The healthcare design and construction picture has been muddied by uncertainty over the new healthcare law. Hospital systems are in a bind, not knowing what levels of reimbursement to expect. Building Teams serving this sector will have to work even harder to meet growing client demands.

March 01, 2012

4. Make spaces more flexible for multiple uses

Stamford (Conn.) Medical Center, designed by WHR Architects. The facility’s emergency department will link triage and testing/treatment rooms to move less critical patients more quickly through the ED. This will enable staff to provide a quick evaluation and appropriate level of care.

Making space as flexible as possible so that it can accommodate a variety of functions or be repurposed in the future at reasonable cost is an increasingly popular highest-value trend. In a survey of attendees at last fall’s Healthcare Design Conference, Mortenson Construction found that nearly half (48%) of healthcare provider respondents “strongly agreed” that healthcare designs must put greater weight on flexibility to address uncertainties in markets, care delivery, and patient volume.

To save money for Middle Tennessee Medical Center, Gresham, Smith and Partners took two departments that traditionally have been kept apart—preadmission testing and the ER—and put them back-to-back.

“The ER tends to be busiest in the evening, while the preadmission area is busiest during the day. We put them back to back so that they would provide surge capacity for each other,” says Gresham’s Gore. Each area has 10 equally sized rooms containing the exact same equipment, thus enabling staff to provide either ER care or preadmission testing in either space.

Stamford (Conn.) Medical Center, designed by WHR, employs a similar ER strategy. “If the staff need to do a test like an EKG, there’s a testing room behind the triage space,” says Charles Cadenhead, FAIA, FACHA, FCCCM, a senior principal with WHR. “The goal is to give a quick assessment and the most appropriate treatment as fast as possible.”

The linkage of triage and testing/treatment rooms speeds up this process. Triage takes about 15 minutes per patient, and about 10% of patients are released right after being examined. Under the old protocol, all patients would be sent from triage to an examination room to wait for a physician’s evaluation. Now, the staff can triage and diagnose in the same room, allowing them to treat more patients in a given time period, thereby increasing patient throughput.


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