Contract - Designing for Health: Research-Based Client Communication

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Designing for Health: Research-Based Client Communication

24 May, 2010

-By By Carrie R. Rich, MS, EDAC and Matthew J. DeGeeter, Allied Member ASID, Associate IIDA, LEED® AP



"Designing for Health" is a monthly, Web-exclusive series from healthcare interior design leaders at Perkins+Will that focuses on the issues, trends, challenges, and research involved in crafting today's healing environments.


Imagine that you are a healthcare administrator for a day. While your medical colleagues strive to keep patient blood flowing, you, the healthcare administrator, attempt to keep the hospital afloat. Your responsibilities typically begin between 6:30 and 7:30 a.m. After chugging a cup of coffee while listening to disgruntled physicians, you’re off to employee staff meetings, health planning councils, and finance meetings. Between your back-to-back meetings, a student arrives to ask you about the medical advances that your hospital is employing— diagnostic technology innovations, electronic medical record implementation, and changes in insurance reimbursement. When, exactly, are you supposed to stay abreast of an industry that's constantly changing?

Then a design team walks into your office. The team is a breath of fresh air, but you’re already running late and your next meeting is with your boss. Your Blackberry is experiencing e-mail overload. You are convinced that the hospital cannot afford capital improvements at this time, even though your facility desperately needs renovations to stay competitive in the market. Now, what’s a charrette?

Good luck, design team.

The Language Barrier
Healthcare executives typically do not concern themselves with the built environment. They have countless other priorities on their to-do lists—many of which are more pressing issues. Most healthcare administrators refer to “design” as “capital improvements.” That’s because administrators think in financial terms—what will physical modifications mean for the hospital's bond rating, loan potential, long-term financing structures? Most administrators have one opportunity, if that, to overhaul the built environment in which healthcare services are delivered; their decisions influence the community, providers and patients for decades. The typical healthcare administrator is under tremendous pressure to redesign, reconstruct, and renovate our unsystematic healthcare system according to evidence-based practices; yet, most administrators have little to no training about how to approach healthcare design.

Design professionals understand that hospital design impacts clinical ability to perform safe procedures and administer quality outcomes, organizational efficiencies, and financial performance. It’s the designer’s responsibility to convey these realities to administrators in terms that make sense to the client. When discussing facilities with healthcare administrators, the focus should not be the facility. The discussion ought to be centered on points relatable to administrators, such as nursing retention, physician-hospital alignment strategies, and changing reimbursement rates. According to Bill Oetgen, MD, MBA, Georgetown University School of Medicine, “Communication between healthcare design professionals and healthcare users is essential if the built environment is to be truly optimal. I would include clinical personnel, healthcare administrators, and—probably most importantly—patients in these communication efforts.” Thus, the designer's challenge is to communicate how administrative priorities support or inhibit the facility design process, and, vice versa, how design can aid and enhance the administrator’s and clinician’s abilities to perform so as to optimally serve the patient.

Effective Communication with Research
Every profession has a unique vocabulary and skill set, so a major challenge of healthcare design is continual learning of the terminology and functions specific to client expertise. Designers who align themselves with the vision of the client are more likely to design thoughtful, effective interior spaces that satisfy client needs.

Effective communication is linked to vocabulary and syntax. Designers recognize that their decisions impact client livelihood end-user comfort. In healthcare, design decisions affect the quality of care, staff performance and retention, as well as patient recovery. Thanks to research and evidence-based design, the impact of design decisions is being quantified and disseminated. Research empowers designers with knowledge to justify costs for single patient rooms, more durable finishes that protect against infection and sustainable practices—language that speaks to administrative priorities.

Healthcare clients understand numbers, figures, and return on investment. Thus, the most positive response may result from a designer who delivers measurable impact that is evidence-based. Design solutions are more likely to be justified when communicated in terms that make sense to hospital administrators.

Designers can help administrators realize shared goals for safe healing environments by communicating research-based design decisions. A seemingly simple task of comparing flooring materials can develop into an in-depth research opportunity (see data matrix and graphic matrix). Here, a significant body of research was visually communicated in a client presentation by compiling information about various flooring products and evaluating the products according to attributes prioritized by the client.

The role of evidence-based design is increasingly important to the design process. Using research to inform design, the client can see that design does have an impact on the bottom line as well as patient care. Building on research from previous projects, designers can positively influence the project at hand, thereby, increasing the value of the design process for both the client and the field of design. Communicating research is one method of engaging the client in the design process and encouraging the client to play a part in innovative design thinking, which ultimately leads to improved project quality. Ideally, the client uses research to better understand and value the design process.

