Future of Design January 11, 2023

The Future of Healthcare Design (Part 3)

Hospitals will promote health at a broader scale

In the last installment of this three-part series, healthcare administrators and designers from around the U.S. share their views on how hospitals can encourage wellness and promote environmental sustainability.

Efficiency and patient comfort will always be important design considerations, but future hospitals will also be more responsive to the needs of the community and the demands of the environment. That’s driven by a growing recognition that hospitals don’t deliver healthcare in a vacuum: As noted by the Lown Institute, a nonpartisan think tank, “Hospitals are also employers, purchasers, political actors, and part of the physical environment of their neighborhoods. The decisions they make have a great impact on the well-being of their community.”

In fact, the journal Frontiers of Health Services Management is exploring the merits of evaluating hospitals according to the ESG (environmental, social, and governance) framework, citing the “moral imperative to address these health determinants.” Promoting responsibility aligns with the healthcare system’s wider goals to address the needs of patients, providers, and the general public, says architect and healthcare strategist Ashley Dias. “Everything is connected,” she says. “Hospitals are increasingly aware of their social and environmental impacts, and of the impact of facility design on provider morale.”

Caring for the caregivers

Doctors didn’t become doctors to mine diagnostics. Nurses didn’t go into nursing to spend a quarter of their shifts looking for linens and supplies. Future improvements in medical technology and back-of-house logistics will free up medical professionals’ time to do the work they find most fulfilling: caring for patients. This is particularly important in light of the current shortage of physicians and other medical professionals, which is only expected to grow as the population ages. “We want to enable caregivers to be operating most frequently at their highest licensure,” Dias says.

Future improvements in medical technology and back-of-house logistics will free up medical professionals’ time to do the work they find most fulfilling: caring for patients.

Chris Nicholas, CEO of Renown Regional Medical Center in Reno, Nevada, offers a concrete example of using AI to free up providers’ time: detecting potentially cancerous nodules in lung scans and referring patients to the appropriate provider group. “We’re working to not only nail down the identification but also to start the care process,” he says. Renown is seeking to become a beta test site for the technology, and Nicholas hopes this program and others like it will free healthcare professionals from rote tasks and give them more time to spend with patients.

This concept extends into carefully designing the spaces that providers work in every day. “How do we reduce burnout? We need more inviting spaces, not only on the front end for the patients and their families, but also on the back end for physicians and nurses,” says Eric Eskioglu, MD, MBA. “Providers should be able to look out the window for a moment or walk on the terrace, where they can just breathe, decompress for a few minutes, and go back in. We don’t have that right now in most healthcare systems, but that is coming.”

“I’m a big advocate for the staff during the design process. Of course we center on the patient experience, but it’s crucial to keep in mind that happy staff lead to happy patients.”
Marvina Williams, a senior medical planner at Perkins&Will

Marvina Williams, a senior medical planner who draws on her experience as an emergency room nurse to help design healthcare facilities, agrees that respite areas serve a vital role. “Nurses and other providers can’t always take the time we need to cope with a tragedy,” she says. “We have to keep going. So I always advocate for a private room right there in the department, with massage chairs, aromatherapy, soothing lighting. It’s a space that acknowledges our need to take a few minutes to let down.”

Well-designed staff lounges, particularly those with windows, also make providers feel valued. “I’m a big advocate for the staff during the design process,” Williams says. “Of course we center on the patient experience, but it’s crucial to keep in mind that happy staff lead to happy patients.” She adds that clients have reported back that provider lounges with windows are a particularly strong factor in recruitment and retention.

Healing the community

In addition to serving the most acute patients, future hospitals will likely be seen as centers for wellness and preventive care, and even as places to heal from collective trauma.

Nicholas says he expects to see healthy eating programs, food pantries, and other social services become more common in the future. Patients often have needs beyond the crisis that initially spurred them to seek treatment, and providers are looking beyond immediate care plans to encourage healthy habits over the long term. “We’re already asking, ‘What are the things we need to do to ensure a successful discharge of the complex patient?’” he says. “‘What are some of the social determinants that we need to make sure to address?’”

Patients often have needs beyond the crisis that initially spurred them to seek treatment, and providers are looking beyond immediate treatment to encourage healthy habits over the long term.

At the new OU Health University of Oklahoma Medical Center—the only level 1 trauma center in the state—a large community room with retractable walls serves multiple purposes. “When large, traumatic events happened in the past, the hallways of the old building would become crowded with families, colleagues, and the general public,” says Casey Woods, OUMC’s chief operating officer. “We wanted the new building to have a space where everyone could be together.” The ground-level space can accommodate up to 300 people for large events, or smaller groups for trainings, grand rounds, and meetings. “It’s at the front of the building, it’s glassed in, and it’s beautiful,” Woods says. “It’s in use every day.”

Restoring the environment

Future hospitals won’t only be designed to build community and promote human health, says designer Pat Bosch. They’ll restore the natural environment, too. For example, the new Jackson West Medical Center in Florida is located on a former brownfield site between the Everglades and the city of Doral. The grounds act as a filter and absorb excess stormwater runoff, thereby improving water quality and mitigating the risk of flood damage.

There’s growing interest in hospitals’ environmental impacts, says Jill Sullivan, senior vice president at Lucile Packard Children’s Hospital Stanford in Palo Alto, California. She expects more scrutiny in the future: “I think hospitals are going to be under pressure to publicly share their carbon footprint, their water usage, and other data,” she says. “That’s going to drive hospitals to be more sustainable, and architects will be required to meet that need.”

If and when that happens, Packard Children’s will be in a good place: its main building was the second children’s hospital in the world to earn LEED Platinum certification, and leadership recently signed the Biden administration’s Health Care Sector Climate Pledge, which commits to achieving a 50% reduction in operational emissions by 2030 and net-zero status by 2050.

Sullivan says that focusing on sustainability goals at the beginning of the design process led to a successful project that will benefit people for generations to come. “I look at this work as being a good steward. I look at it as providing care to these kids and families, even when I’m not here.”

Designing for climate resilience

Despite efforts to restore the environment and combat climate change, extreme weather events are expected to become even more common in the decades to come. The health risks posed by these events led 200 medical journals to name climate change as the top threat to public health around the world.

Climate-resilient design is particularly important for hospitals. Woods felt the weight of that responsibility when supervising the design of a new patient tower at the OU Health University of Oklahoma Medical Center. Given that the hospital is the only Level 1 trauma center in a state that is prone to tornadoes, drought, extreme heat, and ice storms, he advocated for resilient strategies such as impact-resistant glazing on windows of critical care floors to protect against debris, fire-proof terracotta cladding, and radiant heating systems in the sidewalks at entrances to prevent ice buildup during winter storms.

He says knowing these systems are in place to protect patients now and into the future helps him rest easier at night. “This design is anything but cookie-cutter, and that’s what the planning group wanted. They wanted something that would stand the test of time, and that’s what we got.”

‘The journey is changing’

No matter how hospitals evolve, human nature suggests that people will continue to seek high-quality care for their bodies and minds. “People have always made pilgrimages to places of healing,” Dias says. “Even before hospitals existed, people journeyed to temples or to therapeutic springs or other places, and the pilgrimage will keep evolving. Maybe soon we’ll make the journey digitally. The journey is changing, but the possibilities associated with it are really beautiful.”

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