Each year at the Healthcare Design Conference there is a pre-conference session dedicated to coaching health- care systems professionals, providers,
design practitioners, educators, contractors, and
other key players interested in learning or further
developing an evidence-based design (EBD) process.
The recommendation is always to start with what
you know and grow the process appropriately
depending upon the project and desired outcomes.
Although the process is consistent, the priorities and
benchmarks may vary greatly across project types.
However, in evaluating opportunities when establishing baselines for outcomes—which has always
been a tenet of EBD—there is the necessity for
measuring these improvements because they are
tied to reimbursements under the Affordable Care
Act (ACA). This is an important intersection between
EBD and the ACA because evaluating these priorities can result not only in increased efficiencies and
reduced costs, but also improved medical outcomes.
The following three case studies demonstrate an
EBD approach based on varying goals and project
requirements, and they also take new ACA requirements into consideration.
In May 2012, Princeton HealthCare System (PHCS)
opened a new 238-bed, 575,000-square-foot, non-profit acute care hospital as part of the University
Medical Center located in Plainsboro, N.J. This
Pebble Project consisted of a patient bed tower, a
diagnostic and treatment building, an administration
and education building, and an onsite co-generation
plant that supports the hospital. The Center for Health
Design utilizes the Pebble Project to assist clients with
utilizing research to not only make informed decisions,
but also to provide a framework for completing
benchmarks and research within a healthcare setting
to sustain continued improvement.
The vision for this project was to build one of
the finest hospitals in the U.S. that would support
and encourage outstanding clinical care, provide
the most-advanced technology, and demonstrate
commitment to the community by incorporating
sustainable design and function.
Barry Rabner, PHCS president and CEO, along
with the trustees hired Navigant to help manage the
project and two architectural firms, HOK and RMJM
Hillier, as part of the design team. As a participant in
the Pebble Project, the decision-making process was
led by the program’s guiding principles, which include
the use of EBD for enhanced patient safety; the development of environments conducive to healing; ranking
in the top 10 percent of U.S. hospitals for patient satisfaction; embracing patient-centered care concepts;
and optimizing operational efficiency with related cost
reductions. Flexible design was also adopted with the unusual caveat that included
building 150 percent of the current project need to allow for expansion.
Under Rabner’s direction, every detail of the new hospital—from safety
features to patient and family comfort to maximizing staff efficiency—was
thoroughly researched. In working with the Center for Health Design, there
was a review of approximately 1,200 articles of design research, feedback
from staff and administration at 15 other hospitals, and multiple focus groups
of stakeholders and patients.
Likewise, Salvatore Associates and CAMA, Inc. recently completed a new
Adult Emergency Environment of Care for Yale-New Haven Hospital located
in New Haven, Conn. It utilized an interdisciplinary design team that was
guided by the following EBD objectives:
◗ Reduce patient and visitor stress
◗ Reduce wait times and improve flow
◗ Improve staff sightlines—both from a security and clinical care point of view
◗ Capture natural light and views of nature at an urban edge
52 INTERIORS & SOURCES FEBRUARY 2015 interiorsandsources.com
By Jane Rohde
the ACA have in
illustrate the link
CLOCKWISE FROM TOP
Yale-New Haven Hospital’s
entrance to the new Adult
of Care; the same site’s
chair-centric care delivery
utilized for triaging patients.
This rendering of UnityPoint’s
patient lounge depicts a
space where patient-peer
counseling could occur