Healthcare Design - May 2016 - 100

R RESEARCH | 05.16
A rural healthcare roadmap

Critical access hospitals and other remote healthcare sites face unique challenges and provider
goals, calling for healthcare spaces that support those needs. A recent research study identifies
some proven paths for design By Kirsten Staloch

best practices can be used to create facilities that
answer rural hospitals' main objectives through a
graduate thesis concluded in May 2015 at Clemson
University as part of the AIA Arthur N. Tuttle Jr.
Graduate Fellowship in Health Facility Planning and
Design.
The effort studied the implications of rural healthcare delivery and the impact they have on best
practices in the design of remote health facilities.
Research included a literature review that focused
on accessibility, high-quality care, sustainability, and
cultural relevance. These objectives set the basis for
facility observations and site visits to Ely-Bloomenson Community Hospital in Ely, Minn., renovated by
DSGW Architects in 2009; Cook Hospital in Cook,
Minn., designed by DSGW Architects in 2012; Fort
Providence Health Centre in Fort Providence in
the Northwest Territories of Canada, completed
by PSAV Architects in spring 2015; PeaceHealth
Peace Island Medical Center in Friday Harbor,
Wash., designed by Mahlum Architects in 2012; and
Cross Road Medical Center in Glenallen, Alaska, a
demonstration site of a frontier extended-stay clinic
from 2010-2013.
Here are a few examples of the major principles
of rural healthcare design that emerged.

Establishing design guidelines
Architects and designers working on rural projects
must create spaces that support high-quality and
sustainable care. Research digs deeper into what

Optimize accessibility
Facilities should be highly accessible to all patients,
which can be achieved by locating health centers
centrally to dispersed populations and near other

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HCDmagazine.com 05.16

Peace Island Medical
Center in Friday Harbor,
Wash., designed by Mahlum
Architects in 2012, demonstrates multiple architectural
components that serve care
needs of the community.
Located within the San
Juan Islands, the facility
includes environmentally
sustainable measures that
reduce staff maintenance of
the facility, a pattern to the
structural grid to accommodate future expansion
of primary care areas, and
adaptable room layouts for
flexible organization.

Kirsten Staloch

KIRSTEN STALOCH

Many remote and rural areas in the United States
lack adequate access to basic healthcare services
found in more urban locations, such as primary,
urgent, and emergency care. In addition, many of
these communities are composed of an increasing
aging population, a growing number of residents
with chronic illnesses, and, in some communities,
tourists who may require urgent care. The need is
apparent, but patient volumes overall remain low.
Evolving patterns of care delivery, advances in
technology, and physician shortages are affecting
how access to medical care can be delivered in
geographically isolated locations. Additionally, critical access hospitals (CAHs), which have historically
served as the facilities for primary healthcare needs
of rural communities, are struggling with reimbursement challenges. Before 2015, CAHs received
Medicare reimbursements for health services at
101 percent. New policy changes from the Affordable Care Act gradually decrease reimbursements
to 100 percent by 2020.
As a result of all these pressures, an even greater
need exists for rural healthcare providers to deliver
care in an appropriately designed environment
that supports effective-and cost-effective-care
delivery.

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Healthcare Design - May 2016

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