Healthcare Design - May 2017 - 34

SCOTT GARAND

Title: Principal
Firm: EwingCole (Charlotte, N.C.)
Number of employees: 350
Healthcare revenue in 2016: $28.5 million

B U S I N E S S C H A L L E N G E : E L I M I N AT I N G WA S T E
I N FA C I L I T Y C O N S T R U C T I O N A N D O P E R AT I O N

Healthcare organizations must do more with less-less time,
less staff, and less money-and they're looking for ways to continuously improve efficiency. As a result, these organizations
are seeking assurances that planning and design solutions can
lead to proven capital and operational cost savings. The challenge for A/E firms is to add value and demonstrate a return on
innovation in the planning and design of facilities. Offering nontraditional services like design research is one way firms can partner in the effort to meet today's challenge of less is more.
W H AT ' S B E H I N D I T

Two major factors that are driving healthcare systems to demand cost savings are the continuous reduction in reimbursements and an increase in
market competition. Gone are the days of reliable revenue growth. Since
the initiation of the Affordable Care Act, many health systems have seen
lower Medicare and private payer reimbursements along with an increase
in Medicaid patients. This has been partially responsible for the increase
in the merging of health systems so that smaller hospitals, which may be
financially struggling, can now access more capital, advanced technology,
expanded service lines, and increased market share.
Additionally, many larger systems are seizing the opportunity to expand
their footprints by either affiliating with or acquiring smaller health systems. As these "mega" systems begin to encroach on one another, it's creating more financial competition in areas that were once controlled by individual systems. However, many hospitals have realized that there's only so
much market share they can acquire and are looking at their assets to identify creative ways that planning and design can help alleviate the pressure
of tighter budgets.
THE SOLUTION

At EwingCole, design research is the basis for design decision-making and
envisioning innovative design solutions. The research team is a combination of PhD researchers, clinicians, healthcare architects and designers,
and sustainability experts who use empirical data to understand the relationship between building design, user behavior, and user experience. The
team identifies trends in overall efficiency, measures the performance of
specific models of care, and helps to quantify the effectiveness of physical
environments on user needs. Informed design decisions equal savings and
a better understanding and appreciation of the value of design by all stakeholders. In a time when every healthcare dollar spent is scrutinized, it's important to consider a means to validate design choices.

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To do so, we ask a multitude of questions to
identify specific areas of concern. Organizations
looking to improve patient satisfaction scores or
determine if current design standards meet the
needs of changing care models can turn to the
research to ask, "Is design a contributor to our
success? If it is, how do we maximize its return?"
Our approach uses multiple methods, and our
toolkit is made up of three complementary research domains: secondary research, original or
field research, and calibrated simulation. At the
beginning of the design process, secondary research synthesizes existing scientific research
and qualitative data, helping the organization
identify what matters most to their unique staff
and patients. Secondary research can also set a
benchmark for further investigation.
Organizations have found the most value from
original or field research. Detailed behavioral observation, quasi experiments (involving full-scale
and virtual architectural models), and layout
analysis are just a few of the ways we collect data.
The findings and converging evidence are sometimes expected, but more often point to staggering statistics about the correlations between design and behavior. For example, one experiment
revealed that patients were more likely to recommend a facility based on the artwork there. We often find that valuable design improvements don't
require major renovation or redesign. Paint and
furnishing color choice can have a big effect on
the bottom line and overall savings, if the research
data collected demonstrates a correlation to the
patient's perception of care.
Additionally, when organizations look to operations for savings, data collected through work
sampling and behavioral observation can provide real-time information for calibrated simulations. Virtual design options can be evaluated
for efficiency and utilization based on how the
organization was observed to operate and behave, in addition to historical data on volumes
and throughput. This can result in a more accurate picture of the impact of design on operations that spreadsheets can't always reveal.
WORDS OF WISDOM

Healthcare facilities can create measurable and
sustained value by practicing and implementing research to determine appropriate built
environment solutions. Not only can researchinformed design identify potential construction
and operational costs, but, when used effectively, it can create team consensus that streamlines
project delivery and expedites speed to market,
reducing those costs. 

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Healthcare Design - May 2017

Table of Contents for the Digital Edition of Healthcare Design - May 2017