - 41
Healthcare Design - December 2015 - 42
Healthcare Design - December 2015 - 43
Healthcare Design - December 2015 - Master Class
Healthcare Design - December 2015 - 45
Healthcare Design - December 2015 - 46
Healthcare Design - December 2015 - 47
Healthcare Design - December 2015 - 48
Healthcare Design - December 2015 - 49
Healthcare Design - December 2015 - Research
Healthcare Design - December 2015 - 51
Healthcare Design - December 2015 - 52
Healthcare Design - December 2015 - Special Supplement: 2015 Remodel/Renovation Competition
Healthcare Design - December 2015 - Remodel/renovation Competition
Healthcare Design - December 2015 - 55
Healthcare Design - December 2015 - 56
Healthcare Design - December 2015 - 57
Healthcare Design - December 2015 - 58
Healthcare Design - December 2015 - 59
Healthcare Design - December 2015 - 60
Healthcare Design - December 2015 - 61
Healthcare Design - December 2015 - 62
Healthcare Design - December 2015 - 63
Healthcare Design - December 2015 - Special Advertising Section: Remodel/Renovation Directory
Healthcare Design - December 2015 - 65
Healthcare Design - December 2015 - 66
Healthcare Design - December 2015 - 67
Healthcare Design - December 2015 - 68
Healthcare Design - December 2015 - 69
Healthcare Design - December 2015 - 70
Healthcare Design - December 2015 - 71
Healthcare Design - December 2015 - 72
Healthcare Design - December 2015 - 73
Healthcare Design - December 2015 - 74
Healthcare Design - December 2015 - Special Supplement: 2015 Product Innovation Awards
Healthcare Design - December 2015 - Product Innovation Awards
Healthcare Design - December 2015 - 77
Healthcare Design - December 2015 - 78
Healthcare Design - December 2015 - Special Advertising Section: Product Innovation Gallery
Healthcare Design - December 2015 - 80
Healthcare Design - December 2015 - 81
Healthcare Design - December 2015 - 82
Healthcare Design - December 2015 - 83
Healthcare Design - December 2015 - 84
Healthcare Design - December 2015 - 85
Healthcare Design - December 2015 - 86
Healthcare Design - December 2015 - 87
Healthcare Design - December 2015 - First Look
Healthcare Design - December 2015 - Cover3
Healthcare Design - December 2015 - Cover4
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