Healthcare design has undergone rapid changes in just a few short years, with a renewed focus to improve not only the overall healthcare experience for the patient, but also staff satisfaction. Design and construction trends in newly constructed hospitals and renovated healthcare facilities are aimed at increasing patient satisfaction, but these same design trends also align with the goals of increasing staff retention rates and providing a better work environment, both of which directly affect patient care.

The recent expansion at Wise Regional Health System's (WRHS) replacement hospital in Decatur, Texas, featured a design aimed at increasing patient and staff satisfaction simultaneously. This $55-million, 176,000-square-foot, five-story expansion hospital opened on August 12, 2006.

WRHS's expansion has integrated an efficient workplace design aimed at increasing staff satisfaction—and with a side benefit of generating more worker productivity. To better compete with other state-of-the-art healthcare facilities for staff retention rates, the administrative team involved hospital staff throughout the planning process. Through frequent interaction with construction personnel and use of leading-edge technology, the strong design vision of administrators became a shared vision with staff. Continually building consensus with all entities involved in the design process was key to generating a design that was supported by all and that shaped worker productivity in the highly efficient new facility.

Incorporating technology

In new hospital construction, as well as in the renovation of older facilities, hospital design is using rapidly changing technology. These advances have provided increased design capabilities. Some of the newest technology—particularly wireless communication—allows architects to more easily design spaces equipped for efficiency while also boosting employee productivity and satisfaction. In the case of WRHS's expansion, various technologic advances were instrumental in helping planners devise a workstation layout that facilitates the flow of communication between staff and patients.

For instance, on the medical/surgery floor, eight mobile stations have been incorporated into the design so that nurses may administer medications and chart assessments in a patient's room (figure 1). Admitting departments also benefit from a similar design, allowing maximum mobility and flexibility with wireless units, enabling completion of the admitting process at the patient's bedside or in a private waiting room, and relieving high-traffic areas such as the emergency department. At WRHS's ER, private waiting rooms have been integrated into the work-space design, enabling patient privacy in an often-busy emergency waiting area. This added privacy benefits both patients and employees. Patients may be more willing to discuss problems in a private room than in an open admitting area, resulting in their sharing a more complete picture of their condition, which can lead to improved medical care.

An ICU mobile nurses' station at WRHS's replacement hospital in Decatur, Texas, allows maximum flexibility for staff in emergencies.

Traffic and Mobility

Incorporating staff mobility and increased patient privacy into the design has also positively affected traffic patterns, specifically by decreasing traffic in hallways. Planning for foot traffic is one of the most important considerations in creating a functional design that boosts productivity and increases staff satisfaction.

WRHS's original single-story hospital facility stretched out in an L-shape. The new replacement hospital is a five-story building with patient rooms (figure 2) ringing its perimeter. Staff support areas and nursing stations are centrally located within these “racetrack” layouts (figure 3) on each floor. This design's more efficient work flow eases congestion in high-traffic areas and allows staff to get to other areas of the building quickly. WRHS's racetrack layout also allows patients access to natural light via windows and gives caregivers easier access to patients (figure 4). The staff can provide more efficient patient care and also maneuver around the building much faster in an emergency than with the previous design.

(opposite, top). Private patient rooms at WRHS are equipped with wireless units so staff can complete checkups and admitting processes at bedside.

(opposite, bottom). A centrally located nurses' station sits in the middle of WRHS's racetrack design, easing work-flow patterns and allowing easy patient access.

(top). An ICU patient room at WRHS located on the perimeter of the facility is easily accessible from the nurses' station and other staff support centers and provides continual access to natural light.

Increased staff mobility and efficiency are also increasingly important factors within individual rooms, particularly within WRHS's emergency/trauma rooms. Emergency departments tend to generate high levels of foot traffic because of multiple staff members working to quickly and effectively solve patient emergencies. As a result, standardization of emergency/trauma rooms has become a necessity in hospital design. WRHS's standardized emergency/trauma rooms ease traffic and boost staff mobility and familiarity within the space (figure 5).

(top). An ICU patient room at WRHS located on the perimeter of the facility is easily accessible from the nurses' station and other staff support centers and provides continual access to natural light.

Universal Room Design

All medical and surgical patient rooms are designed and equipped with the same cutting-edge technology. As a result, staff members are more familiar with the overall design and can work efficiently throughout the hospital. Any of the more than 60 universally designed medical/surgical rooms at WRHS can be used for surgery or for patient recovery. Hospital staff benefits from these “swing rooms” because the rooms can be used as necessary for patient overflow, allowing more space to accommodate machines associated with particular emergencies.

An employee's familiarity with the layout and design of each room can also lead to reduced medical errors while boosting productivity. A nurse or doctor familiar with the space layout will be more readily equipped to diagnose and treat problems in a more efficient manner if he/she already knows how to adjust a room according to the situation at hand.

Communication Is Key

WRHS staff are familiar with the design layout not only because of the universal design of the facility, but also thanks to administrators' efforts to communicate and obtain balanced feedback from employees about the design of this new replacement hospital. Continually communicating with staff throughout the construction process builds consensus and staff satisfaction.

In fact, WRHS considered internal communication so important that it created a new position during the construction and design phase. The person filling this position acted as a hospital liaison between administration, the architectural/engineering design team, employees, and construction personnel, sending the staff virtual reports via the Web during the initial stages of the foundation and structure's construction.

As the project progressed, the hospital liaison was available for user tours consisting of groups of up to 10 employees, taking them through the space to familiarize them with the facility's new design. The tours, eventually led by in-house managers and directors, built familiarity with the new work flow and a sense of true “ownership” of the space for employees. Instead of dreading the difficult process of moving into the new space, employees were excited and confident as a result of their involvement.

Conclusions

As hospital administrators look to achieve employee satisfaction and attain high staff retention rates, they are more carefully considering the impact of healthcare design. Using and integrating cutting-edge technology, and designing around these innovations to create a more universal, functional facility—in effect, balancing workflow—boosts productivity and increases staff satisfaction. The workplace design that shapes WRHS's new facility ensures that it is on par with other top hospitals in North Texas, able to compete handily for both patients and staff. The hospital's efficient workplace design also helps position it as an attractive alternative to healthcare providers who may be considering transferring to a different facility in search of a better work environment. The number of physicians affiliated with WRHS has doubled in the past several years, with many more specialists now available to serve the specific needs of a growing population.

If hospitals adopt healthcare design that positively affects employees and patients, the resulting higher rates of staff and patient satisfaction can produce many added benefits. A fulfilled employee and patient base may facilitate shorter stays for patients and fewer medical errors. Some believe good design can also improve patient care and even increase philanthropic support. While gathering proof of all the benefits of good healthcare design, hospital administration, staff, architects, and contractors are confident that better hospital design can, without a doubt, increase staff satisfaction and work-space efficiency. HD

Tammy Testa is Project Manager for the Healthcare Team at Corgan Associates, Inc.