Healthcare Design - August 2016 - 36

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Parnell, a medical planner at CallisonRTKL, says it's
important when designing for technology to account
for future needs. "If you miss the capacity on the building air conditioning, power, and plumbing, it's a tough
thing to accommodate in the future," he says.
Academic centers are also seeking new approaches to private office space. "The thought is, if
you're in clinical environments more than 75 percent
of the time, that those 'owned' academic offices are
an inefficient use of valuable real estate," says FKP's
Ragan. Instead, academic facilities are turning toward
hoteling-inspired workspaces that are centered on interaction and flexibility, including lounges with a mix of
furniture and desks for checking email or charting. The
new outpatient pavilion at the University of California
San Diego, designed by CO Architects, features sky-lit
work nodes to encourage informal clinical interaction,
cross-disciplinary collaboration, and teaching opportunities. (For more on the project, see page 39.)
Seeking a different approach
Another topic of conversation between firms and their
academic clients today is process design and how to
manage patients in a different way. "That's probably
where we have the most challenges because they're
not typically the most efficient, streamlined places,"
says CannonDesign's Pukszta.
When the firm started working with the University of
Minnesota Health (M Health) to design a new ambulatory care facility on its Minneapolis campus, it mapped
out the patient's journey using M Health's existing
processes. Among the findings were 20 routes that
patients could take to schedule an appointment and
10 activities they went through before they actually saw
a provider. Instead of bringing these inefficiencies to its
new facility, CannonDesign suggested a total process
redesign focused on efficiency, saving steps, and
reducing redundant services, which would also save
$26 million on the project. "When they started projecting what kind of revenue they were going to get in the
future and projecting decreased per-patient revenue,
they were in a situation where financially they had to
think differently," he says.
The five-story, 342,000-square-foot University of
Minnesota Health Clinics and Surgery Center, which
opened in May, features no check-in or check-out
areas, waiting areas, or private staff offices. (For more
on the project, see page 38.) Pukszta points out two
strategies in particular that helped the new ambulatory center realize cost savings and a smaller building
footprint despite a similar staff size and patient loads:
36

HCDmagazine.com 08.16

zero customization of department suites and exam
rooms (which provides flexibility for future needs)
and technology. For example, wearable electronic
devices are given to the staff and patients upon
arrival to keep track of their movements throughout
the building and help drive operational improvements. Staff members receive a notice when a
patient checks in and can look on a monitor to see
where that person is seated so they can approach
them in the waiting lounge and greet them by name
before taking them back to an exam or procedure
room. "There's no more calling out names or anything like that," Pukszta says.
The staff is also alerted when a patient has been
sitting in an exam room for longer than 10 minutes
without seeing a provider. "With the data they're getting out of the system, they can make adjustments
on a daily basis," he says. "It's invaluable as a tool
for them to refine their processes."
Staying connected
Like other healthcare sectors, academic medical
centers will need to continue refining their processes
and adapting their built environments, especially as
patient acuity levels rise. "It's the place where the
sickest of the sickest go," HKS' Webb says, which
can impact a range of design and planning considerations, from lengths of stay and staffing needs to
layout, bed counts, and facility sizes.
Addressing those clinical issues while balancing their research and education missions will be
another challenge. One key, says FKP's Ragan, is to
create a physical connectivity among departments
or buildings to promote collaboration and ease sharing of ideas, such as bridges or tunnels connecting
buildings, back-of-house elevators for staff, and
open work spaces. "Academic medical centers are
complex organizations," she says. "Having some
sort of connectivity between buildings facilitates an
environment for discovery and socialization."
Anne DiNardo is senior editor of Healthcare Design. She
can be reached at anne.dinardo@emeraldexpo.com.

Nurses' stations at the
University of Connecticut
Dempsey Tower, in
Farmington, Conn., include
glass-enclosed teaming
rooms where academics,
researchers, and clinical
practice staff can come
together. Designed by HKS,
the project was completed
in 2015.

©ROBERT BENSON PHOTOGRAPHY

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Healthcare Design - August 2016

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