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In Focus

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communicate expectations around scrubs versus street clothes, changing on-site, directional access (addressed using signage), and personal
devices such as smartphones to imbue staff confidence. If patients suspected of COVID-19 will be seen in the clinic, PPE protocols must be in
place for those encounters and appropriate space must be provided to
don and doff, such as a staff-designated bathroom, where lockers can be
added to store street clothes. In some practices
where there may an excess of exam rooms due
IN THE ERA OF COVID-19,
to lower patient volumes, an exam room could
CREATING A WELCOMING
be taken out of commission and dedicated as a
staff changing room.
AND STRESS-FREE
Telehealth. The use of telemedicine has
ENVIRONMENT IS MORE
been vital to the safe continuation of urgent and
IMPORTANT THAN EVER.
chronic outpatient care during COVID-19. Going forward, healthcare organizations should
develop standard algorithms for determining which visits are appropriate to conduct via telehealth as well as which patients can be assessed by
scheduling/clerical staff and which require review by a clinical team member for a telehealth visit.
The physical footprint required for a successful telehealth consult in an
outpatient setting is modest, with a desk, video-conferencing equipment,
web access, and secure email capabilities. The space should be uncluttered
to reduce distraction and set a professional tone. Neutral, matte finishes
reduce glare and will help focus attention on the speaker. Camera placement should promote eye contact; lighting should be placed to minimize
face shadows to promote personalized care; and visual and acoustic privacy are paramount and can be achieved by selecting an area with full-height
acoustic partitions and, ideally, a door. If a private space isn't available, the
telehealth zone should be out of view of others to ensure privacy.
Arrival. In the era of COVID-19, creating a welcoming and stress-free
setting is more important than ever, because patients and caregivers are
legitimately worried about becoming infected during these visits. Starting at the entrance, discreet, contactless temperature scanning and clear
cues for social distancing can support the perception of wellness and
overall well-being and start to put patients' minds at ease. The addition
of directional travel signs and messaging on protocols for hand hygiene,
masks, and surface cleaning are also advised, as these unfamiliar practices have the potential to dramatically increase patient stress levels.
Adoption of a concierge model where a staff member may serve as a roving greeter to screen arriving patients, provide guidance for PPE, direct
the check-in process and where to sit, and share next steps will likely be a
much-appreciated courtesy.
Check-in. A quick and streamlined check-in process will increase
consumer confidence and satisfaction. Healthcare operators can leverage existing electronic medical record systems to launch and promote
portal-based check-in modules located front-and-center of the entry
point of the facility to reduce interactions with staff and queuing (depending on the geometry of the waiting space). To relieve concern about
touching a screen, practices may include the use of unsharpened pencils
with erasers to interact with the touchscreen as well as providing disinfecting wipes.
Immediate rooming. By moving patients to exam rooms directly after
check-in, the number of patients in common areas is reduced. If exam
room capacity is not sufficient for immediate rooming for all patients,
criteria should be developed for identifying special populations for this
service (e.g., at-risk, immune suppressed, respiratory symptoms).

38

AUGUST 2020

HCDMAGAZINE.COM

Waiting. While reducing or even eliminating
waiting is ideal, additional strategies should be
considered to ensure safety and well-being. Removing elements from common spaces such as
literature, toys, and water dispensers that promote the spread of infection via shared surfaces
will decrease the burden of cleaning. Patients
will feel more comfortable if waiting zones
aren't crowded, so designers can develop alternate seating arrangements and take out some
furniture. The addition of freestanding screens
can also help achieve separation and reinforce
distance between patients.
Exam/intake. An efficient and effective
point-of-care workflow will minimize unnecessary patient and staff movement. In support of
that, room layout, sink placement, exam table
placement, and the consultation zone will be
essential considerations. Collection of vitals
and confirmation of medication lists and symptoms in the exam room instead of an intake
zone will reduce patient moves (and cleaning).
The addition of waterless sanitizer dispensers on both sides of exam room doors will help
prevent the spread of infection. Reduction of
staff moves in and out of the exam room can be
achieved by stocking the room for a full shift.
To improve patient and staff safety during this
stage in the patient journey, consider active and
passive infection control interventions, including UV-light self-cleaning keyboards and the
adjustment of water flow sensors on faucets
to encourage proper handwashing duration.
Finally, staff should have all necessary resources, including after-visit summary printouts,
scheduling capability, and wellness/post-visit
educational materials, to complete all checkout activities while still in the exam room.
T H E PAT H F O R WA R D

