by Jason Costello
With the current and proposed changes to our nation’s healthcare delivery system, there is one aspect of healthcare that is often overlooked: the healthcare setting as a workplace. The workplace is an environment where your greatest asset — your people — come together to invent, produce, create, and, frequently, improve the lives of others, and nowhere is the latter more true than in a healthcare workplace. Large hospitals and medical centers may employ thousands of patient-focused staff, including doctors, nurses, lab technicians, and a variety of medical support employees in every capacity. The healthcare setting is their workplace, and healthcare organizations are right to be embracing the current trend in workplace strategy for rethinking the design of healthcare settings.
Just like their corporate counterparts, healthcare organizations function in a highly competitive marketplace for both new patients and physicians. Hospitals aim to attract — and retain — the best medical talent, and administrators understand that the work environments they create for employees play a significant role in achieving that goal. The different workstyle needs of a multigenerational medical workforce are also a consideration in workplace design. Finally, space utilization, collaboration, and technology are each playing a role in this overlay of healthcare and workplace strategy.
Broader changes to the healthcare team are shifting space and technology requirements in hospitals as well as medical offices. For example, a collaborative treatment team in a patient-centered medical home model must accommodate an interdisciplinary team, including a physician, social worker, nutritionist, physical therapist, and other providers. This team-based approach requires technology-enabled meeting spaces for the team to develop treatment plans and review patient care progress, especially for chronic conditions like hypertension, diabetes, and obesity. Conference spaces are also needed to accommodate patients participating in group education programs, particularly with the trend to incorporate behavioral health into primary care.
Corresponding to the space needs of new healthcare delivery models, hospitals are investing considerable resources to convert to electronic health records (EHRs), digitizing patient records, and eliminating the need for paper filing. This paperless approach has extended to the patient’s bedside, with clinicians requiring mobile connectivity to access medical records while doing rounds. Hospitals are redefining mobile work to address the needs of clinicians who may not have a personal office (or even a desk) on campus but still require access to digital information beyond the capacities of their phones.
Hospitals are also taking a new look at space utilization and evaluating administrative, department, and clinical support spaces for efficiency. The anesthesia department at a major Boston-area teaching hospital had grown by 30%, but available space limited its response to growth to an ad hoc expansion in different locations that led to a variety of inefficiencies. It was evident that the nonclinical shared office space for anesthesiologists, located adjacent to the surgery department, wasn’t efficient, and when studied, Margulies Perruzzi Architects (MPA) found that shared offices were utilized only one day a week — a 20% utilization rate. Rotating surgical, teaching, and research schedules by doctors sharing an office resulted in this space inefficiency.
Working with MPA, the anesthesiology department reflected on how the space could be better utilized as well as facilitate interaction and communication. The solution was to move the group offices and create hoteling work spaces in a nearby administrative building, providing physicians with space for task-intensive research in less valuable real estate. Training rooms, huddle spaces, as well as high-density benching solutions for checking email and resident research were designed in direct proximity to the operating room to allow staff to productively utilize time between cases. The new setup allows the anesthesiologist to meet with residents in a convenient huddle space after surgery, rather than walk across campus. The task-based, high-utilization design will transform the space into a shared resource for everyone in the department.
Finally, the design of multifunction spaces is another page taken from corporate workplace strategy. For the anesthesiology department in its new location, a break and lounge space doubles as a collaboration room for presentations and meetings. The movable café furniture ensures that the space stays active throughout the day, providing a casual setting that creates community and supports social interaction.
The healthcare setting is intrinsically a task-based work space, one that is shifting in design requirements. With the emergence of new medical delivery models, the need for improved utilization, and the desire to attract and retain top medical talent, healthcare organizations are tapping workplace strategy best practices to rethink the healthcare workplace.
Jason Costello, AIA, EDAC, is an associate principal and partner at Margulies Perruzzi Architects.
