Healthcare Design - November 2016 - 68

68

NOVEMBER 2016

Clinic growth isn't going
anywhere, at least not for
a while. Deborah Franqui, healthcare market
leader at Leo A Daly and
coordinator of healthcare design programs
at University of Miami
School of Architecture
(Miami), says the trend
is fueled by increasing
demand for primary care
services. "And that's going to continue beyond
the year 2025, mostly
influenced by the growth
of the aging population,
the growth of the population in general, and the
expansion in health insurance coverage."
That's why she and
Dina Battisto, associate
professor at Clemson
University (Clemson,
S.C.), decided now was
an ideal time to conduct a
post-occupancy evaluation
(POE) with the goal of
assessing strengths and
weaknesses of different
clinic environments in

order to create a standardized approach for design.
The two will present their
work in the session "An
Evidence-Based Design
Checklist to Inform Clinic
Design" (E61) at the 2016
Healthcare Design Expo &
Conference.
For the project, which
was Franqui's dissertation,
three unnamed primary
care clinics designed by
award-winning healthcare
design firms were analyzed using a methodology developed by Battisto
for a similar effort at the
military health system,
tailoring it for outpatient
care. The three sites
individually represented
the three most common
models used in clinic
design: a traditional layout
with back-to-back exam
rooms and staff integrated
throughout, onstage/
offstage with a dual-side
exam room, and onstage
with patient and staff
circulation in a common

Jennifer Kovacs Silvis is executive editor of Healthcare Design. She can be
reached at J E N N I F E R . S I L V I S @ E M E R A L D E X P O . C O M .

corridor with access to
exam rooms and a central
teaming area.
The POE weighed
design strategies against
four specific outcomes:
operational efficiency,
space efficiency, clinical
effectiveness, and positive
experience. Areas studied
in relation to those outcomes included flow, flexibility, functionality, quality
of care, safety and infection control, and access
and wayfinding. "So if we
look at the clinical pods or
overall design, what are
some design strategies we
can implement to improve
movement and flow, to improve flexibility, to achieve
operational efficiency?"
Franqui says. And identifying areas that achieved
higher scores than others
provided a framework for
the checklist.
Among the findings
was that all excelled at
aesthetics but didn't do
as well with operational

HCDMAGAZINE.COM

efficiency, and a lack of
privacy emerged as a
common issue. "The more
we see clinic design move
toward an open staff/
team approach, it creates
issues with privacy. Even
in the onstage/offstage
model, it became more
critical-since [staff] don't
think patients see them,
they tend to be louder,"
Franqui says. Another
common finding across
different layouts was the
perception by staff that
there were never enough
exam rooms, influenced
by limited flexible and
productive use of rooms
and limited visibility across
pods preventing awareness of when exam rooms
were free.
The findings and checklist will be presented in
the session, with the goal
of providing a standardized approach to POE
for designers to use in
measuring the success of
their own designs in order

to build a database of
findings that could shape
future building solutions.
"[POEs] are not
funded usually and there
are limited examples to
demonstrate the value or
the power of the POE.
This is because a lot of
times the results of the
POE sit on a shelf. ... In
the end, lessons learned
from POEs could help us
avoid making the same
mistakes over and over,"
Battisto says.
Although the project
focused on primary care
clinics only, Franqui says
the results will be applicable across clinic types.
The two also caution that
their recommendations
aren't prescriptive but
rather performance-based
and that ideal solutions
will always vary based
upon organizations and
culture.

