Design Ideas For The Medical Home Model
Once a dot on the healthcare landscape, the medical home model is a growing trend in healthcare design. During the session "Transitioning to a Medical Home Model Through Building and Organizational Re-Design," at the Healthcare Design Conference in Orlando this week, attendees got the chance to look at some of the design challenges and solutions associated with this emerging format.
"It's the organizations that can see around the corner that will not only survive but thrive in the future," Kris Krail, senior associate, NBBJ, said during her opening.
A few years ago, Chase Brexton Health Service (Baltimore) was looking to move into a new building and expand its services. CEO Richard Larison says the 35-year-old community health center also took the chance to re-organize and find better ways to provide services. Chase liked the team approach of a primary care medical home, where a core team of physicians, specialists, and care coordinators handle all aspects of care for a patient. After deciding to transform its practice delivery method, the next step was looking at the environment and considering how to build something that promotes that team approach.
"Ideally we'd have everyone taking care of that patient in one space," says Hao Duong, senior associate, NBBJ. "But we all know that's challenging."
The project team looked at the best environments for patient care and what providers needed, and then how to find the right balance. "If all the clinicians are seeing patients on one day, what does that mean to the space?" Duong says.
For example, a primary care physician may need a space with an exam table but a specialist such as a dietician could see patients in a less clinical setting, using a couch or chairs.
Each pod within the new facility was designed with nine exam rooms and two talking rooms for more face-to-face interactions. “It was a challenge to give up exam rooms to embrace that,” Larison says. “As people started utilizing it, they realized the benefits of taking patients out of the exam room and into the talking rooms.”
While flexibility is one aspect of the medical home model, collaboration is another key. To eliminate silos, Duong says the staff spaces are organized in the center of the pods, with a team table for the staff to dock electronics and engage with each other while doing computer work.
With a number of services under one roof, Chase recognized a trend in group visits, especially in addiction and behavioral health care as well as more chronic conditions, such as diabetes. So group rooms on every floor off the waiting room area allow for larger gatherings.
Larison says the result is “a space that gives us lots of flexibility,” and that the organization is looking to add walk-in or urgent-type care in the future.
"It starts with understanding the space and the experience," Duong says.