In 2022, it is clear that the practice of healthcare design remains a dynamic and challenging one. As designers, we have worked hard to respond to changing needs, manage stalled project timelines, and navigate supply chain and labor challenges. We don’t have a crystal ball or any certainty on what will happen to our industry next. In March 2020, I recall naively thinking that this would all blow over in a few weeks. Here we are almost 2 years later! So, where do we go from here? What can we look forward to in 2022 and beyond?
The Importance of Caring for the Caregivers
One of the major challenges facing the healthcare industry is staffing—caregivers have taken the brunt of the pandemic stresses for 2 years and are burning out and leaving direct patient care. Health systems have been forced to limit nonemergent procedures, limit admissions, and even consolidate facilities because there are not enough staff to provide patient care. The consequence is lost revenue, increased costs due to reliance on travel nurses, and a detrimental impact on overall patient outcomes. The healthcare design industry cannot solve such a complex problem alone, but we can be part of the solution.
It’s proven that the built environment positively impact patient outcomes—I believe that the same can apply to staff spaces. Too often, caregiver respite areas are afterthoughts, relegated to cramped, windowless spaces with few amenities. As we move forward, we need to work with our clients to make these environments reflect the value these critical employees bring and ensure they are truly places to rest, recharge, and connect with colleagues. That might mean access to outdoor space, comfortable lounge seating, or private areas to rest during a long shift.
Efficiency Is Key
An upgraded staff lounge is no good if the workers don’t have time to use the facilities. The design community can’t change increased caregiver workloads, but we can work closely with staff on process improvements.
Some studies indicate that up to 40% of clinical office work is redundant or wasted effort, so we can make this a focus of our design programming. Work closely with clinical employees to determine where current bottlenecks are and where steps are wasted. Some potential time savers can include decentralizing critical supplies to reduce back and forth travel, using automation and technology to eliminate manual processes, and standardizing rooms and equipment.
Implementing standard designs and furniture in patient spaces can help ensure uniform and consistent processes. Reducing room variations can save staff time looking for needed items during a patient visit and potentially allow any provider to use any room during busy times. Standardizing furniture, surface materials, and equipment can have the additional benefit of saving time for maintenance staff and environmental services as well.
Flexibility Isn’t Optional
The past 2 years have shown us that the move toward resilient and flexible healthcare spaces is increasingly important. We’ve seen clinic spaces transformed into vaccination centers, hospital units moved to COVID wards, and in an extreme case, a parking deck used as overflow care space. Healthcare design needs to continue to push boundaries as to what is possible as we prepare for post-COVID and potential future pandemics.
Many of these changes will take place at the architectural level, like improving HVAC, using UVC lighting, and increasing the ability to effectively isolate infectious patients. From a design perspective, we can plan interior spaces that promote teamwork and coordination of care among staff and help patients communicate with family by including screens and technology that allow remote communication.
The New Waiting Room
From a patient and family perspective, the waiting area is one of the biggest changes to healthcare facilities during the pandemic. Some healthcare facilities have eliminated them altogether, opting for a self-rooming model. Most others have removed much of the existing seating to provide safer distancing between patients. Packing waiting rooms as densely as possible with rows of bus-station-like seating is a thing of the past.
There will always need to be patient and family-friendly waiting areas—as designers, I think we can take lessons learned from COVID and make these spaces welcoming and safe for all. Studies show that patients prefer seats with a direct line of sight to either the reception desk or doorway to treatment spaces (or both). Patients want to ensure they aren’t “forgotten,” and those with visual or auditory limitations want to ensure they aren’t missed. Create smaller groupings of varied types of seating rather than long rows of chairs – this ensures that everyone can be accommodated safely and allows privacy for families that may want to discuss health issues.
If space permits, designate “sick” and “well” waiting areas where those coming in for routine care are separated from potentially infectious patients. This design strategy has been used very effectively in pediatric practices. Using wider seats—like benches, loveseats, or bariatric chairs can help create distance between patients while offering a safe place for larger users.
One of the many challenges facilities faced during the pandemic was the degradation of surface materials due to increased cleaning protocols. It’s more important than ever to strategically choose materials in healthcare spaces. Manufacturers are working hard to bring innovative materials to the design community that will withstand harsh disinfectants while still being safe for users. The choices are overwhelming—how can we choose a material that performs well while still meeting our aesthetic goals?
The DCF (Durable Coated Fabrics) Task Group is an interdisciplinary team of designers, textile suppliers, and furniture manufacturers working on this challenge since 2017. They publish ongoing updates, recommendations, and research on materials that have been tested in healthcare settings. By reviewing their recommended performance standards and CFFA (Chemical Fabrics and Films Association) certified products, you will find a group of materials tested thoroughly in health environments.
The past 2 years have been challenging for the healthcare design community but have taught us many valuable lessons that we can use to create more effective spaces for patients and caregivers. There is no way to predict what 2022 (and beyond) may hold, but we have a strong community of passionate designers dedicated to delivering beautiful, safe, and efficient healthcare spaces. I am excited to see where the future takes us!