HALKIN MASON PHOTOGRAPHY

GETTING IT
RIGHT

The Tisch Center for Men's Health at New York University
Langone Medical Center in New York, designed by
Perkins+Will and opened in January 2014, uses a rich
materials palette. The design harvests natural light
from exterior windows while easing patient anxiety by
offering sight lines into clinical areas via glazed panels.
"These spaces, in some ways, should be better than the
best restaurants you go to. It's an uplifting experience,
so you feel like, hey, this isn't so bad," says Ted Shaw,
associate principal at Perkins+Will.

for the provider with a seven-state reach to not always require patients
to travel hours for a visit or to loop in a parent or primary care physician who can't make the trip. "I feel this is a significant piece of where
healthcare is going, because trying to get every provider who needs to be
involved in a space at the same time is challenging. Telehealth will play
a huge role for providers as well as families," Costantini says. To support
efforts now, the clinic uses a conference room but is planning to add telehealth capability to exam rooms in the future, with modular wall systems
allowing the ability to take out a panel and replace it with a monitor. "It
goes to the point of showing you can add monitors and connectivity to the
exam room without a whole lot of construction," Glasco says.
Vickery anticipates technology even further influencing clinic operations,
too, by streamlining workflow and care delivery, requiring designers to create flexible space that's able to adapt as technology evolves. "[Clinics] will be
much more high-tech when you get in there. You will be taking yourself to
the exam room, you will check in online, schedule your appointment online.
There will be a lot more happening electronically and virtually. It's very exciting to think about how efficient we can make this," she says. 


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Healthcare Design - November 2016