Adding Value
Every project is an opportunity for the design team to increase the value of design. Through a mutually beneficial partnership between the client and designer, the design team learns about the client, and the client has the opportunity to become more educated about the value of design. This outcome can be achieved through increased communication in the form of shared research.

The value of a project can increase as more information is gathered about the results of design solutions (e.g. comparative analysis of the facility pre and post design changes). Results from informed design solutions can help shape future design solutions and ultimately add value to the design profession. Furthermore, design professionals can measure the success of research-based communication strategies by tracking the number of return clients, positive feedback, and project references for more design work.

Conclusion
A new or renovated space is almost always a monumental project in the eyes of the client, but is one piece of a hospital's long-term plans and one component of a designer’s portfolio. As the perception of healthcare design emerges into a research-based process with measurable results, design can assist in changing the state of the current healthcare system. Instead of thinking about the problems at hand, designers and hospital administrators can be visionary pioneers of the hospital’s future, redesigning a system founded on evidence-based infrastructure.

Carrie R. Rich, MS, EDAC is a healthcare specialist at Perkins+Will’s Washington, D.C., office and holds an adjunct faculty appointment at Georgetown University, School of Nursing and Health Studies, Department of Health Systems Administration. carrie.rich@perkinswill.com

Matthew J. DeGeeter, Allied Member ASID, Assoc. IIDA, LEED® AP is a designer in the healthcare market sector at Perkins+Will’s Washington, D.C., office. Matthew.DeGeeter@perkinswill.com.

 

sources
Clancy CM. Designing for safety: evidence-based design and hospitals. Am J Med Qual 2008;23(1):66-9.

The Joint Commission. Health care at the crossroad: guiding principles for the development of the hospital of the future, 2008.

Framton SB, Gilpin L, Charmel PA, eds. Putting patients first: Designing and Practicing Patient-Centered Care. New York, New York: Josey-Bass, 2003.


Past installments of "Designing for Health" include (click on title to access the full article):
Designing For Health: An Urban Clinic
Designing For Health: Patient and Staff Safety in Behavioral Health Facilities
A Harmonious Companionship-- Rejuvenating State-of-the-Art
Leading by Design – A Place to Flourish
Expanding the Definition of Sustainability to Include Chemical Awareness
10 Strategies to Move Your Client Toward Sustainability




Designing for Health: Research-Based Client Communication

24 May, 2010



"Designing for Health" is a monthly, Web-exclusive series from healthcare interior design leaders at Perkins+Will that focuses on the issues, trends, challenges, and research involved in crafting today's healing environments.


Imagine that you are a healthcare administrator for a day. While your medical colleagues strive to keep patient blood flowing, you, the healthcare administrator, attempt to keep the hospital afloat. Your responsibilities typically begin between 6:30 and 7:30 a.m. After chugging a cup of coffee while listening to disgruntled physicians, you’re off to employee staff meetings, health planning councils, and finance meetings. Between your back-to-back meetings, a student arrives to ask you about the medical advances that your hospital is employing— diagnostic technology innovations, electronic medical record implementation, and changes in insurance reimbursement. When, exactly, are you supposed to stay abreast of an industry that's constantly changing?

Then a design team walks into your office. The team is a breath of fresh air, but you’re already running late and your next meeting is with your boss. Your Blackberry is experiencing e-mail overload. You are convinced that the hospital cannot afford capital improvements at this time, even though your facility desperately needs renovations to stay competitive in the market. Now, what’s a charrette?

Good luck, design team.

The Language Barrier
Healthcare executives typically do not concern themselves with the built environment. They have countless other priorities on their to-do lists—many of which are more pressing issues. Most healthcare administrators refer to “design” as “capital improvements.” That’s because administrators think in financial terms—what will physical modifications mean for the hospital's bond rating, loan potential, long-term financing structures? Most administrators have one opportunity, if that, to overhaul the built environment in which healthcare services are delivered; their decisions influence the community, providers and patients for decades. The typical healthcare administrator is under tremendous pressure to redesign, reconstruct, and renovate our unsystematic healthcare system according to evidence-based practices; yet, most administrators have little to no training about how to approach healthcare design.

