Case Study: Focusing on the Patient A Deeper Look Many seniors and their family caregivers find themselves in need of Behavioral Health Services at some point in their lives. A Behavioral Health Unit focused on senior patients may see a vast difference in the specific needs of its patients, both in acuity and physical / mental cognition. We employ Lean Assessments and design strategies to help our clients focus their resources on the areas that will bring the most benefit to the patients.
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case study: emergency departments | PAGE 1
Mobilize for Patient Satisfaction BEHAVIORAL HEALTH
PROCESS OVERVIEW
CHALLENGE
The design teams facilitated a series of Lean design events to assess the client’s current
To expand the program to better fit the needs of two distinct patient populations - higher functioning and more acute care. The team was also charged with incorporating the client’s experiential design concepts to help tell a story within the space.
SOLUTION The team was able to create two wings within the unit to separate and serve the needs to the two populations while allowing a core space to provide shared services. The design incorporated many experience design concepts for both patients and staff to create an engaging and healing space.
state, validate and prioritize their goals, identify areas of improvement and map their ideal future state. For this client, the future state sought to minimize or eliminate the features and workflows that detract from the patient experience in the current state.
The series of Lean events took place over several weeks after the team observed the workflow of the current behavioral health unit. The team performed a targeted work session with patient room and toilet room mock-ups. The data collected during the Discovery and Analysis phases was turned into a floor plan for the new unit which satisfied the top priorities of the team. The plan was unanimously accepted with minor modifications.
Implementation Methods •
Observation and current state mapping
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Empathy Mapping
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Conditions of satisfaction: Top Dot Voting
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Future State Mapping
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Rapid schematic level mock-up
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CURRENT CONDITIONS Holy Redeemer is a faith-based hospital serving the surrounding community, the residents of its independent/assisted living communities as well as the skilled nursing facility adjacent to the Hospital. Their current Senior Behavioral Health Unit is a 14-bed unit occupying a converted med-surg department. The space provides caregivers with a less than ideal floor plan with inadequate space for therapy. The
Guide the project team to capture the vision and deliver the right project.
dining/activity room had no visibility from the nurse station, requiring a caregiver to be in the room at all times or the patients to be queued in the hall prior to each meal/activity. The lack of flexible communal area often required multiple activities to be collocated. The team observed meals being served to some patients while physical therapy was happening at the same table with blood draw occurring in the same room. Cramped conditions in the patient toilet rooms were a major safety concern of the staff. The conversion of med-surg rooms with small toilet spaces made it difficult for staff members to assist the patient. The patients are often in wheelchairs or geriatric chairs and must be walked into the toilet room, creating a fall risk for the patient and a potential injury to the caregiver. The review of the current state revealed many storm clouds created by the physical environment and the operations of the unit in a virtual patient day. The arrival of patients to the Hospital is often a predictable event, but delays in patient assessments in the Emergency Department often caused a ripple effect in getting the patient admitted to the Unit and comfortably in a room.
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Collaboration to Define the Future
DATA When Holy Redeemer first conceived of this project, they solicited the help of their Patient Experience team to assist them in visualizing how the space could feel and what amenities might be added to enhance the patients’ family and caregivers experience. They produced a “Dream Book” that summarized the efforts of their initial visioning. We used the ideas and imagery as a starting point. For one of the early visioning sessions the team used “top dot” voting to draw out what the staff felt was the most important and prioritize which enhancements would be incorporated into the project. Things like televisions in the patient rooms and areas for family members to stay overnight were quickly weeded out and higher priorities such as personalization in the patient rooms and nature sounds and imagery rose to the top. FUTURE STATE The diverse, multi-disciplinary teams of users involved in mapping the current state brought much insight to the future state meetings. The groups prioritized the issues and amenities most important to be included in the new unit.
• Sensory opportunities throughout the Unit • Residential feel to the interior design • Optimal visibility from nurse station to dining and quiet rooms • Adequate toilet rooms • Designated physical therapy area • Increased storage/activity resources located within the rooms • On-stage/off-stage circulation to limit locked unit access for dietary and environmental staff
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Who We Are
With Quality and Safety as the top two priorities for families,
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number three was identified as the Patient Experience. Three factors contribute to ideal experiences: people, process and place. By evaluating all three, organizations can create a link between their core values and the healing space design to create differentiating touch points for the patient’s experience.
We Are Healthcare Architects
Evaluating the Experience through these three perspectives, you are able to create the theme, “The Big Idea,” to unite the space. This theme aids in setting the major design guiding principles for Dreamscaping which allows the team to imagine the greatest experiences by examining and understanding the ideal future state. Experiential Design can create individualized experiences which anticipate unknown needs, increasing the healing value to the patient. By incorporating the Patient Experience into the design, the environment encourages transformational thinking which can have positive effects on healing in a Behavioral Health setting. One design element to personalize and engage the patient is the patient memory box. By bringing small mementos that inspire thoughts of family, home and comfort - patients may more readily share their life story and experiences and connect to their care providers in a different way that may aid in their acceptance of care. The Big Idea and Dreamscaping also affects the design of the
We are a team of architects and designers with unique backgrounds, but we all have one thing in common - we share a strong desire to use our expertise and knowledge to design solutions that will help people in moments that matter most. This focus makes us leaders in our field. There’s a degree of compassion, empathy, and sensitivity that goes into every project that we touch. It’s designing a nurse station with sight lines to every patient. It’s building a Behavioral Health facility without corners, so that patients are safe. It’s translating the operational needs through the technical details to fine tune the lighting system in a neonatal unit so caregivers can match the lighting to each baby’s stage of development. It is a deeper understanding, honed through relationships spanning decades. Together, we discover optimal solutions with our clients. It is our four decades of specialization that allows for effective communication, collaboration and precision in the complex, changing world of healthcare.
staff-only space. In Behavioral Health, as in so many service lines, off-stage space for clinicians - whether their break room/ lounge or quiet space for patient documentation and peer discussions - is an important factor in staff satisfaction and retention. Holy Redeemer’s Dreamscaping also allows staff to express their life story and individualize their environment which provides much needed respite from the patients when they are not providing direct patient care.
Array’s Knowledge Communities We believe strongly in sharing our expertise and knowledge with others. We invite you to explore each of our thought leaders and share your thoughts with the healthcare design community. Click here to visit our Thoughts page.
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to view our thought leadership on behavioral health
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