The Intersection Of Healthcare And Politics
Since passage of the Affordable Care Act (ACA) in 2010, politics and healthcare have taken center stage in a national discussion. Some have considered the ACA government intrusion; others find it to be necessary reform to achieve better population health.
Yet this fusion of politics and healthcare is nothing new. The federal and state governments have been involved in healthcare since the founding of our country.
The pilgrims actually funded public care for disabled soldiers through the Plymouth colony in 1636. Later, the Continental Congress provided pensions to disabled Revolutionary War veterans, while Abraham Lincoln committed “to care for him who shall have borne the battle and for his widow and his orphan” during the Civil War. From the trailblazing work of Florence Nightingale who implemented hygiene improvements in the 19th century to passage of Medicare and Medicaid in 1965, government has always played a key role in healthcare.
This historic narrative will continue to impact healthcare services as designers collaborate with providers to plan clinics that meet immediate and long-term needs. Knowing history enables us to better understand the variables that shape the healthcare industry.
Passage of the Americans with Disabilities Act (ADA) in 1990, for instance, led to substantial changes in healthcare facilities planning. Early compliance essentially involved tacked-on solutions to make buildings accessible. But now ADA standards for new construction and renovations are integral to the planning and design process from project kick-off. Accessible entrances, elevator lobbies, registration desks, toilet rooms, commons spaces, and drinking fountains seamlessly integrate with overall building plans. Generally, a designated design team member oversees compliance.
Now with the ACA, facility design is evolving further to accommodate new regulations. For instance, many healthcare organizations are developing wellness centers, community rooms, and educational spaces to address the legislation’s focus on wellness and preventive care. Clinics are also taking cues from corporate workplace trends to design flexible workspaces where nurses, doctors, and specialists can collaborate more easily to improve services as reimbursements emphasize outcomes over procedures.
One example at the new Devils Lake Clinic in North Dakota, Altru Health System bypassed private offices for multi-teaming areas to encourage collaboration and knowledge-sharing within a realigned patient-centric care model. Exam rooms are standardized to encourage multiple physicians to use the same space, ultimately saving square footage cost. Clear circulation separates staff and public areas while natural light floods interior spaces to improve the patient experience and workplace environment.
As the ACA continues to evolve, so will its impact on design. By staying on top of legislation, designers can help healthcare organizations shape the future of clinic design.