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Issue link: https://mcdmag.epubxp.com/i/509247
Life has become increasingly dif cult for me over the past 23 years, as dif erent parts of my body have stopped function- ing. I live with a progressive neuromuscular disease, which has forced me to use braces, a cane, a manual wheelchair and, most recently, a power chair for mobility. As someone who experienc- es life from a wheelchair and who relies solely on others for many aspects of daily living, I have developed a keen sensitiv- ity and unique perspective on navigating the day to day. Everything is more dif cult because of the challenges my disability brings. Access to vari- ous types of services is some- thing I have become acutely attuned to; access to businesses, access to airlines, access to ho- tels and, perhaps most impor- tantly, access to healthcare. Don't get me wrong, I have access to healthcare services, but access to healthcare facili- ties often leaves something to be desired. Individuals with disabilities are the fastest growing mi- nority group in the U.S., with current estimates at 56 million (Disability Statistics, 2014), not to mention the more than 30 million baby boomers set to retire by 2020 (Janger, 2011). Approximately 19 percent of the nation's population falls into this group (with more to come). With these numbers, why does access often feel like an afterthought or, in some cases, a burden? Recently, I was performing some property accessibility as- sessments for some healthcare organizations and, in my obser- vation, the simplest changes to plans would profoundly impact the patient experience. During the assessments, I frequently encountered sidewalks/pathways, which I could access on one side, but had no exit point. This required backtracking and looking for another route. Parking areas of ered access to sidewalks via curb cutouts (which is nice) however, these curb cutouts were frequently so of center from the access aisle that they were not navigable in a wheelchair because of being blocked by parked vehicles. Choice in carpet frequently presented dif culty. Heavy textures or inconsistent grooves make it very hard to travel in a straight line when using a walker, manual chair or power chair. Another challenge — As I entered one facility through the main lobby, I immediately en- countered a fl ight of stairs with no ramp access. In order for me to access the upper level, I was required to use a tiny lift of to the far side. As it ratcheted and loudly squeaked to the top, heads turned and stared. I felt embarrassed and like a head of cattle. Accessible? Yes, but defi nitely not optimal. These are just a few exam- ples of challenges people with disabilities face on a daily basis. I could go on about seemingly endless scenarios where ADA is met but functionality and equal access is executed poorly. ADA is a godsend when it comes to providing accessibil- ity here in the United States (outside the U.S. is another story) but, in my opinion, ADA is the fl oor, the minimum level necessary. Who wants to sleep on the fl oor? The changing landscape of healthcare In light of the growing number of Accountable Care Organizations, Medicare Shared Savings Plans, hospital comparisons through Hospital Consumer Assessment of Healthcare Providers and Systems and a growing number of at-risk contracts, hospitals and health systems looking to build new campuses or re- model existing locations have a unique opportunity to gain ad- vantage over their competitors. With everyone being measured by the same tools, everyone is teaching to the same test … but that doesn't have to be the case. So how does a hospital, healthcare system or architec- tural fi rm gain a unique and signifi cant advantage? While universal design is nothing new, its being applied to healthcare is. Without going into the details of universal de- sign, I believe there are three principles that, if applied to the design of healthcare facili- ties, could address many issues hospitals face with regard to patient satisfaction, the overall patient experience and the environment of care. These principles are: 1. Accessibility by design (prioritizing accessibility within the design process) 2. Broad accessibility (accessibility for the greatest number of people) 3. Added value (design that ISSUE FOCUS Going above and beyond the ADA BY JUSTIN SKEESUCK THE ACCESSIBILITY EXPERIENCE Justin Skeesuck shares his insight on how to best design for persons with disabilities. POPULATION PLANNING 30 Medical Construction & Design | M AY/ J U N E 2015 | MCDM AG.COM