3 Ways Healthcare Facility Planning and Design Can Improve Patient Outcomes
Starting in medical school, patient safety is woven into the hearts and minds of physicians. While the Hippocratic Oath has been modernized over time, the patient-centric message of “to do good or to do no harm,” remains.
However, although healthcare professionals work tirelessly to improve patient outcomes, imminent harm can be difficult to predict and control. As an example, consider recent reports of patient illness and death from infected waste in a Glasgow medical facility. After two patient fatalities, the hospital is facing scrutiny of its water filtration systems, which are currently being upgraded putting contractors into the hot seat. It’s not entirely clear that construction practices lead to contamination, but it’s certainly a question many are now asking.
Was proper oversight involved? Did construction teams have all the information and data needed to make an informed decision? If another company had designed the systems, would this still have happened? What if another company had constructed them? Reviewed them? Upgraded them? Could other systems be compromised?
Incidents like this force us to ask hard questions, questions we’d all rather not have to ask. Nevertheless, it’s vital these questions are put in the spotlight to improve healthcare construction on the whole. In light of that, and since 2019 Patient Safety Awareness Week is this week, it’s more important now than ever for construction teams to pay attention to healthcare facility planning and design, specifically with an eye to how it impacts patient, public and jobsite safety. While poor or overlooked design and construction aren’t the only causes of situations like these, they most certainly play a role–and it’s our responsibility to address the issue.
Here are three ways construction teams can play a significant role in maintaining health and safety in our healthcare institutions around the world.
1. Emphasizing Patient Centric-Designs
Unfortunately, smart, safe healthcare facility planning and design don’t just “happen.”
At the very start of a construction project, designers have a significant role to play in impacting patient safety, and it’s critical we acknowledge this responsibility. Today, we need a patient-centric approach to designs: increasing the efficiency of rooms, making the most of extra spaces, simplifying safety routines for personnel, and–like the doctors and nurses themselves–avoiding doing any harm throughout the process.
Even lighting and the smallest details matter when it comes to providing the best care for patients. According to a Health Facilities Management report, “Research also shows that designing spaces that optimize staff efficiency and supports their workflow improves patient safety, leading to fewer medical errors.”
WHR Architects Director Laurie Waggener told HFM, “If you design to facilitate the front-line practitioners’ workplace needs, you can contribute to patient safety. If we’re providing the nurses what they need at the time they need it, that’s creating an efficient environment and it is known to reduce medical errors and expedite care delivery.”
Other research shows correlations between the physical environment, the patient and the healthcare practitioners. By building intelligently designed spaces, we can help increase patient health and generate more positive hospital outcomes.
One of the best ways to approach healthcare facility planning and design is through Building Information Modeling (BIM). As defined by Constructible, “BIM is a highly collaborative process that allows multiple stakeholders and AEC (architecture, engineering, construction) professionals to collaborate on the planning, design and construction of a building within one 3D model.”
This highly collaborative approach does away with the downsides of siloed construction, in which various teams, contractors and stakeholders all try to meet their own objectives without consideration for others’. Instead, each has access to the building’s three-dimensional design details and can contribute information that helps to enlighten the whole. This model can carry the entire team from the project’s inception to the final handover and occupancy.
BIM can also be integrated with virtual reality (VR) so that teams can walk through patient rooms and conduct structural reviews and test efficiency. Moreover, it allows end users like doctors and nurses to visualize the space before it’s built. When healthcare facility planning and design teams gather feedback before construction, they’re even likelier to build useful spaces that prioritize patient outcomes.
Once designed and built, though, the hospital can only function if the entire design and building process adhere to rigorous standards, which will carry through the lifetime of the building and its occupants.
2. Maintaining Exacting Standards
In no other sector of construction are there as many regulations and standards to meet as in healthcare. Naturally, that means that healthcare facility planning and design is exacting as well. This becomes even more of a challenge when the hospital or clinic has patients in residence during the construction process. Even construction projects that might not necessarily be in the healthcare sector still need to consider proximity. Take the “major setback” experienced by the Durham-Orange Light Rail Transit project as an example. Project plans were put on hold due to the potential impact it would have on Duke’s nearby patient and biomedical research facilities.
