“These are consumer-driven things, but they’re not luxuries,” insists Dr. Tingwald. “They’re often things that save time, increase the ability for education, and significantly decrease errors.”
Another argument for adding amenities like plasma screen TVs and room service: “In healthcare you think adding this technology must be too expensive,” says Dr. Tingwald, “but if you walk into a fast-food place, the person behind the counter uses a touch screen. Everybody else has done this already. Facilities that don’t partake in these transitions are not going to survive.”
Other family-centered improvements include major changes in patient registration. “Most registration can be done from home, over the Internet,” he says. “At Northwestern Memorial Hospital [in Chicago], patients have an encoded card they swipe when they drive into the parking garage, and the receptionist knows they’re coming and gets their room ready before they arrive.”
In the future, more facilities will offer options like these to make the registration process easy and fast.
The hospital of the future will feature a friendlier environment, with landscaping and nice views from patient rooms, artwork and amenities that are important in the healing process. They will also include an emphasis on alternative treatments, says Dr. Tingwald, “from massage to aromatherapy to spaces for yoga or meditation.”
Plan for Flexibility
The key to the design of the hospital of the future will be its ability to change without building additions, remodeling, or rehabbing.
“We’re no longer planning a facility in a static way, thinking that things will not change. Flexibility and adaptability are planned from the beginning,” explains Dr. Tingwald. “You’ll see a lot more generic room types—rooms that are all a single size, but adaptable. A private patient room might be initially planned for acute care, but it can be adapted for an ICU room with minimal or no remodeling.”
This holds true for other room types as well. “In diagnostic and treatment spaces, we plan for one, or no more than two, sizes of space,” he says. “You don’t know if in the future more procedures will be surgical or non-invasive, so rooms are planned to handle both functions. Also, the kingdoms are coming down and divisions between diagnostic departments are blending.”
The Johns Hopkins Hospital (Baltimore), the University of California, Los Angeles Medical Center, and California Pacific Medical Center in San Francisco are all designing “platform floors,” where surgery, interventional imaging, cardiac catheterization, and other procedure-based services share preoperative and postoperative areas and have single access.
“These floors provide adjacency of services allowing a lot more flexibility and decreased redundancy,” explains Dr. Tingwald. “Also, there aren’t as many patient transfers, and a key to patient-centered care is less movement of the patient.”
Built-in flexibility is designed to accommodate scalability as well. “In the planning process, we anticipate higher volumes in an emergency or disaster,” he says. “We plan how to expand the emergency room, and we make rooms larger than we used to. That way, if volumes increase quickly, you could put two, three, maybe more patients in a space. Nurses hate when you say that, but we have to have timely solutions that are affordable. This approach can be considered on nursing units as well, with these ‘super singles’ able to handle a second patient during a February flu outbreak, for example. That’s better than having an entire wing of the hospital that’s only used during winter months, patients stuck in the emergency department for days, or patients in the halls.”
A Design with Built-In Patient Safety
The physical design of the hospital of the future will better address and correct issues with patient safety. “Whatever design elements can minimize errors and improve outcomes are being studied intensively right now,” says Dr. Tingwald. “For example, we used to mirror many room types so that walls could share plumbing, etc. One room would be the mirror image of the one next to it, requiring the staff to learn different layouts, which increases time of response and possible errors. Now, we try to make procedure rooms as similar as possible to reduce the potential for error.”