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03/01/2013

Accommodating the ACA

A look at how the Patient Protection and Affordable Care Act has the potential to influence the future of healthcare design.

By Kylie Wroblaski

 
  • /Portals/3/images/magazine/2013/0313/I_0313_Web_Focus_1.jpg

    Because of the ACA, healthcare designs moving forward will have to be more adaptable and accommodating. Corgan and HDR’s design for the New Parkland Hospital in Dallas provides separate circulation paths for patients and staff to reduce noise and congestion.
    rendering courtesy of HDR+Corgan View larger

  • /Portals/3/images/magazine/2013/0313/I_0313_Web_Focus_2.jpg

    Because of the ACA, healthcare designs moving forward will have to be more adaptable and accommodating. The above nurse’s station, designed by Inner Design Studio, is modular, so it can be reconfigured as the facility’s needs change.
    Photo courtesy of inner design studio View larger

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    The patient rooms at the New Parkland Hospital have been designed to be acuity-adaptable, reducing intra-hospital transfers, while nursing stations have been decentralized to increase staff time spent on direct care.
    rendering courtesy of HDR+Corgan View larger

influx of the insured
Effective January 1, 2014, nearly all individuals in the country will be required to obtain and maintain at least minimum coverage or pay a fine. With a greater number of individuals carrying insurance, there is bound to be a rise in individuals seeking healthcare, as studies have found that the lack of insurance is what currently keeps many from doing so.

To accommodate the influx of new patients and hopefully reduce already overcrowded emergency rooms, hospital systems are rapidly expanding into off-campus outpatient facilities.

READ: Get more resources for the coming changes in healthcare design at the Inside Sources blog.

“We’re seeing more outpatient services,” says Rebecca Donner, principal of Nashville’s Inner Design Studio. “We have a client that’s building these free-standing EDs [emergency departments] and it’s like we can’t build them fast enough. I would say that this past year and going into 2013, there are a lot more services being offered outside the hospital.”

These facilities can offer anything from primary care and surgery to emergency care, be located closer to patient neighborhoods, and built free-standing or in a retail setting. Designers will be expected to provide solutions for caring for more people in an efficient way, all in a variety of environments that may not have previously been considered for healthcare use. Consider having a range of efficient concepts and ideas ready for fast deployment.

paying for positivity
Pay-for-performance requirements in the ACA now tie portions of Medicare payments to hospitals to a range of quality metrics, including “patient experience measures.” That puts the onus on hospital administrators and designers to find ways to create safer and more pleasing patient environments.

“We are seeing an increase in the attention being given to upgrades for hospitals that would improve patient satisfaction,” says Tina Larsen, vice president and healthcare design studio leader with Corgan. “There is compelling research available that shows that patients who perceive the healthcare environment as less stressful and more visually appealing associate the facility with higher levels of care. Upgrades include art and other positive distractions, better acoustics and clear wayfinding.”

Donner provides a recent cancer center as an example of positive distractions in action. The design team chose to create an outdoor healing garden with a waterfall, giving patients a place to sit quietly and relax in-between the rigors of cancer treatment—and hopefully improving the overall perception of care.

In short, good design has a significant and quantifiable effect on the bottom line. Be ready to discuss the benefits of evidence-based design—and bring the numbers to back it up. 


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