If you like this post, please share:

If you liked this post, please share:

I was surprised at how many people commented on the post I wrote last week, Why One Size Fits All Patient Rooms Don’t Work.

Apparently, I struck a chord when I called for designing choice into patient rooms.

I was lamenting the fact that not all patient chairs, beds, and patient room bathrooms fit all sizes of patients.

Last week, I saw this firsthand when my 5’2″ mother was hospitalized.

Among other things, I wondered why hospitals couldn’t offer a selection of patient room chairs to accommodate different body types.

Dean Russell wrote in response to my post, “Creating choice is an admirable goal. Unfortunately, the cost of building and designing healthcare facilities is astronomical.”

“How do you propose creating a more tailored experience without adding cost? As a designer, I would argue this isn’t a design issue, it’s a financial issue…Cash fixes lots of design problems.”

Money, Money, Money

Does it always have to come down to money?  If that’s the case, when will healthcare decision-makers understand that investing in design makes good business sense?

That a patient who is comfortable in her chair may not call for the nurse so often? Which means that the nurse may not take as many steps during her shift, causing her to be less stressed, leading to greater productivity and less turnover?

Assumptions yes, but there have been studies that show how unit layout contributes to more steps and nurse fatigue. And do you know how much it costs to replace a nurse? $36,000-$57,000, according to HR firm Streamline Verify.

$36,000-$57,000 would buy lots of different kinds of patient room chairs.

Why Haven’t We Made the Business Case Yet?

After all these years, we’ve yet to collect convincing data to make the business case to invest more in design. People have tried (see my post, Fable Hospital Story Still Needs to be Told), but I really haven’t heard much about it recently.

Why is that?

Well, for one thing, collecting that kind of data takes a lot of time, money, and effort. And healthcare leaders in the U.S. have had their hands full with all the changes that are happening as a result of health reform.

They are all looking at their HCHAPS scores, though.  Because they don’t want to lose their Medicare reimbursements. If we can make the connection between the physical environment and HCAHPS scores, then maybe we can begin to talk about ROI again.

Here’s some good news. The American Society of Healthcare Engineers (ASHE) and the American Hospital Association (AHA) just published a guide that shows how the design of the physical environment affects HCAHPS scores.

I’m encouraged by this. Because if it gets into the right hands, the guide could shift the conversation at some hospitals.

Final Word

Cathy Dolan-Schweitzer of Health Well Done, responded to Russell’s comment on my post by writing, “…the ROI needs to accommodate the new delivery of care compensation in the future.”

“We need to wrap our minds around the hard fact that we are being compensated for quality not quantity. This supports investing in good design based on the sharing of wisdom and experience of teams that are on the frontline taking care of the patients.”

Don’t you agree?

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Robert Levine

4 years ago

Nice post Sara. The problem is it’s easy to show the correlation with healthcare outcomes and good design, but not causation. And it’s possible to get high patient satisfaction scores and still get bad medicine, as well as low satisfaction scores while still getting good medicine.

The real question is why do we have to make a business case for good design. We don’t live our lives making decisions that are only business related. Good designs enrich our lives. Isn’t that good enough?

Sara Marberry

4 years ago

In theory, I agree with you, Bob. But as you well know, in healthcare design and construction, it’s usually all about the budget!

Rachel

4 years ago

Hi Sara,

I like that you brought the topic up about designing with the patient in mind because it is important. ROI is not always cut and dry, but when you keep the customer in mind, the ROI is there one way or another.

Working for an office furniture company, I’m proud to say that we offer many types of chairs that aren’t just your standard computer or waiting room chair, including petite, bariatric and big & tall chairs to name a few. And often, these are among the most popular.

It would be interesting to see a study on the outcome of investing in some of what you mentioned in your post. Let me know if you ever post or come across one!

Rachel

Sara_Marberry_Sq

Sara Marberry, EDAC, is a healthcare design knowledge expert, thought catalyst, and strategic marketing and business development consultant. The author/editor of three books, Sara writes and speaks frequently about industry trends and evidence-based design. She can be reached at sara@saramarberry.com.

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