Medical Construction & Design

JUL-AUG 2018

Medical Construction & Design (MCD) is the industry's leading source for news and information and reaches all disciplines involved in the healthcare construction and design process.

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50 Medical Construction & Design | J U LY/AUGUST 2018 | MCDM AG.COM opportunity for the disciplines to fl ex with adjacent pods as volume changes. The pod model is conducive to value- based care because: > Confi guration aims at increasing co-location and collaboration, while decreasing distance and hierarchy > Pod layout supports the tendency for smaller units to form more cohesive groups, increasing communication > Centrally located team center fa- cilitates increased interaction between patients, family and care team > Clinic-within-a-clinic concept opti- mally supports multispecialty ambula- tory care centers since each pod can maintain its own identity/specialty > Each pod adds additional circulation that renders the pod model less effi cient in space use than the linear team-cen- tered model On-stage/off -stage model The on-stage/off -stage model is an adaptation of a Disney principle that emphasizes a consumer-centric ap- proach to designing the experience. This principle has been adapted to hospital planning and operational design, and is being applied to outpatient clinics in an attempt to create an innovative take on the patient-centric experience. The pub- lic side (on-stage) is typically designed to mimic the hospitality model to reduce patient stress, while clinical work areas (off -stage) are hidden from public view and arranged to promote collaboration. The on-stage/off -stage principle creates a distinct separation of staff and patient circulation, both visually and acoustically, giving providers private spaces to work and collaborate. Staff work spaces are centralized by creating a working core with surrounding pods of exam rooms that are accessed from with- in the core. Patients access exam rooms from separate public corridors on the perimeter of the clinic. This organization of space separates the hustle and bustle of staff work zones, transforming the clinic into a quieter and calmer environ- ment. It also increases patient privacy by reducing opportunity for other patients to overhear sensitive conversations. However, there are disadvantages with this model. Firstly, it tends to isolate patients and family, limiting accessibil- ity to staff . Secondly, the dual circulation system requires more circulation space, and larger exam rooms are required to accommodate the two separate entrances into the room. Lastly, a dual on-stage/off - stage circulation system increases space requirements and, in turn, capital costs. The on-stage/off -stage model is con- ducive to value-based care because: > A more desirable patient experience results from reduced clinic noise levels and traffi c, and increased patient privacy > Closer proximity between the collabo- ration zone and exam rooms increases turn-around time > A centralized collaboration zone mini- mizes travel distance and time, increas- ing staff effi ciency > Physician/clinician adjacency within the collaboration zone leads to better communication and case knowledge and management > A separate collaboration zone away from patient circulation provides clini- cians the opportunity to block out diver- sions and disruptions, allowing them to narrow their focus Future of clinic planning Healthcare delivery is dynamic and must respond to changing demands, population and cost drivers. In turn, as care models transform, so too must the methodologies for design and planning evolve to ensure better outcomes amidst continuous, albeit systemic change. With increased demand for services performed in convenient ambulatory care settings, outpatient facility design and planning remain integral to delivering cost-eff ec- tive, quality healthcare services. As history has proven, today's trend will not be tomorrow's standards. Reprioritization and reevaluation of planning and technology considerations, in response to operational models, will inspire development of hybrid design solutions that enhance the quality and access of healthcare services. As outpatient facilities become the primary access point of patient contact, and healthcare delivery models move toward a more holistic and integrated treatment approach, planning and design must be responsive to this transformation. Haewon Kim-LaBroad, AIA, NCARB, LEED BD+C, is a senior healthcare planner and vice president at Hoefer Wysocki.

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