Lean design principles stem from the ideals of Lean manufacturing, or the systematic approach to identifying and eliminating waste through continuous improvements in staff and work-process efficiencies. HGA Architects and Engineers embraces Lean as a pre-design methodology for eliminating excess square footage, construction materials, and energy use during the space planning of hospitals, whether the project is new construction or the renovation of an existing department. At its core, Lean’s purpose is to create more value for the end user or customer, with less work and expense on the part of the service provider.
HGA also uses Lean principles during pre-design to add value to the consumer experience by eliminating wasteful aspects of service delivery. That waste might be defined as unnecessary square footage impeding staff efficiency in recovery rooms, or unnecessary steps a caregiver takes to reach a patient in need. Input from hospital employees is essential to predesign and space planning. From administrators to caregivers to support staff, everyone should be involved from the start in the Lean pre-design process to eliminate waste and improve patient satisfaction.
Integrating evidence-based design (EBD) into the Lean-driven pre-design process increases Lean’s impact. EBD is a research-based approach to healthcare design that focuses on features that improve patient health and healing, wellbeing and safety, and staff efficiency and safety. Such features may include access to natural daylight and views to outdoor gardens in patient rooms, stress-free wayfinding throughout a hospital for patients and family, and task-efficient or even mobile workstations for staff.
Just as EBD augments the Lean-oriented design process, so does an attention to sustainability further decrease energy use, streamline staff efficiency, and increase patient satisfaction. Windows oriented and glazed to maximize daylight streaming into patient rooms or staff offices not only reduces energy costs but also enhances staff and patient wellbeing. Likewise, hospitals pre-designed using Lean principles to increase efficiency and reduce square footage result in a smaller building footprint, and thus reduced construction and energy costs overall.
Today, hospital administrators are exploring ways to streamline work processes and reduce unnecessary square footage before beginning construction on a new facility. But applying a three-pronged approach to space planning—one that integrates Lean principles, EBD, and sustainable strategies—is useful at any stage in a building’s lifecycle.
St. Elizabeth Hospital, Appleton, Wisconsin
In 2006, three to four departments across Wisconsin’s Affinity Health System were rated in the top 10% for patient satisfaction. HGA worked with Affinity on space planning for several new construction and renovation projects using the three-pronged approach, to escalate Affinity’s strategic goals for staff efficiency and positive patient outcomes while positioning the company for long-term growth.
By the second quarter of 2009, more than 30 departments were highly rated in patient satisfaction. In 2009, Affinity was also named one of the top 10 healthcare systems in the United States. Here’s how HGA and Affinity achieved such results at St. Elizabeth Hospital.
Listening to staff and patient concerns
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