“Hospital interiors are where aesthetic indigestion really sets in, where the patient or visitor is most seriously challenged.” - Roger K. Lewis, Washington Post, 4/20/02

 

Once upon a time, typical health care consumers parked in the furthest lot from the hospital door, and frequently found that door wasn’t even the right entry. Exterior signage was inadequate or confusing, and it didn’t get much better inside. Mazes of corridors and lack of wayfinding devices (except maybe a bunch of colored lines on the floor) made it difficult to get anywhere without asking for help. At their destination (after a lengthy registration process) patients nearly always endured long waits in crowded waiting areas, with coughing neighbors, screaming babies, and loud televisions tuned to insufferable shows. And the fun didn’t stop once the patients were seen. Many patients suffered additional indignities as they were shuffled from one department to another for batteries of tests – and each department had its own version of waiting room hell. No wonder people groaned at the prospect of a visit.

 

Times have changed.

 

The booming economy of the late 1990s, coupled with insurance reform and the ubiquity of the Internet, has given rise to a new breed of health care consumers – people with the money, knowledge, and clout to choose their health care providers. To avoid customer defection in the new era of choice, hospitals are changing. Forward-thinking providers are courting the patient population, offering convenience, comfort, and confidence through staff attitude and efficiency – and through their facilities.

 

Aging Baby Boomers – educated and financially influential consumers – are the major drivers of change within the health care delivery system. Not only are Boomers demanding more from their usual health care providers, they are influencing a trend toward super-specialty or “niche” hospitals that concentrate on the treatment of particular groups of diseases or disorders, like oncology, orthopedics, or cardiology.

 

One firm, RTKL, is addressing this New Consumerism in the planning and design of health care facilities, whether all-new hospitals, major additions, or renovation programs. These facilities offer a glimpse into the future of health care delivery.

 

Thinking Inside the Box

 

At Florida Hospital in Tavares, a community 40 miles north of Orlando, an aging population was demanding competent treatment in a comfortable setting, and encountering an over-extended caregiving staff working in crowded conditions. The hospital’s owner, Adventist Health Systems, turned to RTKL for the design of a new hospital that could serve a community where most patients were in their 70’s and which could compete in a saturated market.

 

“People have pre-conceived notions about visiting medical facilities,” says John Castorina, AIA, the RTKL vice-president-in-charge of the project’s design. “Our goal was to change those impressions by giving them a relaxed environment that didn’t look like a hospital, but which still delivered the very best in care.”

 

The new Florida Hospital Waterman promises to do just that. It will not only attract new patients, it will also significantly improve the working environment of the staff and thus the quality of care. The 450,000-square-foot facility offers the latest in medical care and technology in a decidedly different atmosphere. The building is infused with a hospitality ambience; it is enriched by retail space, novelty stands, and art displays; and it offers a cafeteria, a restaurant, and outdoor park-like areas for the convenience and respite of patients, visitors, and staff. Other innovations include lobbies and central control stations on each unit that act as “funnels” for the patients. It is virtually impossible to avoid being greeted or to become lost. As an option to remaining in the waiting area, patients and their families may take hand-held beepers and enjoy the building’s amenities until summoned to their appointments.

 

“The goal is to give people – patients, their families, and the staff – a sense of empowerment,” says Castorina. Fundamental to the success of a new hospital in a fiercely competitive market, these improvements illustrate how health care can be made better through design. The first phase of the $76 million project is slated for completion in October of 2002.

 

Hospitals with Heart

 

As Boomers grow older, so do their hearts. The incidence of heart disease, the nation’s leading cause of death, is only going to increase.

 

Community Hospitals Indianapolis recognized this reality and decided it was time for a special “niche” hospital, one offering heart services ranging from wellness screenings to open heart surgery. Working with Community Hospitals Indianapolis and a local physician practice, RTKL developed the design for the new Indiana Heart Hospital, a smart and inventive answer to a rising need and an educated consumer.

 

The design team envisioned an integrated plan in which every element supports the facility’s unique focus. Because open-heart surgery patients begin ambulatory therapy within 12 to 24 hours after surgery, and because family members now play an important role in patient rehabilitation, the hospital incorporates an ambulation arena and temporary family lounges outside patient rooms. Nursing units are designed to handle post-op as well as recuperation. A one-stop shop, the hospital has its own emergency room and pharmacy.

