The image of healthcare facilities has evolved ever since the nation's first hospital opened in Pennsylvania, in 1752. Through history, the perception of a hospital has progressed from chaotic and filthy, to cold and impersonal, to spa- and hotel-like. Healthcare spaces need to embrace their own unique identity. Anyone (patient, visitor, staff) who enters a healthcare space should immediately know that they have arrived at a center of health and healing. They should trust that this specific healthcare facility will take better care and provide the best experience possible. With the rising costs of healthcare, a patient's choice of a healthcare provider is difficult. The hospital's brand and ability to build trust with the patient may aid in the decision-making process.

Hospitals serve people during their most emotional experiences ranging from the birth of a child to the death of a loved one. As such, the hospital's influence emerges from the confines of the institution's walls and into the community. According to the Bureau of Labor Statistics, healthcare is the largest industry (in 2006) providing 14 million jobs, and between the years of 2006-2016, healthcare will generate 3 million new wage and salary jobs. In smaller communities, a local hospital may be the largest employer and an integral part of the community's framework. Thus, the community becomes the hospital's identity. Similarly, if the population cannot identify with the hospital, they will find another hospital that better earns their trust.

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Brand

According to The Brand Gap: How to Bridge the Distance between Business Strategy and Design by Marty Neumeier, a brand is the gut feeling a person has about a company. The goal of branding is to create a consistent perception of what a company stands for and what they believe in. As such, branding is personal. Each person has his or her own opinion of a company which is used while making a selection from the flood of products and information. Consumers do not make decisions based on logic alone. Decisions are influenced by emotional cues-a sense of trust and visual appeal. Many patients select a physician and hospital based on personal recommendations from family and friends despite the affluence of healthcare information from Hospital Compare (http://www.hospitalcompare.hhs.gov). It's all about trust.

A sense of trust can be created by capturing the attitude and aspirations of the consumer. People will pay more for coffee, running shoes, or technology because of the perceived lifestyle achieved by purchasing a specific product. Ultimately, it is the connection between consumer and company that helps consumers make a decision because the company understands the consumer's needs and offers a better product.

Our culture is visual. Apple transformed the way consumers viewed technological products in 1998 with the introduction of the iMac and its brightly colored, translucent plastic shell showcasing the inner workings of a computer. Apple encouraged its consumers to “think different,” and captured that attitude in their products. Instead of a dull box sitting on the desk, the desktop computer became an item consumers wanted to display in their home. A product-design revolution ensued as computers, televisions, music players, and phones evolved into attractively designed objects. These gadgets are so desired that people stand in long lines for the release of a new phone or prominently display a new flat-screen television in their living room. Later, Apple revolutionized the technology retail experience by aligning the image of their stores with that of their brand. The result is a technology retail experience with exponentially better results than past computer retailers (such as Dell or Gateway, who both had unsuccessful retail stores).

Essentially, good branding effectively communicates to consumers and the market at large.

Healthcare brand

As one of the most human-centered services offered, healthcare is personal. The connection between healthcare provider and patient needs to be developed to improve the delivery model. If the healthcare system is rooted in the community, then the image is a portrayal of what the community aspires to be. The healthcare environment is a reflection of that brand (similar to the way Apple's iconic glass retail stores represent their brand). Every part of the healthcare experience must embody that brand and convey the message that the hospital is the center of health and wellness in the community, including healthy facilities and healthy staff.

According to Scott Regan of Anderson Healthcare, the healthcare mission needs to be clear so that everyone on staff-from the CEO to the volunteer at the reception desk-may communicate it effectively. Most importantly, the mission must be a shared goal. If everyone on staff supports the mission, then it is easier to achieve a common goal. A clear and concise mission establishes the big idea that organizes all other decisions in the organization. Not only does this apply to a hospital but also any organization from the community clinic to the entire healthcare system. The result is a brand-guided organization. In Managing Brands for Value Creation from Booz Allen Hamilton with Wolff Olins, brand-guided companies make a difference in the bottom line by outperforming competitors as well as gain an edge over non-brand-guided companies through the attitude of employees.
Diagram by Matthew DeGeeter

Diagram by Matthew DeGeeter

Diagram by Matthew DeGeeter

Diagram by Matthew DeGeeter

The result of shared commitment to an organizational mission is a greater sense of trust and internal brand loyalty. What would be the impact on the patient experience and, potentially, evidence-based design if the brand fosters trust between patient and care provider? The connection between delivery of care and patient needs to be understood and leveraged in order to create an experience that makes the patient choose to attend that hospital and make a positive recommendation. For healthcare systems, effective branding creates a unified front for all hospitals, clinics, and other healthcare modalities to communicate effectively to the population served and the broader community.

The Arlington Free Clinic in Arlington, Virginia, is rooted in its community. As a private, nonprofit, community-based organization, the clinic provides medical care at no charge to low-income, uninsured people using nearly 500 volunteers and partnerships with other health providers (http://www.arlingtonfreeclinic.org). At its root, the clinic makes healthcare accessible and reaches out to the community. For the clinic's new space, Perkins+Will designed an environment using the organization's mission as inspiration for a healing environment. The design team surveyed patients, volunteers, and staff to better understand all of the clinic's goals. The plan centralizes around a core including the executive director, conference room, and nurse station that then reaches out to treatment, support, and welcoming spaces. The clinic is working towards LEED certification and would be the first healthcare facility in Arlington county and first free clinic in Virginia to be LEED certified. Although small in scale, the Arlington Free Clinic makes healthcare accessible to those who need it in a space that promotes their mission and brand.