Table of Contents for the Digital Edition of Healthcare Design - November 2016

HEALTHCARE DESIGN - NOVEMBER 2016
CONTENTS
EDITORIAL
SHOW TALK
PHOTO TOUR
MEETING OF THE MINDS
POWER TRIO
GET SMART
WHAT ARE WE WAITING FOR?
HAVING IT ALL
HERE & NOW
WELCOME ADDITION
FIVE BUILDING BLOCKS OF WAYFINDING
FINANCIAL MATTERS HEALTHY SAV-INGS
PRODUCT SPOTLIGHT DINING
THE CENTER
AIA-AAH
Healthcare Design - November 2016 - HEALTHCARE DESIGN - NOVEMBER 2016
Healthcare Design - November 2016 - Cover2
Healthcare Design - November 2016 - 1
Healthcare Design - November 2016 - 2
Healthcare Design - November 2016 - CONTENTS
Healthcare Design - November 2016 - 4
Healthcare Design - November 2016 - 5
Healthcare Design - November 2016 - 6
Healthcare Design - November 2016 - 7
Healthcare Design - November 2016 - 8
Healthcare Design - November 2016 - EDITORIAL
Healthcare Design - November 2016 - SHOW TALK
Healthcare Design - November 2016 - 11
Healthcare Design - November 2016 - PHOTO TOUR
Healthcare Design - November 2016 - 13
Healthcare Design - November 2016 - 14
Healthcare Design - November 2016 - 15
Healthcare Design - November 2016 - 16
Healthcare Design - November 2016 - 17
Healthcare Design - November 2016 - 18
Healthcare Design - November 2016 - 19
Healthcare Design - November 2016 - 20
Healthcare Design - November 2016 - MEETING OF THE MINDS
Healthcare Design - November 2016 - 22
Healthcare Design - November 2016 - 23
Healthcare Design - November 2016 - POWER TRIO
Healthcare Design - November 2016 - 25
Healthcare Design - November 2016 - 26
Healthcare Design - November 2016 - 27
Healthcare Design - November 2016 - 28
Healthcare Design - November 2016 - 29
Healthcare Design - November 2016 - 30
Healthcare Design - November 2016 - 31
Healthcare Design - November 2016 - 32
Healthcare Design - November 2016 - 33
Healthcare Design - November 2016 - GET SMART
Healthcare Design - November 2016 - 35
Healthcare Design - November 2016 - 36
Healthcare Design - November 2016 - 37
Healthcare Design - November 2016 - 38
Healthcare Design - November 2016 - 39
Healthcare Design - November 2016 - 40
Healthcare Design - November 2016 - 41
Healthcare Design - November 2016 - 42
Healthcare Design - November 2016 - 43
Healthcare Design - November 2016 - WHAT ARE WE WAITING FOR?
Healthcare Design - November 2016 - 45
Healthcare Design - November 2016 - 46
Healthcare Design - November 2016 - 47
Healthcare Design - November 2016 - 48
Healthcare Design - November 2016 - 49
Healthcare Design - November 2016 - 50
Healthcare Design - November 2016 - 51
Healthcare Design - November 2016 - 52
Healthcare Design - November 2016 - 53
Healthcare Design - November 2016 - 54
Healthcare Design - November 2016 - 55
Healthcare Design - November 2016 - 56
Healthcare Design - November 2016 - 57
Healthcare Design - November 2016 - HAVING IT ALL
Healthcare Design - November 2016 - 59
Healthcare Design - November 2016 - 60
Healthcare Design - November 2016 - 61
Healthcare Design - November 2016 - 62
Healthcare Design - November 2016 - 63
Healthcare Design - November 2016 - 64
Healthcare Design - November 2016 - 65
Healthcare Design - November 2016 - 66
Healthcare Design - November 2016 - 67
Healthcare Design - November 2016 - 68
Healthcare Design - November 2016 - 69
Healthcare Design - November 2016 - HERE & NOW
Healthcare Design - November 2016 - 71
Healthcare Design - November 2016 - 72
Healthcare Design - November 2016 - 73
Healthcare Design - November 2016 - 74
Healthcare Design - November 2016 - 75
Healthcare Design - November 2016 - 76
Healthcare Design - November 2016 - 77
Healthcare Design - November 2016 - 78
Healthcare Design - November 2016 - 79
Healthcare Design - November 2016 - 80
Healthcare Design - November 2016 - 81
Healthcare Design - November 2016 - 82
Healthcare Design - November 2016 - 83
Healthcare Design - November 2016 - 84
Healthcare Design - November 2016 - 85
Healthcare Design - November 2016 - 86
Healthcare Design - November 2016 - 87
Healthcare Design - November 2016 - 88
Healthcare Design - November 2016 - 89
Healthcare Design - November 2016 - 90
Healthcare Design - November 2016 - 91
Healthcare Design - November 2016 - WELCOME ADDITION
Healthcare Design - November 2016 - 93
Healthcare Design - November 2016 - 94
Healthcare Design - November 2016 - 95
Healthcare Design - November 2016 - 96
Healthcare Design - November 2016 - 97
Healthcare Design - November 2016 - FIVE BUILDING BLOCKS OF WAYFINDING
Healthcare Design - November 2016 - 99
Healthcare Design - November 2016 - 100
Healthcare Design - November 2016 - 101
Healthcare Design - November 2016 - 102
Healthcare Design - November 2016 - 103
Healthcare Design - November 2016 - 104
Healthcare Design - November 2016 - 105
Healthcare Design - November 2016 - 106
Healthcare Design - November 2016 - 107
Healthcare Design - November 2016 - 108
Healthcare Design - November 2016 - FINANCIAL MATTERS HEALTHY SAV-INGS
Healthcare Design - November 2016 - 110
Healthcare Design - November 2016 - 111
Healthcare Design - November 2016 - 112
Healthcare Design - November 2016 - 113
Healthcare Design - November 2016 - PRODUCT SPOTLIGHT DINING
Healthcare Design - November 2016 - 115
Healthcare Design - November 2016 - 116
Healthcare Design - November 2016 - 117
Healthcare Design - November 2016 - 118
Healthcare Design - November 2016 - 119
Healthcare Design - November 2016 - 120
Healthcare Design - November 2016 - 121
Healthcare Design - November 2016 - 122
Healthcare Design - November 2016 - THE CENTER
Healthcare Design - November 2016 - 124
Healthcare Design - November 2016 - AIA-AAH
Healthcare Design - November 2016 - 126
Healthcare Design - November 2016 - 127
Healthcare Design - November 2016 - 128
Healthcare Design - November 2016 - 129
Healthcare Design - November 2016 - 130
Healthcare Design - November 2016 - 131
Healthcare Design - November 2016 - 132
Healthcare Design - November 2016 - 133
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Healthcare Design - November 2016 - 140
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Healthcare Design - November 2016 - 142
Healthcare Design - November 2016 - 143
Healthcare Design - November 2016 - 144
Healthcare Design - November 2016 - Cover3
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