CHCF Seminar Whitepapers FINAL

8/13/2019 CHCF Seminar Whitepapers FINAL

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Promising Practices inPromising Practices ina ety- et n c es gna ety- et n c es gn

Presented by The Center for Health DesignAmy Keller, M. Arch : Anjali Joseph, PhD : Ellen Taylor, AIA, MBA : Xiaobo Quan, PhD

April 5, 2011

Presented by The Center for Health DesignAmy Keller, M. Arch : Anjali Joseph, PhD : Ellen Taylor, AIA, MBA : Xiaobo Quan, PhD

April 5, 2011


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Safety-Net Clinics: Between Today - 2015

$10.5 Billion in facility construction, renovation, & expansion Rethink how clinics can:

Provide reater access to care

Better patient experiences

Improve organizational outcomes


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Inform and educate

Publications describe design strategies that are enabling safety-net clinics to supportbest practices as they grow and change

Designing Safety-Net Clinics for Innovative Care Delivery Models;

es gn ng a e y- e n cs or ex y; an

Designing Safety-Net Clinics for Cultural Sensitivity

Based on literature reviews, interviews, & visits to exemplary health centers & clinics

Health care experiences

Patients, providers, & communities

Facilit lannin decisions

Health care interactions, patient flow, use of new technology, & changingneeds of the community


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Designing Culturally Sensit ive Community Clinic Settings


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Key definitions

Culture Cultural sensitivity

Cultural com etence


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Culture and healthcare interactions

Models of health and disease Perception of hospitals, doctors, and other healers

Hierarchical vs. e alitarian cultures

Family and social relationships

Communication norms


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Key design recommendations

Signage, symbols and artwork tocommunicate meaning and empathy

Provide spaces to support communityactivities


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Key design recommendations

Locate clinics for easy access Integrate with public transit

Incor orate wa findin strate ies

Consider universal symbols


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Key Design Recommendations

involvement of families


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Designing for Flexibi lity and Adaptability


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The importance of flexibil ity/adaptability

Changes in:

Population

Services

Result in physical changes:

Relocation of functions

Renovation

Equipment

Technology

Care models

Expansion


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Frameworks

Learning buildings

Open/ change-ready buildings

Adapted from Stewart Brand's representation of building layers (the 6 Ss) and incorporating Soni Diamonds conditions for indeterminate change


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Universal Grids

Source Citation


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Modular Systems / Flexible Technology

Herman Miller Furniture System, Grace Hill Water Tower Health Center, Arcturis


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Visibility

Clinica Family Health Services, Boulder Associates


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Universal Rooms - Pods

Clinica/Peoples Clinic in Boulder, CO , Boulder Associates


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Incremental Growth

Buckner, Lee, and Dan Hightower. 2006. Universal Design for the Rural Environment.


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The Business case

Manewa, A, et al. 2009. A Paradigm Shift Towards Whole Life Analysis in Adaptable Buildings.


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Design for Innovative Care Delivery Models in Safety-Net Clinics


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Significance

Safety-net clinics have consistently engaged with innovative care delivery models tobetter serve target populations and reduce health care costs.

Safety-net clinic design has a substantial impact on the effectiveness of innovativecare delivery models.

However, guidelines and literature are limited.


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Purpose of Paper

To identify key features of the physical environment design for new care deliverymodels

To provide preliminary design recommendations


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Key Design Features

Innovative Care Models in Safety-Net Clinics


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La Maestra

, , ,Pediatrics, Family Medicine

Additional Services: Nutrition and obesity, Prenataland Ultrasound, Pharmacy, Optometry, HumanTrafficking, Domestic Violence, Vision, Housingassistance, Literacy training, Laboratory, Substance

Abuse, Food pantry, Economic development


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Design recommendations

Co-Location of Services

Determination of services provided based on communitys needs

collecting anecdotal information documenting existing services in the area, analyzing the special needs of targeted populations,

and formally soliciting inputs

Focus groups, community meetings, interviews, and questionnaire

Facilitating patient flow and way-finding

a cognitively comprehensible layout design

hi h visibilit of ma or destinations

perpendicular intersections

location of key facilities near the main hallway

signs


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Outreach of Services Mobile Clinics

An innovative way to reduce health care disparity by moving care settings closer tothe homeless and underserved populations

Examples:

Clinica Sierra Vista

Project HOPE (Health Outreach for People Everywhere) of Shasta Community

Health Center in Redding, CA Salud Family Health Centers in Colorado


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Outreach of Services Mobile Clinics

Size and interior layout should be determined by the services to be provided

Large operable windows should be installed to reduce claustrophobia and providenatural ventilation

Proper insulation and air-conditioning for energy conservation, thermal comfort,medical equipment maintenance

Finish materials - ease of maintenance and disinfection Barrier-free environment for disabilities


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Patient-Centered Care

Patient-centered care is a key component of many innovative care delivery models

for the uninsured and underserved

A healing, empowering, and supportive physical environment is an essential part ofpatient-centered care models.


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Patient-Centered Care

A welcoming environment (aesthetics)

Architectural motifs, signs, colors, and materials that are familiar to the localcommunity

emotional discomfort

Extra spaces and amenities support patients families to meet patients need for social support Improve patients physical comfort

Comfortable and adjustable furniture Efficient ventilation and air conditioning Glare reduction Partition design ensures visual and audio privacy


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Space for Team Collaboration

Effective collaboration between health care professionals is very important in

innovative care delivery models that emphasize a holistic approach and deployinterdisciplinary teams for care delivery.

Improves understanding of team members knowledge and skills,

Enhances decision-making,

Raises job satisfaction Boosts efficiency

Failures of team collaboration are not uncommon


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Use of New Technology Telemedicine

Telemedicine, a fast-growing means of health care delivery to patients in remote,

rural, and underserved areas

Depending on the needs at specific facilities, telemedicine can encompass a varietyof technologies and applications

Telephones, robotic instruments, interactive videoconferencing, biosensors,

artificial intelligence, patient information storage and transmission


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Use of New Technology Telemedicine

A componentbased framework including a set of functionality components

provides a cost-effective way to construct a telemedicine system Accommodate probable future changes because of rapid technological progress

- Suitable lighting design and interior finish materials are essential to enhance the quality of

video images

Locate the telemedicine room away from noise sources and use high-quality acousticceilin tiles Convenient location of electric and Internet outlets Careful selection of telemedicine apparatus


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In SummaryPatient Experience

Welcoming, familiar, unintimidating

Patient-centered care: developing personal relationships

One-sto care

Family member presence & participation


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In SummaryProvider Experience

Interdisciplinary teams

Collaboration & group interactions

Technolo ical advances


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In SummaryCommunity Experience

Location, location, location

Way-finding

Outreach ro rams


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CHCF Seminar Whitepapers FINAL

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