By Mackenna Moralez, Associate Editor

Even before the COVID-19 pandemic placed a strain on healthcare operations, there was already a demand for more hospitals and other healthcare facilities. As designers and architects worked to create these spaces out of seemingly nothing, many have turned to healthcare workers to aid in their designs. With their expertise, healthcare workers are able to help create a space that is functional to both employees, patients and visitors.  

Healthcare Facilities Today recently spoke with Resa E Lewiss, MD, professor of emergency medicine, physician healthcare designer, Perkins&Will and Julie Frazier, AIA, ACHA, LEED AP BD+C, principal, health, Perkins&Will on how they have collaborated to create healthcare facilities that are designed to enhance the well-being of all occupants.  

HFT: What are the key considerations when designing a healthcare facility to optimize patient care and safety? 

Julie Frazier: When designing a healthcare facility, it is critical to minimize travel distances between support spaces and patient rooms. This approach not only reduces the likelihood of fatigue but also diminishes the chance of errors, affording healthcare professionals more time at the bedside for focused patient care. Additionally, providing dedicated places of respite for staff allows them to recharge and provide better care to their patients. 

Resa Lewiss: It is important to approach new projects with curiosity: an open mindset that supports brainstorming for better solutions. One way to achieve this is to design alongside stakeholders such as nurses, physicians, patients, caretakers, and community members through all phases of design. When designing healthcare facilities with patient care and safety as a central mission, it's crucial to avoid adhering to traditional approaches simply because "that's the way it's always been done.” 

HFT: How can architects and physicians collaborate to create a healing environment for patients? 

Frazier: This is where theory and practice intersect. Physicians and architects both focus on research, but physicians uniquely possess firsthand experience with the real-world application of strategies, which offers invaluable insights. For example, during a recent discussion on the trauma helicopter patient transport path to the Emergency Department or a high acuity patient unit, I proposed the inclusion of a resuscitation room on the roof to facilitate stabilization. Resa shared how this could be clinically challenging for staff. A rooftop resuscitation room would be unfamiliar if the space is not often used, and people may not be readily available to provide backup. Another consideration is the challenge of keeping equipment maintained in an infrequently utilized area. Resa’s feedback was incredibly helpful as it helped shape the team’s recommendations. 

Lewiss: The physician and the architect bring complementary perspectives and lenses to the design process. Together, they can create better designs, with physicians bringing their expertise from their clinical practice, research, and healthcare network, as well as experience storytelling from patient encounters. Diverse teams are smarter and more productive, with better morale and even return on investment. Physicians can help translate language and share stories to help inform the design process, and their ability to share pain points and offer perspectives into what works and what doesn't is invaluable. 

HFT: What strategies can be employed to create a flexible and adaptable healthcare facility that can respond to changing healthcare needs? 

Frazier: Recent years have highlighted the importance of being able to respond quickly to changing demands, whether stemming from a surge in patient numbers or shifts in acuity due to natural disasters or pandemics. The use of modular spaces that can readily adapt to changing technologies has proven effective. Examples include converting educational spaces into mass triage areas or transforming patient units into isolation units, facilitating the continuity of care amidst dynamic healthcare challenges. 

Lewiss: One strategy is the creation of healthcare facilities in closer proximity to people's homes and communities. This could involve refreshing retail spaces into healthcare spaces like we see with medical malls. 

HFT: What are the specific needs of different departments within a healthcare facility, and how can these be addressed in the design phase? 

Lewiss: One example of an area of a healthcare campus that is not typically considered a department but serves a crucial function is parking. The significance of parking, especially for hospital workers, is often underestimated. Parking poses a considerable challenge for trainees, staff, and physicians, becoming a notable source of stress, resentment, frustration, low morale, and even burnout. Survey data confirms that parking is a significant stressor for healthcare workers. This stress worsens when individuals struggle to secure parking due to limited spots, when parking spaces or lots are physically distant from the administrative or clinical areas, when the costs seem prohibitive, or when safety concerns arise. 

Frazier: Beyond addressing the challenges of parking, it's crucial to recognize that each department within a healthcare facility has its unique purpose, needs, and requirements. However, several departments share direct synergies, particularly in cases like the Emergency Department (ED), Imaging, and Surgery. Often patients will flow through each of these departments to use various modalities in their continuum of care. Engaging in detailed discussions with the facility early in the project to explore the optimal planning for “the seven flows” proves incredibly beneficial. These seven flows encompass the movement of patients, families, providers, information, medication, equipment, and supplies. By outlining these, efficiencies can be found and will inform the overall structure and appropriate adjacencies of departments in a hospital. 

Mackenna Moralez is the associate editor of the facilities market.