As healthcare designers, we often invest pre-design time with clients, caregivers, and patient groups to understand needs when planning a new or renovated healthcare facility. When it opens, we then return for a post-occupancy evaluation (POE) to test the effectiveness of design decisions.

Yet how often do we experience a hospital we’ve designed as an actual patient, and not an objective designer?

I asked Steve Christoff, an HGA colleague and healthcare principal, this when I recently saw him in a wheelchair. He’d just spent a night recovering from ankle surgery at St. Cloud Hospital’s Bed Tower (St. Cloud, Minn.) which he designed more than 10 years ago.

He told me being a patient brought fresh perspective on the design. His 24-hour stay allowed him to experience three full nursing shifts, as he observed design decisions that worked well and other things that he may have done differently.

“It was important that I was able to control my environment,” he said. “With the integrated bed controls, I could turn the lights on and off, and dim them; raise the bed up and down; turn the TV on and off; and raise or lower my leg without constantly calling the nurse. In fact, as a patient, I felt I didn’t want to bother the nurses unless it really mattered.”

Because he slept intermittently throughout the night, he was able to talk with the nurses and coax some comments from them. He learned that the nurses actually would have liked one extra foot of space between the patient bed and in-room nurses’ station, with an electronic medical records monitor. This consistent comment told him that the emphasis on maximizing in-room family space may have been at the expense of the nursing space.

While Steve’s notebook contained many pros and cons (he liked having access to Wi-Fi and learned the family/visitor desk was rarely used), he also gained a fresh perspective on how he might approach future planning.

“Although we did a full-scale patient-room mock-up to test ideas when planning St. Cloud, I would still spend a night in the hospital and put myself in the patient perspective for 24 hours—full immersion,” he said. “And I would go through every operational process without compressing time in a typical “Gemba” walk by shadowing nurses and doctors for a full shift. You have to be able to understand what they are working around and where the real needs are. By focusing more on front-end and back-end post-occupancy research, you’ll learn about reasons why.”


Read Christine Guzzo Vickery's next blog in this series: "Full Immersion: A Personal Perspective On ADA Codes."