 

“This building allows Community Hospitals to centralize its cardiovascular services in a facility that caters specifically to those receiving and delivering cardio care,” says Castorina. The 64-bed, $60 million structure offers a number of special features, including an inventive patient care unit. Dubbed “The Hurricane,” the unit allows entire nursing teams to move among patients while keeping other patients and nurses within sight and earshot. This configuration allows continuous, thorough care for every patient on the floor and rapid response to emergency situations. Other conveniences include a discharge lounge and a concierge service. The hospital is expected to open in late 2002.

 

Even in Trauma

 

Sometimes people don’t have a choice when it comes to emergency care. Sometimes they do. Today, the emergency department is an essential source of inpatients. Offering patient-friendly, technologically superior emergency services can serve to differentiate a hospital from its competitors and draw consumers.

 

RTKL provided programming and design for the new 400,000-square-foot Trauma/Critical Care Building for Community Regional Medical Center in Fresno, California. Two major goals were to provide patients with full critical care services without multiple departmental transfers, and to reduce the average length of stay.

 

An expeditious intake process limits patient registration to critical questions if a treatment bay is available. The balance of the registration is completed at the patient bedside. A real-time electronic tracking system shows the locations of patients and their test results, mitigating lost time and confusion. Digital imaging equipment is located right in the emergency department, so physicians can immediately view images and quickly formulate optimal treatment plans.

 

The waiting area, visible from registration, triage, and security stations, is remarkably patient-friendly. To enhance the sense of privacy, the area is divided into more intimate zones through the introduction of low decorative dividers. When standing, patients can view the entire area; when seated, patients and their families are afforded a degree of privacy. Enclosed inner waiting rooms, a separate waiting area for Pediatrics, and enclosed treatment positions with two chairs for family members, also protect the privacy of patients.

 

The emergency department is a place that can attract both patients and staff, even as it deals with life-threatening injuries and illnesses.

 

Customers First

 

In the past, a lack of competition and insurance restrictions meant that patients often had no say in the choice of a hospital. The result? Too many frustrated customers. Too many negative experiences.

 

Today, the customer comes first.

 

In a fiercely competitive market, cutting-edge yet comfortable health care environments are a necessity. The best hospitals serve patients and their families graciously, expeditiously, and effectively. The best hospitals attract and retain staff, and assure that they deliver the highest level of care by providing areas of respite and rejuvenation. This serves to improve patient care and eliminate clinical error.

 

Forward-looking health care environments are the result of designs that enhance productivity, help improve the quality of care, and bolster consumer confidence and satisfaction. And a great facility can raise a health care organization above its competition.

 

As the health care consumer grows more demanding, as health care providers grow more competitive, and as economic and legislative trends continue to have a dramatic impact on everything from reimbursement to business growth strategies, hospitals will increasingly look for ways to position themselves. Facilities are a way to compete and advance.

 

Additional projects pictured:

 

Christus Santa Rosa Medical Center, San Antonio, TX: RTKL completed the preliminary design for the master plan of this facility located in San Antonio, Texas.

 

St Luke's Episcopal Hospital, Denton A. Cooley Building, Houston, TX:

Located in one of the most densely populated urban settings in the country, St. Luke's Episcopal Hospital is working with RTKL to implement a phased master plan. The first phase, was the move the Texas Heart Institute from a space within the hospital into its own building named after Denton A. Cooley, a pioneering heart surgeon.

 

Memorial Hospital, Colorado Springs, CO:

Winner of a Modern Healthcare design award, this multi-phase redevelopment has at its core a new seven-story tower housing diagnostic/treatment services and inpatient beds. The new complex works both internally and externally to facilitate efficient delivery in a positive healing environment.

 

Memorial Hospital, Printers Park Medical Plaza, Colorado Springs, CO:

A new 267,000-square-foot medical plaza, this facility is designed like a hospital without beds. It includes a series of clinics, independent physician office space, a conference center for educational activities, and supporting amenities.

 

One of the world’s most highly recognized multi-disciplinary design firms, RTKL has amassed a portfolio of work that exceeds 1 billion square feet and extends to 60 nations. With 14 offices located around the globe, the firm’s expertise includes planning and urban design, mixed-use developments, retail and entertainment centers, hotels, resorts, office facilities, government buildings, healthcare facilities, and engineering services

 

Leeza Hoyt is a writer based in southern California.