“Working in healthcare and hospitals, you can’t do anything to endanger the safety of the patients or your visitors, and that is really the top priority, beyond anything,” says James Barnes. As Project Manager for McElroy Specialty Interiors, a commercial drywall outfit also based in Atlanta, Barnes has plenty of experience completing complex construction tasks in buildings adjacent to occupied facilities, or in wings of the buildings themselves.
Moreover, says Rachel Shingleton, Assistant Project Manager for Brasfield & Gorrie, “We have to make sure we’re not putting patients at risk of infection or complicating any illnesses that they might already have.”
As a result, healthcare facility planning and design construction teams need to operate at a high level of coordination and efficiency. That means:
- Staying on top of all project changes in real time
- Communicating changes and updates to members of the team and other teams as quickly as possible through integrated communications systems
- Coordinating tasks to a high degree, to account for the complexity of the healthcare system
It is this complexity that creates such a challenge for healthcare construction workers. For instance, mechanical, electrical and plumbing (MEP) are some of the most intricate in healthcare systems, and one small mistake could put patients at risk. Patients need unpolluted air, water, gases, medical supplies and other necessities, and errors in construction or operation–as we saw with the Glasgow case–can have fatal results.
Therefore, healthcare construction companies should maximize use of construction cloud collaboration software to connect on designs and important changes and documents. This will help them better maintain health standards and regulations. A thorough understanding of the whole built environment and what needs to be attended to is essential for passing inspections and keeping patients healthy down the line.
3. Addressing Facilities Faster
In all major buildings, attending to facility needs quickly and accurately is essential. But in healthcare facility planning and design, as well as healthcare construction, it becomes a true life-or-death imperative. If something goes wrong, patient lives are on the line.
The answer? Having access to complete and updated construction data in operations and maintenance. Basically, you need your construction data to be portable and accessible in a moments notice. This is critical to reducing hazards, and it also saves facilities time and money.
“The Stanford University Neuroscience Health Center is a case study of how BIM in operations can improve quality and reduce costs,” Healthcare Business Today reports.
“By applying BIM in operations to the 92,000-square-foot facility, which centralizes comprehensive care of neuroscience patients, the center realized many benefits including quick response times and a 4.5% reduction in maintenance costs.”
Moreover, says the journal, BIM’s 3D visualization abilities led to a 60-70% reduction in repairs. When building and maintenance staff have easy visual access to the location of patient and procedural rooms, their jobs become much more streamlined. The same goes for when they can pull up specs such as ceiling height, tile placement and materials affected in the blink of an eye. They can plan their routes, tools and approaches in significantly shorter timespans–and with far fewer trips to and from the worksite. This is, of course, better for patients as well, who spend less time surrounded by the disruption of construction.
“In one case, the correction time was reduced by 80% or two hours,” Healthcare Business Today adds, tacking on some additional impressive figures: “With the data supplied by BIM, the time needed to resolve the second case was decreased by 63%, a savings of 35 hours, and BIM allowed systems engineers and field staff to communicate more efficiently.”
Of course, this only works if all workers, contractors, managers and stakeholders have access to the information and the ability to update it. In real time, that is. Given the rapid rate of construction and the many, many changes that take place throughout the course of a renovation or add-on, lightning-fast cloud-based construction software is a must.
Healthcare Facilities and Patient Safety: A Brighter Future?
Naturally, we all want to imagine a bright future for healthcare facility planning and design. Rosy thoughts and high hopes do not a safe environment make, however. While construction professionals shouldn’t have to take the Hippocratic Oath, they should work with its primary principles in mind. It’s up to construction teams to implement and enforce the above safety steps and best practices–for the sake of the hospital, for the sake of your company’s reputation and for the sake of our fellow human beings.