each operation and activity at the facility. We discussed training materials and the
requirements needed for each function. For example, from a design perspective,
discussing the entry sequence is important. It is necessary to consider the drop-off
at the front of the community; the greeting/reception/concierge process for existing
residents, prospective residents, and family members; the requirements for accessibility, storage, office space, and equipment; and most importantly, the first
impression from aesthetic, branding, and welcoming perspectives.
Each of these design elements includes an operational component that requires
training. We planned to implement a complete training program with mock-ups and
role-play scenarios for Cypress Gardens. Taking a continual quality improvement
approach, we begin by explaining the “why” aspects of a position, so that improvements are well-informed. Training is no longer a stagnant thing happening within a
closed multipurpose room or bedside. Interactive opportunities can provide experiential training, supporting staff by fulfilling education and communication needs.
Communication is essential for successful healthcare projects. In the beginning of one
design process, we were asked to come in and evaluate senior living designs that had
been developed, but quickly realized that adequate input had not been gleaned from the
existing residents, patients, and staff. The lack of communication created an atmosphere
of distrust, conjecture, suspicion, and speculation about what was happening—spurring
dissatisfaction. We were able to relieve the situation by holding focus groups for all of the
stakeholders. Allowing everyone to feel heard is a critical factor. Satisfaction comes in
following up with additional information, asking questions, and solving problems.
Regular communication that opens up channels from the top down as well as
the bottom up can be a successful approach. Providing information in multiple
ways is also important, considering the various employee ages. Apps are the latest
wave for communicating in healthcare settings, but some staff may be uncomfortable
with technology. Design can support communication by incorporating hubs and
areas that are naturally conducive to interaction.
Providing unique opportunities for advancement also supports staff retention.
This can be done through continuing education and also by allotting employees
time to attend a class or participate in additional training. In China, staff housing
is available and a meal during shifts is included as part of the compensation package.
In the U.S., most of us are guilty of eating at our desks, but supporting communal
meal settings allows for interaction and communication. Upon returning to China
Senior Care’s office one afternoon, I found the entire staff participating in a stand-up
exercise class together, building camaraderie and enhancing wellness. The director
and administrator were side by side with IT, HR, communications, and administrative
support staff. I tried thinking of ways that a similar concept could be brought back
and implemented in my design firm. It would take a large cultural shift. Dance
moves will take some time!
Jane Rohde, AIA, FIIDA, ASID, ACHA, AAHID, LEED AP, is the
founding principal of JSR Associates, Inc., located in Ellicott City,
Md. She champions a global cultural shift toward de-institutionalizing
senior living and healthcare facilities through person-centered
principles, research and advocacy, and design of the built environment. Clientele
includes non-profit and for-profit developers, government agencies, senior living
and health care providers, and design firms. Rohde speaks internationally on senior
living, aging, healthcare, evidence-based design, and sustainability. For more information
or comments, please contact her at firstname.lastname@example.org.