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Welcome to the 21st century
Trish Martineck says that "patient hospitality" is being seen as an element of healing in the US, and suggests that the UK is soon to embrace the concept.
Outside Orlando, Florida, a group of business people drove up a palm tree-lined entry drive to a contemporary, dramatically-lit building. They grabbed their luggage and walked into a spacious atrium with a water feature and headed for the reception desk. The friendly concierge informed the group that they had entered a healthcare facility - not their hotel.
Today in the US, healthcare facilities are designed with many features that spring from concepts of 'hospitality.' Grand entries, flowing fountains, natural daylighting, warm wood features, cafe-style dining and landscaped walking trails are just a few of the elements that welcome patients and their families.
Healthcare providers in the US, similar to hospitality firms, are competing for market share in an increasingly competitive market. Unlike the UK, managed care has been a driving force in the healthcare industry of today and the foreseeable future. It has been estimated that 80 to 85% of Americans are covered under some form of managed care plan. These plans have forced a heightened efficiency and competitiveness within the healthcare industry. To stay in business, each system must keep current subscribers as well as attract new ones. To achieve this, healthcare providers must create a human-centred environment that is flexible as well as appealing, differentiating their products to remain competitive in a growing and changing market.
"Our philosophy is based on patient care," says Joe Swedish, president and CEO at Colorado-based hospital system Centura Health. "We recognise the patient and provide a healing environment for them as well as their families. We feel that an inspiring environment designed to improve workflow and information management enhances caregiver abilities. This leads to better care of our patient or customers."
One firm of architects subscribing to the ideas in Ryder/HKS, a design consultancy jointly owned by American healthcare specialist HKS and London-and Newcastle-based architects Ryder. It says it utilises its unique fully integrated structure to provide a balanced exploration of alternative and complimentary philosophies from both countries' healthcare systems to develop more comprehensive healthcare design solutions.
"We believe that the synergy created by this relationship allows us to develop solutions which benefit from US experience but are uniquely focused on UK healthcare requirements," said Mark Thompson, director, Ryder/HKS. "What HKS can boast is a continuous healthcare development programme with a research and education base dedicated to the improvement of healthcare design. When this is teamed with an experienced British healthcare team cognisant of the specialist technical and cultural needs of the NHS, the resultant collaboration is able to deliver a more educated, progressive and responsive service to our clients."
For more than a decade, the healthcare industry has been borrowing design concepts as well as ideas regarding amenities from the hospitality market. The idea behind it is simple - hospitality equates to relaxation, comfort, and convenience. The more amenities provided by a healthcare system, the better it can attract savvy healthcare consumers.
"Dramatic lobbies, atria, and hospital spines are used as focal points," says Swedish. "They allow branding for the hospital as well as positive distractions and creative wayfinding to be included."
Patient registry is in parallel with hotel guest registration. Currently, many patients are pre-registered over the phone. Upon arriving at the facility, a patient will check in with the front desk and go to their room. If further registration is required, information is gathered at the patient's bedside. All elements of interior surroundings, such as walls, floors, and ceilings, are incorporated into the design concept, creating a sense of harmony and balance. Patient rooms are designed to include views to mountains, lakes, or gardens. Patient amenities such as a private television, VCR, movie channels, computer ports, internet access, and room service balance care with positive distractions.
"Similar to the hotel experience, patient/human-centred care begins with providing a positive experience for the healthcare guest," said Jeff Stouffer, senior vice president and design director, HKS. "Private rooms with private baths - even jacuzzi tubs - create a hotel-like experience. Adequate space for personal belongings, including personal computers and refrigerators, allows the feeling of home and control. Space is also provided for families to visit and spend the night."
A variety of public spaces are included in today's healthcare facility. Unlike storefront pharmacies and cart-operated vendors of the past, the new retail outlets offer a variety of choices of essential items as well as gifts and accessories, and a a valuable distraction. Libraries, business centres, hair salons, gift shops, and pharmacies all form part of the healthcare facility's main street. Concierge services for food delivery, laundry pick-up and valet parking are becoming commonplace.
The dining experience has also dramatically changed. Dining rooms, fresh food markets, cafes and coffee houses are replacing the cafeteria of the past, traditionally tucked away in the basement. "Healthcare facility conference centres are now rented for family events such as weddings and family reunions, as well as community activities including seminars, wellness education and town hall meetings," says Stouffer.
Many Healthcare buildings are being designed as public use facilities as well as healthcare facilities. Atrium spaces can host a variety of events - from art shows and children's concerts to health fairs and screenings. In addition, smaller, more intimate gathering areas are available throughout the facility. A resource library is also offered at most facilities. Business centres, open to patients, family members, and guests, host high-tech communications including computer and intranet access, e-mail, audio/video conferencing, telephone, fax, and copy capabilities.
Fitness, as well as rehabilitation centres, is part of the new hospitality-oriented model. The facilities offer wellness counselling and education, fitness evaluations, personalised exercise prescriptions, aerobics and other guided exercise and weight management programs. Additional cognitive therapy areas including massage therapy, touch therapy, and aromatherapy are offered to relax and soothe patients.
Departure from the facility also resembles that of a hotel. A patient can be picked up curbside by a family member with taxicab stands available to departing guests. Many healthcare facilities are now offering valet parking services to guests and family members.
"In addition to public spaces, designers are focused on the organisation and calibre of clinical services," said Craig Beale, principal and health facilities group director, HKS. "Clinical spaces are organised to expedite care in a pleasant family environment as well as localise patient care and provide expedient services. An inspiring environment helps not only patients and families but the staff."
At Utah Valley Regional Medical Center in Provo, Utah, clinical spaces are designed to be less threatening and more inviting. A larger nursery provides the opportunity for babies to be examined by staff while allowing the new mother the flexibility of having the baby stay when she is resting. At Baystate Chestnut Surgery Center in Springfield, Massachusetts, a doctor's station is located directly outside each operating room. This allows doctors to dictate the outcome of their procedure immediately following surgery. In addition, mobile cabinetry is located in all the operating rooms, allowing flexibility of use.
In the UK, the concept of consumerism has been introduced by the Government to aid the delivery of high-quality, patient-focused service. Increased financial provisions aim to deliver an environment more conducive to the needs and wishes of the 'healthcare client.'
"American healthcare design ideas have obviously developed directly in response to the needs of the market while the procurement and retention of a client base has not been an issue in the UK," said Morag McGill, principal healthcare architect, Ryder/HKS.