Design professionals understand that hospital design impacts clinical ability to perform safe procedures and administer quality outcomes, organizational efficiencies, and financial performance. It’s the designer’s responsibility to convey these realities to administrators in terms that make sense to the client. When discussing facilities with healthcare administrators, the focus should not be the facility. The discussion ought to be centered on points relatable to administrators, such as nursing retention, physician-hospital alignment strategies, and changing reimbursement rates. According to Bill Oetgen, MD, MBA, Georgetown University School of Medicine, “Communication between healthcare design professionals and healthcare users is essential if the built environment is to be truly optimal. I would include clinical personnel, healthcare administrators, and—probably most importantly—patients in these communication efforts.” Thus, the designer's challenge is to communicate how administrative priorities support or inhibit the facility design process, and, vice versa, how design can aid and enhance the administrator’s and clinician’s abilities to perform so as to optimally serve the patient.

Effective Communication with Research
Every profession has a unique vocabulary and skill set, so a major challenge of healthcare design is continual learning of the terminology and functions specific to client expertise. Designers who align themselves with the vision of the client are more likely to design thoughtful, effective interior spaces that satisfy client needs.

Effective communication is linked to vocabulary and syntax. Designers recognize that their decisions impact client livelihood end-user comfort. In healthcare, design decisions affect the quality of care, staff performance and retention, as well as patient recovery. Thanks to research and evidence-based design, the impact of design decisions is being quantified and disseminated. Research empowers designers with knowledge to justify costs for single patient rooms, more durable finishes that protect against infection and sustainable practices—language that speaks to administrative priorities.

Healthcare clients understand numbers, figures, and return on investment. Thus, the most positive response may result from a designer who delivers measurable impact that is evidence-based. Design solutions are more likely to be justified when communicated in terms that make sense to hospital administrators.

Designers can help administrators realize shared goals for safe healing environments by communicating research-based design decisions. A seemingly simple task of comparing flooring materials can develop into an in-depth research opportunity (see data matrix and graphic matrix). Here, a significant body of research was visually communicated in a client presentation by compiling information about various flooring products and evaluating the products according to attributes prioritized by the client.

The role of evidence-based design is increasingly important to the design process. Using research to inform design, the client can see that design does have an impact on the bottom line as well as patient care. Building on research from previous projects, designers can positively influence the project at hand, thereby, increasing the value of the design process for both the client and the field of design. Communicating research is one method of engaging the client in the design process and encouraging the client to play a part in innovative design thinking, which ultimately leads to improved project quality. Ideally, the client uses research to better understand and value the design process.

Adding Value
Every project is an opportunity for the design team to increase the value of design. Through a mutually beneficial partnership between the client and designer, the design team learns about the client, and the client has the opportunity to become more educated about the value of design. This outcome can be achieved through increased communication in the form of shared research.

The value of a project can increase as more information is gathered about the results of design solutions (e.g. comparative analysis of the facility pre and post design changes). Results from informed design solutions can help shape future design solutions and ultimately add value to the design profession. Furthermore, design professionals can measure the success of research-based communication strategies by tracking the number of return clients, positive feedback, and project references for more design work.

Conclusion
A new or renovated space is almost always a monumental project in the eyes of the client, but is one piece of a hospital's long-term plans and one component of a designer’s portfolio. As the perception of healthcare design emerges into a research-based process with measurable results, design can assist in changing the state of the current healthcare system. Instead of thinking about the problems at hand, designers and hospital administrators can be visionary pioneers of the hospital’s future, redesigning a system founded on evidence-based infrastructure.

Carrie R. Rich, MS, EDAC is a healthcare specialist at Perkins+Will’s Washington, D.C., office and holds an adjunct faculty appointment at Georgetown University, School of Nursing and Health Studies, Department of Health Systems Administration. carrie.rich@perkinswill.com

Matthew J. DeGeeter, Allied Member ASID, Assoc. IIDA, LEED® AP is a designer in the healthcare market sector at Perkins+Will’s Washington, D.C., office. Matthew.DeGeeter@perkinswill.com.

 

sources
Clancy CM. Designing for safety: evidence-based design and hospitals. Am J Med Qual 2008;23(1):66-9.

The Joint Commission. Health care at the crossroad: guiding principles for the development of the hospital of the future, 2008.

Framton SB, Gilpin L, Charmel PA, eds. Putting patients first: Designing and Practicing Patient-Centered Care. New York, New York: Josey-Bass, 2003.


Past installments of "Designing for Health" include (click on title to access the full article):
Designing For Health: An Urban Clinic
Designing For Health: Patient and Staff Safety in Behavioral Health Facilities
A Harmonious Companionship-- Rejuvenating State-of-the-Art
Leading by Design – A Place to Flourish
Expanding the Definition of Sustainability to Include Chemical Awareness
10 Strategies to Move Your Client Toward Sustainability

 


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