Healthcare experience

The healthcare experience begins long before a patient reaches the front door. The first interaction is more than likely to be online at the hospital's Web site. The patient will receive information about the facility including directions, parking instructions, and information about the treatment. Family will learn how to visit loved ones. The patient will develop a positive (or negative) first impression about the upcoming experience depending on whether the Web site information is well organized and easy to navigate. This is also the first experience patients have with the healthcare provider's image. If Web page graphics are dated, a tone for a dated facility will be set long before the patient arrives. Well-designed Web sites allow the patient to access information about the facility and the upcoming procedure. The design and implementation of interactive maps could make navigating the hospital and campus much easier and less stressful. The result from the “online front door” is the building of trust.

Healthcare design

Just as the Web site begins the patient experience, the facility must build upon that trust. If the healthcare brand promotes health and wellness, then the healthcare environment ought to be the epitome of that image. Every aspect of that hospital's image must project the brand including the physical space. The architecture and interior design of a hospital literally lay the foundation; setting the stage for the patient and family experience. The facility is the backdrop that provides the necessary tools for care providers to do their job, but the design must do more than provide enough space for medical equipment and enough desk area for staff. Outdated equipment, subpar functioning space, and outdated finishes will only hurt the image of the hospital and the patient experience. Staff will not be able to fulfill their roles and duties and patients will lose trust for the care provider. Evidence-based design strategies use pertinent research to create a facility that honors the patient, family, and staff. The goal in utilizing evidence-based design strategies is to produce results. Improvements to the facility should be reflected in a return on investment and better experience for all.

Hospitals have the opportunity to become the community center for health and wellness.

Consistency is one of the most difficult elements in creating brand recognition. On large hospital campuses, it is common for multiple design teams from multiple firms to be working on different projects. Each group employs a different design strategy and develops a different solution for the hospital. If the design process is guided by the brand, design teams and clients can have a mutual understanding of the intent of the project and the experience it must embody. For larger healthcare systems, the technique of branding each healthcare environment within the system consistently creates a unified visual front for the system. Patients may be sent from one facility to the other (depending on treatments offered and patient needs), but with the implementation of consistent branding, the patient will always know he or she is at the correct facility because of the consistent image.

Kaiser Permanente introduced the Kaiser Template Program to standardize the design of their facilities. Not only does this streamline the design process, the planning of the facility may decrease time spent on reorienting staff to a new facility when transferred. The next step is to ensure that each patient knows that at any Kaiser Permanente facility, the same quality of care and similar experience will be received.

Potential

As today's hospitals treat patients with the most advanced technologies available, hospitals need to provide patient-centered care in a facility that honors the environment and community. Hospitals have the opportunity to become the community center for health and wellness. The entire healthcare experience could become an inspiration for all who enter the facility to improve their health and wellness by promoting a brand that the community aspires to be. The current healthcare system offers few incentives for preventative care: leading a healthy lifestyle improves the quality of one's health given one's existing health conditions. Preventative health measures will require a different mindset and a different design strategy. This thought process changes the perception of the hospital brand, and as such, may revolutionize the image of the hospital. Healthcare environments can change the image of the institution.

The result of investing time, energy, and funding in the design and development of healthcare facilities that promote health and wellness is a greater sense of trust between the patient and healthcare provider. The more a patient trusts the healthcare provider, the better the experience. This gut feeling of trust is the healthcare brand and realized in the facility. Every hospital should strive to become the first place to go for any current or potential patient. HD

Matthew DeGeeter, Allied Member ASID, Associate IIDA, LEED AP, is a designer in the healthcare market sector with Perkins+Will in Washington, DC. He can be reached at

matthew.degeeter@perkinswill.com

Sources

  1. Bureau of Labor Statistics, Department of Labor. Health Care. Career Guide to Industries, 2008-09 Edition. Retrieved from http://www.bls.gov/oco/cg/cgs035.htm
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  3. Harter G, Koster A, Peterson M, Stomberg M. Managing Brands for Value Creation. Retrieved from http://www.boozallen.com/media/file/145647.pdf
  4. The Joint Commission. Health Care at the Crossroads: Guiding Principles for the Development of the Hospital of the Future. Retrieved from http://www.jointcommission.org/NR/rdonlyres/1C9A7079-7A29-4658-B80D-A7DF8771309B/0/Hosptal_Future.pdf
  5. Neumeier M. The Brand Gap. Retrieved from http://www.slideshare.net/coolstuff/the-brand-gap
  6. Regan S. Is the mission the brand? Or is the brand the mission? Message posted to http://blog.andersonhealthcare.com/
  7. Rodi B. Kaiser Putting Final Touches on Template: The HMO and Design Experts Develop ‘Whole Hospital’ Concept. California Construction. Retrieved from http://california.construction.com/features/archive/0302_Cover.asp

Healthcare Design 2009 December;9(12):10-15