As baby boomers age — 10,000 Americans will turn 65 every day for the next 20 years — the total demand for inpatient care will witness enormous growth. With the number of mental health patients on the rise, micro-hospitals are steadily evolving into consumer-friendly environments, taking their cue from the hospitality industry.
In addition, architects are prone to further incorporate digital technologies in the ways in which both patients and employees interact with and within medical spaces. So what features should healthcare designers watch out for in 2018?
Architect Jason Carney, partner at Environments for Health Architecture, shares his views about the subject on these pages. The ensuing interview with Carney is republished by permission of Commercial Property Executive, where it originally appeared.
What are the major trends influencing today’s healthcare industry?
The trend of healthcare as a commodity continues in many different markets across the country. It’s driving the tailored placement of core services at convenient locations and in the design of consumer-friendly spaces that draw from the hospitality industry to attract patients. In these cases, market competition is driving providers to focus on building the “right” styles of facilities, with the “right” services, in the “right” places to attract patients, many of whom are increasingly making healthcare-provider decisions based on how close a facility is to mass transit, a highway off-ramp or a shopping center. Technological innovation and medical breakthroughs are accelerating changes in the way care is delivered and spaces are configured.
It seems industry leaders are moving away from inpatient structures, while micro-hospitals are growing more popular. How does your
vision fit this general framework?
Long-term success of micro-hospitals requires flexibility. As growth occurs or markets change, micro-hospitals need to be able to adapt. It is important to understand the core medical services that are needed in each market to sustain a micro-hospital, and how that facility may grow and adapt over time as the market changes.
How can outdated healthcare facilities be upgraded and adapted to the needs of patients and staff?
Space within an existing hospital campus comes at a premium and must be thoughtfully designed to provide an optimal experience, utilization and return on investment. In some cases, the best choice is to remove outdated buildings and provide for replacement within the existing campus structure.
One version we are seeing is the creation of the “hospital within a hospital,” essentially, a specialty hospital sited within the existing or reconfigured shell of a larger “host” hospital. These can include maternity hospitals, heart-focused hospitals or other specialty hospitals that sit inside a larger medical center. And whether it’s expanding access to tele-health or creating spaces that feel more like extended-stay hotels than inpatient hospitals, opportunities abound to reconfigure existing hospital spaces to better serve patients.
How can large-hospital services be integrated into smaller, off-campus facilities?
One leading solution we see healthcare providers opting for is “micro-hospitals,” which are typically 15,000 to 50,000 square feet in size, open 24/7, and providing five to 15 inpatient beds for observation and short-stay use. Micro-hospitals are an affordable, effective way to provide a large variety of big-hospital services in the community, including surgery, radiology, emergency departments and related services.
At least 19 states now have at least one micro-hospital, and many more are coming. Now that the Centers for Medicare and Medicaid Services have authorized micro-hospitals that have dedicated emergency departments as being eligible for both 340B discounted drug pricing and the Outpatient Prospective Payment System, we expect micro-hospitals will prove increasingly popular with providers and patients alike.
How can new design features offer better solutions to efficiently accommodate cognitively impaired patients as opposed to older construction types?
Between the impacts of the national opioid abuse crisis and the rising awareness of mental health conditions, we’re seeing more hospitals — such as Connecticut’s Waterbury Hospital and Newport Hospital in Rhode Island — reconfigure their emergency departments to accommodate cognitively impaired patients more effectively and more sensitively. A big part of this is simply creating spaces for cognitively impaired people that are thoughtfully segregated from areas serving trauma victims or cardiac arrest patients, places where they can receive a behavioral health or addiction management intervention with compassion and dignity.
Spatial arrangements and interior design elements that improve a patient’s understanding and awareness of their environment while working to reduce anxiety are important components of this design. Also, because patients with cognitive impairment and behavioral issues often require longer stays than the general emergency department population, a definite emerging best design practice is adding features for them such as bathroom showers, places to securely store belongings and access to decompression space.
What can the healthcare industry learn from the hospitality sector in terms of design trends?
We see many hospitals embracing the trend of removing outpatient services from traditional, larger hospitals and moving them into more consumer-friendly, hospitality-influenced environments, like new medical buildings near shopping malls or transportation nodes. These aren’t just spaces that feel more hospitality than hospital, they create operational efficiencies, improve clinical outcomes and reduce readmission rates. There’s also a growing recognition that larger parts of the inpatient hospital experience can be accommodated in less hospital-like environments, which patients prefer.
How will tele-health affect the industry going forward?
Numbers we’ve seen from the healthcare consulting firm Sg2 project that just in the next two years the volume of virtual healthcare patients will rise 7 percent and in-home healthcare services will rise 13 percent. Evermore sophisticated patient monitors and evermore robust communications platforms are allowing more patients to enjoy tele-health consults with physicians and care team professionals. Increasingly, we see tele-health being used to consult with specialists like dermatologists, radiologists, psychiatrists and others without patients having to schedule a second appointment or hospital visit.
How does it influence the actual design of a facility?
Tele-health is absolutely continuing to grow, and healthcare facilities need to be thinking about how to incorporate more of it in their master facility plans. That can mean everything from configuring treatment rooms to accommodate remote consultation and providing infrastructure for broadband video links to heightened attention on the lighting, aesthetics and privacy of rooms in which tele-health consultations will occur. Tele-health technology is also transforming lobbies, common spaces and admissions areas. Increasingly, these areas are being designed to include accessible areas for kiosks or tablets from which patients can register, view their records or videoconference with a provider. As tele-health continues to expand, we will see changes to staffing models and reduction of provider support space at care locations.
What about augmented reality?
As we look even further into the future, the use of augmented reality will change the way that patients interact with providers and how providers collaborate, research and plan their delivery of care.
What can we expect beyond 2018 in terms of trends and challenges in healthcare?
Pressures to manage costs, accommodate continued medical and technological breakthroughs, and meet the preferences and desires of healthcare consumers and practitioners will only grow. New developments in approaches such as gene therapy and bioprinting will drive a greater need for specialized laboratory functions as a component of treatment. Further miniaturization of robotic systems will mean changes in surgery and the way that operating rooms are configured, with a growing emphasis on support for technology-assisted procedures.
Alex Ciorogar is a reporter for Commercial Property Executive. To read the complete and original version of this report, go to this link: https://bit.ly/2Awigr2.