Three years ago, Langlade Hospital in Antigo, Wisc., set out to construct a new critical access hospital, responding to not only the pressing need to replace its existing Hill-Burton-era building with a new facility but also to create a care environment that would be primed for the future of value-based care and heightened accountability for providers.

“We knew it was coming, and we knew this facility didn’t position us well for some of the challenges we’d be facing,” Schneider says.

At the same time, nearby Memorial Health Center in Medford, Wisc., went through the process of recognizing its replacement facility built in 2006 without staff buy-in was intrinsically flawed and required a number of updates. To do so, they hired the same team working on Langlade.

The session “Critical Access Hospitals, One New, One Existing—Transforming Experience and Outcomes Through Architecture” held at the HEALTHCARE DESIGN Conference in Phoenix Nov. 3-6 explored the tale of how both facilities projects came together. Sharing the story were Kristin Dufek, AIA, EDAC, LEED AP, principal-in-charge health & wellness studio, Eppstein Uhen Architects; Steve Tynik, LEED AP, EDAC, vice president of business innovation, Miron Construction; Dave Schneider, executive director, Langlade Hospital; and Julie Kent, senior healthcare planner, Eppstein Uhen Architects.

When setting out on the Langlade project, Schneider says his primary goal was not to hear from staff after opening that they weren’t consulted about the design and subsequently couldn’t work in the space. “That was not what happened,” he says.

Instead, every single one of Langlades’ more than 500 employees signed-off on the planning of their departmental workspace. While their opinions shaped the resulting facility, Schneider says their limitations in terms of evidence-based design and other specific design knowledge were recognized, as well.

That’s where the design team of Eppstein Uhen and Miron Construction stepped in, working side-by-side with staffers in an integrated approach to the facility design. Twenty-five innovation teams were created and assigned specific jobs, from process improvement to move planning, to determine what needed to be done even before the project was complete.

The same process eventually unfolded at Memorial, as well, and both projects had the following goals:

  • Patient experience—improve it from the front door to point of care
  • Safety—Reduce the risk of infection and injury to 0%
  • Efficiency—Create the shortest distance between the user and need
  • Flexibility—Rapidly respond to daily demands

The projects didn’t come without challenges, though, namely in that staff were used to what they know. However, the team wanted to teach them not to rely on what they’d always done or what the competition was doing. “We started to challenge the team with a completely new way of looking at it,” Tynik says.

And while there was push-back, the team credits ownership with being firm in its commitment to bring something new to their facilities and community.

However, the process itself helped gain buy-in as well by looking to other facilities as benchmarks and even other industry powerhouses, such as Anthropologie in retail, Apple in technology, and Southwest in travel. The success of each, Tynik says, was that those companies understand the emotional connections users have to their experiences and standardize that process. “They can tell you how it’s going to go and how it’s going to feel connecting with a provider before it happens,” he says.

At Memorial, though, fears were escalated, especially because the facility had been build just six years ago and staff were worried it would be flawed once again. So, for example, research showed a number of inefficiencies in the registration process. To alleviate this, Miron built a mock-up of a new model, allowed staff to walk through and mark it up as necessary, identified the major obstacles, redrew the plans, mocked it up again, and, finally, got 100% buy-in on the design. Staff then began to plan ahead to change internal processes now to support the registration process of the future.

While Memorial is in the construction document phase today, Langlade is enjoying the fruits of its labors.

“I really do believe we have a facility for the future, and I can say not one employee has come to me to say, ‘I can’t work in this space because you never talked to me,’” Schneider says.