The healthcare industry is finally awakening to the power of thoughtful design. Studies show that design decisions affect many aspects of patient care, including recovery times and fall risks. However, we may need to take a more introspective approach to designing hospital systems. Otherwise, hospitals risk losing their identities.
This morning, as I was reading the New York Times, I came across an article on NewYork-Presbyterian’s David H. Koch Center for ambulatory care. I was very impressed by the thoughtfulness involved in constructing this hospital. When it came to design choices, the architects clearly put the patient in the center.
Nowadays, you might wonder why we are even having this discussion–aren’t healthcare organizations, at their roots, supposed to be patient centered? What is so innovative about this? Well, healthcare organizations don’t build hospitals–architects do. And architects have not always thought like physicians.
In 1946, Congress passed the Hill-Burton Free and Reduced-Cost Health Care Law that gave health facilities grants and loans for construction and modernization. The architects of the time likely did not create hospitals using the process of human-centered design. They focused solely on function and efficiency. The buildings that resulted from this legislation have shaped our current image of health facilities, especially in small towns. Many of these facilities have not had an upgrade since.
More innovative hospitals, however, are starting to realize that well-designed environments significantly impact a patient’s health, and thus, hospital designs of the past are being overhauled. Hospital management groups also realize that it is imperative to design purposely and with human values in mind, which requires collaboration between architects and physicians. This has led to the mission adopted by current day hospital architectural firms: hospital design should empower patients and maintain their dignity.
The David H. Koch Center is a system that resulted from interdisciplinary teamwork between architects, providers, and other stakeholders. This collaboration is what has enabled medical care to progress into the 21st century at this center. For outpatient procedures, patients register online before they arrive. They are mailed an ID band in advance, and on the day of their procedure, they are directed to the operation suite via dedicated elevators. Rather than having to anxiously navigate the maze-like hallways, patients find their way to the appropriate location in less than 2 minutes. This not only increases efficiency but also increases patient satisfaction by putting patient at ease.
Another design change evident in the Koch center is in response to a new mindset: medicine is transitioning away from disease prevention and towards health maintenance. At the Koch Center, patients have private procedure rooms with lockers for their belongings, a flat-screen TV, and a tablet. While waiting, loved ones have access to lounge areas equipped with WiFi. Additionally, the Health and Wellbeing program offers meditation classes ahead of surgery. These changes are excellent steps forward and have been very well received. According to patients and their families, this makes a “huge difference” in their wellbeing. Other hospital systems should strive to replicate the Koch center’s innovative initiatives.
However, before we go too far, let’s take a step back and look at healthcare re-design as a whole. Between all of the different stakeholders and borrowed design principles, I can’t help but feel uneasy about where our industry is going–uneasy because I don’t know what we are trying to do, and I’m not sure anyone else knows either.
Healthcare facilities are starting to resemble pre-existing infrastructures. Private lockers are reminiscent of luxury spas, flat-screen TVs are reminiscent of hotels, lounge areas equipped with WiFi are reminiscent of modern day airports. This isn’t a coincidence, as architects are actively and vocally looking outside of healthcare for ideas. In fact, a designer for the Koch Center states, “We took a lot of lobby tours: 11 Madison, Goldman Sachs, Hearst.”
Perhaps this approach to designing hospitals represents something darker. Behind the amalgam of a spa-hotel-lounge structure is an industry that is losing its core identity. What purpose should a hospital actually serve? Is it a wellness center, a temporary home, a gathering place for the ill? Is it and should it actually be all of the above?
We have spent so much time studying outside industries but not enough time studying our own. As a result, we have a conglomeration of ideas without a cohesive, unifying principle. If we continue creating without introspecting, we risk hospitals losing their purpose and identity as they undergo the design process.