In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Craig Watterson is a senior healthcare planner at architecture and design firm DesignGroup (Columbus, Ohio). Here, Watterson shares his thoughts on creating buildings that effectively support the healing process, designing with staffs’ needs in mind, and the growing desirability of environments that reflect society’s increasing diversity.

1. Buildings are still fundamentally about people

How a person’s brain naturally responds to the healthcare environments we create has been increasingly understood and documented. Today, there’s no excuse for failing to factor some aspects into creating not just efficient, well-designed spaces, but also ones that are truly effective in supporting the healing process and a person’s wellness. Things have shifted from the intuitive “wouldn’t it be nice if …” to the mandatory “it’s necessary that …” attributes be incorporated into design, including providing access to daylight, a connection to nature, and controlling sound in spaces (among others). It’s often easy to selectively provide environments that are sensitive to these factors. However, over time, an expedient or easy change to facilities to accommodate an immediate need can eliminate what was originally provided—cutting off the benefits derived from them. We have the opportunity to purposefully set up a new building’s (or alter an existing building’s) organizational infrastructure to provide for these fundamentals in an inherently lasting, rather than fleeting, manner.

2. Who is the customer in healthcare design?

While there has rightly been a focus on designing for the patient, the importance of creating supportive work environments for those providing care has become increasingly clear. This is expanding from the realm of creating functionally effective work spaces and flows (including accommodating the increasingly collaborative nature of healthcare) to one that also includes amenities and features for those who are working there, with a goal of being an uplifting and preferred workplace of choice. The patient is still the reason we’re creating facilities in the first place and will continue to be a primary focus. But it’s apparent that significant attention and care must also be given to employees, staff, and physicians, and the spaces that are created for them as they go through their workday. What is disruptive or stressful? What aids in concentration and focus? What challenges and opportunities can be explored in some of the new care environments that are coming online?

3. Efficient flexibility

The importance of using Lean principles and tools in the design process has been driving the development of many healthcare projects for several years now. Processes can be studied and facilities can be designed to optimize workflow very effectively. However, as that workflow evolves (either through an incremental adjustment or disruptive change), what was once optimal can potentially become problematic. The resolution of the dichotomy of “optimal” and “flexible” must be consciously achieved to meet immediate needs more effectively while providing for future value in a continually evolving healthcare environment.

4. Regulatory environment changes

As the provision of healthcare has changed, there’s also been a continual evolution in the regulatory environment. Terms have different definitions than they may have had in the past.  For instance: What is an MOB? What is an ED? What is an ambulatory facility? Who is an inpatient? What is a hospital? This affects not just what must be provided, but also the classification and type of construction used. It likewise must be seriously considered when strategizing approaches, estimating costs, and considering reimbursements. Change is opportunity, but it can also be a stumbling block if you don’t stay on top of those changes and the reasons for them.

5. Designing for diversity

Provision of healthcare environments that are appropriate for cross-generational and cross-cultural populations must be intentional. While there are regional norms that sway specific design decisions and support a sense of place, society increasingly comprises different people—groups and individuals who react differently to the situations and environments in which they find themselves. Care must be taken to consider these differences while designing healthcare environments so they provide convenience, lowered stress, and a healing environment for all. It’s likewise important to glean the characteristics that should not differ while orchestrating flows and spatial features that interface with those that should. Settings and opportunities range from traditional hospital to outpatient to MOBs to retail to community settings (with virtual settings as well). Attributes and cues that are incorporated into each help create a connection to the different populations that interface with them.