Burgeoning Retail Clinics Require Unique Designs
Gone is the weekend and after-hour panic when an ear infection or strep throat sets in, and the physician’s office has long been closed. Now, instead of counting down the hours until the next morning, folks are hopping over to the closest shopping plaza to check in at a retail clinic.
More than 1,350 retail clinics can be found in drugstore and retail settings nationwide, and the country’s largest retail clinic chain, CVS Caremark MinuteClinic, plans to add 100 new clinics every year for the next few years.
“The right care, at the right time, at the right price: This is what’s driving the convenient care industry,” says Stephen R. Lazzari, director, FastCare Retail Health Clinics (Green Bay, Wis.). “With a primary care physician shortage surfacing and the attractive price point of about $65 per visit, convenient care clinics will flourish.”
With patients rating convenience and accessibility as the major factors driving their decision to visit a retail clinic, 44% of clinic visits are taking place on the weekends and weekday evenings, according to the Convenient Care Association.
Retail clinics are typically found within grocery and drugstores, where a pharmacy is as close as the next aisle. Many, but not all, are affiliated with local health systems. For those that are, the clinics help healthcare providers expand their affiliations and perhaps contribute to a better continuum of care, which will be essential as healthcare reform rolls out.
This includes screenings and preventive care to help reduce acute care needs. When acute care is required, the clinics can help provide follow-up care and health management on the latter end of the continuum.
Financially speaking, with nurse practitioners primarily staffing these clinics, payroll expenses are lower, and hospital networks are saving money by delivering more primary care in their communities, as opposed to their emergency rooms. “The retail setting has good access and parking, and it eliminates the need for a bricks-and-mortar building, thus eliminating expensive overhead,” Lazzari says.
Serious healthcare, retail setting
Because the footprint of a retail clinic is relatively small (400 to 600 square feet) and must co-exist inside its retail host, it can be challenging to create a welcoming, comfortable environment.
For example, when MemorialCare Health System designed three separate clinics inside Albertsons/Sav-On stores in Long Beach, Calif., Shelly Lummus, MemorialCare director of retail medicine, says, “It was important to us that the patients not feel like they were stepping into a closet.”
To accomplish this, the clinics need to be a mix of retail and hospitality design with both visibility and curb appeal, according to Haley Driscoll, a senior associate and healthcare interior designer with Francis Caufmann (Philadelphia).
“For example, while we might not use stone for countertops, we might use more interesting textures of plastic laminates that one won’t typically see in a hospital, along with other retail-quality materials. Or we might create an interesting floor pattern like one might see in a store,” Driscoll says.
At Walgreens (Deerfield, Ill.), when the national drugstore chain began rolling out its TakeCare clinics, which currently number more than 360, “we partnered with a design consulting firm to gather qualitative data on end-user expectations, then leveraged what we learned to drive the architectural and aesthetic design of the space,” explains Jim Cohn, media relations, Walgreens. “From there, details of the design, from lighting to material finishes, were inspired by other areas of the healthcare world.”
It follows that furniture and finishes must meet the durability and cleanability requirements of healthcare spaces, and the atmosphere needs to be comfortable, appealing, and suitable for all different types of people, age groups, and sizes. Furniture, lighting, materials, and finishes should be selected carefully to make sure, for example, that glare is minimized and colors and textures are soothing, Driscoll says.
A cornerstone of healthcare design, daylighting is also desirable in retail clinics. But in some cases, that’s simply not feasible. For MemorialCare HealthExpress, architect Alexander + Hibbs (Anaheim, Calif.) tried to make up for a lack of daylight by creating interior window walls, which also maximize the clinic’s visibility to the store’s shoppers.
“The image of the clinic portrayed through the window wall is that of an upscale medical office,” Lummus says, “with warmth from the use of wood-tone floors, cherry-laminated casework, solid-surface countertops, and a feature wall, where possible.”
Overall, the main goals guiding the architecture should be creating an open, airy, and friendly environment; achieving HIPAA and code compliance; and designing for privacy, functional efficiency, and comfort, says James G. Easter Jr., senior vice president, principal and director of planning, HFR Design (Brentwood, Tenn.). As with any healthcare environment, additional guiding principles include patient access and comfort; efficient workspaces for staff; and easy, clear patient flow through the clinic.
Practically speaking, a typical clinic consists of a small reception desk or kiosk for registration, a waiting area, a couple of exam rooms, a lab area, and a restroom. Ideally, the clinic should have its own heating/cooling system.
“Most host retailers are set-up to monitor large zones, whereas a retail clinic, without doors, is typically at the whim of the retailer,” explains John Corpus, vice president, strategy, Legato Healthcare Marketing (Green Bay, Wis.).
By having entry doors, clinics can gain some temperature regulation independent of their retail homes. However, in the absence of their own HVAC systems—preferably a split system—maintaining separate temperatures in exam rooms and reception/waiting areas isn’t possible.
All about branding
When it comes to branding the clinic within its host retailer, medical credibility is a big issue, so in cases where the clinic is run by a healthcare provider, it’s important to highlight that fact by incorporating the provider’s brand name and colors into the clinic’s signage and logo.
According to Lazzari, FastCare Clinics place so much emphasis on their partnerships with local hospital systems that don’t consult the host retailer when it comes to branding.
On the other hand, MemorialCare feels it’s important to have its clinics blend into their surroundings, so the provider sat down with Albertsons/Sav-On’s marketing team to ensure that HealthExpress’s color palette would work with the store’s neutral tones. The underlying goal, however, was to ensure that the MemorialCare brand would be showcased.
As a result, an illuminated MemorialCare HealthExpress sign is prominently displayed on each retail store’s exterior,
in front of every in-store clinic, and throughout the stores.
Corpus, who has worked on a number of retail clinics, including FastCare, emphasizes that clinics must be designed as a destination point and located prominently within the retailer—for example, near the checkout lanes or next to the pharmacy with clear signage.
In cases where the retailer is running the clinic, strategically integrating the space within the larger store is still key. With Walgreens, for example, “the branding and colors of the health and wellness space blends seamlessly across business units to provide one retail health and daily living destination,” Cohn says.
Here to stay
Moving forward, the industry can expect to see an even greater proliferation of convenient care clinics, and possibly some new innovations, such as drive-thru clinics where a patient can get a shot without having to get out of the car.
“The model is reaching a point of stability and maturation, with continued growth in the number of clinic locations nationally,” says Tine Hansen-Turton of the Convenient Care Association (Philadelphia). “The founding priorities of accessibility, affordability, and quality will continue to drive industry expansion, especially with the implementation of the Affordable Care Act.”
Looking at the big picture, Harry Hummel, principal, healthcare, Francis Caufmann, sees retail clinics as a throwback to the days when doctors made house calls. Although it’s not quite to that extent, the clinics are reaching further into communities than a doctor’s office or hospital may be able to do.
“I think the future of walk-in, short-stay, real-time ‘insta-care’ is here to stay,” adds HFR Design’s Easter.