Designers have a duty to work with their healthcare clients to reimagine the new normal in the
outpatient setting. As we envision what that
built environment will look like in the short,
mid-, and long term of a COVID-19 world, we
must address the very real risks of infection
transmission in tandem with the psychosocial
impact of experiencing our physical environments. In the process, we must not abandon our
commitment to create environments that are
welcoming and collaborative and promote healing and well-being. 
Pat Malick is a founding principal at Array Architects (Philadelphia). She can be reached at
P M A L I C K @ A R R AY - A R C H I T E C T S . C O M .


http://www.HCDMAGAZINE.COM

Healthcare Design - August 2020

Table of Contents for the Digital Edition of Healthcare Design - August 2020

Healthcare Design - August 2020
Editorial
Show Talk
Remote Impact
Signs of the Times
Design Inspiration
Photo Tour
Acute Condition
Holistic Hospitality
Operations Resetting T H E S Tage
Product Spotlight Surfaces
The Center
Welcome
2020 Design Show Case Jury / Award Winners and Finalists
Award of Merit: Trend Setter
Award of Merit: Southern Charm
Honorablemention : Water - Front Wonder
Honorablemention : Iconic Innovation
Honorablemention: Coastal Hero
Right Spots
Project Directory
Healthcare Design Showcase
Face Time
Healthcare Design - August 2020 - Healthcare Design - August 2020
Healthcare Design - August 2020 - Cover2
Healthcare Design - August 2020 - 1
Healthcare Design - August 2020 - 2
Healthcare Design - August 2020 - 3
Healthcare Design - August 2020 - 4
Healthcare Design - August 2020 - 5
Healthcare Design - August 2020 - 6
Healthcare Design - August 2020 - 7
Healthcare Design - August 2020 - 8
Healthcare Design - August 2020 - 9
Healthcare Design - August 2020 - 10
Healthcare Design - August 2020 - Editorial
Healthcare Design - August 2020 - Show Talk
Healthcare Design - August 2020 - 13
Healthcare Design - August 2020 - 14
Healthcare Design - August 2020 - Remote Impact
Healthcare Design - August 2020 - 16
Healthcare Design - August 2020 - Signs of the Times
Healthcare Design - August 2020 - Design Inspiration
Healthcare Design - August 2020 - 19
Healthcare Design - August 2020 - Photo Tour
Healthcare Design - August 2020 - 21
Healthcare Design - August 2020 - 22
Healthcare Design - August 2020 - 23
Healthcare Design - August 2020 - 24
Healthcare Design - August 2020 - 25
Healthcare Design - August 2020 - Acute Condition
Healthcare Design - August 2020 - 27
Healthcare Design - August 2020 - 28
Healthcare Design - August 2020 - 29
Healthcare Design - August 2020 - Holistic Hospitality
Healthcare Design - August 2020 - 31
Healthcare Design - August 2020 - 32
Healthcare Design - August 2020 - 33
Healthcare Design - August 2020 - 34
Healthcare Design - August 2020 - 35
Healthcare Design - August 2020 - 36
Healthcare Design - August 2020 - Operations Resetting T H E S Tage
Healthcare Design - August 2020 - 38
Healthcare Design - August 2020 - Product Spotlight Surfaces
Healthcare Design - August 2020 - 40
Healthcare Design - August 2020 - The Center
Healthcare Design - August 2020 - Welcome
Healthcare Design - August 2020 - 43
Healthcare Design - August 2020 - 44
Healthcare Design - August 2020 - 2020 Design Show Case Jury / Award Winners and Finalists
Healthcare Design - August 2020 - Award of Merit: Trend Setter
Healthcare Design - August 2020 - 47
Healthcare Design - August 2020 - Award of Merit: Southern Charm
Healthcare Design - August 2020 - 49
Healthcare Design - August 2020 - Honorablemention : Water - Front Wonder
Healthcare Design - August 2020 - Honorablemention : Iconic Innovation
Healthcare Design - August 2020 - 52
Healthcare Design - August 2020 - Honorablemention: Coastal Hero
Healthcare Design - August 2020 - Right Spots
Healthcare Design - August 2020 - 55
Healthcare Design - August 2020 - 56
Healthcare Design - August 2020 - 57
Healthcare Design - August 2020 - Project Directory
Healthcare Design - August 2020 - 59
Healthcare Design - August 2020 - Healthcare Design Showcase
Healthcare Design - August 2020 - 61
Healthcare Design - August 2020 - 62
Healthcare Design - August 2020 - 63
Healthcare Design - August 2020 - 64
Healthcare Design - August 2020 - 65
Healthcare Design - August 2020 - 66
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Healthcare Design - August 2020 - Cover3
Healthcare Design - August 2020 - Cover4
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