Healthcare environments often get a bad rap-and why is that? Is it because of the design of the space? The level of service, or the lack thereof? While any of these issues can contribute to a patient’s negative experience, as a provider of healthcare services, you can’t escape the fact that one issue remains: the state of mind patients are in as they walk in the door. Concerned, hurting, worried, or time-stretched; regardless, in a heightened state of anxiety. It’s no wonder why patients consider the whole atmosphere as “clinical.”

Oftentimes, when planning the design of care centers-be they urgent care, customer-facing medical offices, physical therapy centers, and even regular doctors’ offices-the primary concern appropriately begins with functionality: how examination rooms relate with screening, waiting, administrative, and lab functions. Many times, design professionals and their clients see the sequence of movement from the point of view of the doctor and staff. The resulting spaces reinforce the patient’s perception that they are unfortunately “in the queue” awaiting their turn. Perhaps the more appropriate strategy for the design of the experience should be through the eyes of the patient: How would you like to be treated when you likely already have “issues”?

As designers of many types of customer-facing businesses, including retail stores, banking centers, and the like, we’ve applied design strategies that focus on the customer experience: How does the physical setting of a place improve the likelihood of being in a positive state of mind? Many a book has been written about the causal connection between such a positive state and the increased incidence of making a purchase. The same principle that applies to retailing should be applied to healthcare environments.

As with the retailer, the journey to discover that which will improve the customer experience begins with brand principles: What are the key drivers that define your core business, differentiators, your expressed personality, etc., and are they aligned with your customers’ needs and desires? You may have noticed that the aforementioned banking centers are put in context with retailers, yet banks don’t sell anything, just as a clinic doesn’t send a patient on their way with a bag of wellness! But, in fact, a bank-and a healthcare clinic-do sell something beyond service: trust and even loyalty. While neither of these notions is in a package, each results from the perfect alignment of your brand with your customer/patient’s unique state. The design of a healthcare environment is perhaps the most impactful way of expressing that alignment and therefore, it becomes increasingly important to “get it right” when so many options are available for patients to choose from.

A brand-centered approach to design

Undoubtedly, every successful business has a brand position, but it seems that outside of retail, many consider it to be related more to their marketing materials than to their facilities. However, if a design is to improve the connection between your offering and the customer/patient, it has to become a key driver. Similar to retailers and bankers, with healthcare providers we begin this process through a series of sessions with key management which we call a “deep dive”-uncovering the salient aspects of their business goals. These goals may relate to their market-share, their target areas for growth in customer-base, and geographic coverage (very rational and quantifiable concepts). But we probe further to uncover their perceived points of differentiation from their competitors, the unique qualities and approaches that make their offering special (very subjective and qualitative). From the merging of these two related aspects, we create a vision statement that centers the design goals on management’s fundamental drivers.

As a means of deepening our understanding, we also conduct interviews with nonmanagement staff and directly with customers/patients with the intent of integrating their unique perspectives, often uncovering misalignment that can thwart the best of intentions, but must be addressed, nonetheless. Lastly, we analyze competitors and noncompetitors (those outside of the industry that serve as benchmarks of exemplary positioning) so that an accurate gap analysis can be integrated into specific design goals and the subsequent strategy and execution, results and measurement.

While many of these processes are central to a brand consultancy’s core competency, rarely are the outcomes translated into the design of the business facility. They’re often relegated to “shelf-ware.” When integrated into a designer’s approach, the discovery of the real goals (beyond those important functional ones, which will be addressed) assist the entire team’s efforts to focus on the customers/patients’ point of view as a driver, not as a result of some other, often unaffiliated, motive.

Your brand manifested

In order for a brand-centered design strategy to be effective, it must permeate every aspect of the facility that the customer/patient comes in contact with. In fact, it must unify the staff’s experience with those that are being served. It can’t just affect the waiting room, the exam room, or the check-in/out area. In order for an experience to improve, it must be consistent at every point along the customer/patient’s path. If comfort is a goal, it can’t just be in the waiting lounge seating; it should also affect all the senses: what colors, lighting, sounds, and smells are conducive to comfort? In retail, we call these concepts “immersive experiences.”

To truly see experience through the customers/patients’ eyes, we must choreograph their movement through the space-every point, from entry to exit-and design each “event” as an important setting to represent your understanding of their needs. Great retailers do this all the time, somehow knowing exactly what is wanted (say the latest fashion or tech gadget) and putting it right in the customer’s field of vision or path of movement. This applies to healthcare, too; if a patient is already anxious, eliminate their disorientation by placing signage (preferably in sync with your trademark DNA) where it can be seen.

While coordinated graphics can make a big difference, it is only one part of improving the experience and therefore connecting with your patient on a deeper level. And yes, functionality is critical. The last thing a patient needs is to feel like they’re in an experimental labyrinth of dead-end corridors. In order to benefit from better care, support spaces must be carefully placed, so wait times are limited. Further, the patient must never come in contact with functions that increase their anxiety. In effect, all aspects of design are informed by a brand-centered approach, as seen through the eyes of the customer/patient.

Does your facility need a brand check-up?

It is a common misconception that real solutions to the ills of bad design are expensive. Sometimes that is the case, but more often, design solutions that solve for brand-plagued environments can be simple and inexpensive. Improved alignment between your brand and your patient frequently results from better use of the dollars already being spent. But if you’re going to get it right, the road from “clinical” to “facility wellness” follows the path of a branded environment strategy. HD

Bruce Barteldt, AIA, is the Partner & National Studio Principal for Little’s Retail Practice, which designed the new prototype for Concentra retail clinics resulting from these principles, as pictured in this article. He can be reached at 704.561.3461 or

bbarteldt@littleonline.com. Healthcare Design 2010 June;10(6):46-50