ABSTRACT
Beginning in 2000, a research collaborative of progressive healthcare organizations came together with The Center for Health Design to evaluate the impact of their new buildings on patient outcomes. Those organizations are now engaged in three-year programs of evaluation, using comparative research instruments and outcome measures. Their experiences are synthesized here in a composite 300-bed "Fable Hospital" to present evidence in support of the business case for better buildings as a key component of better, safer, and less wasteful health care.
Subject(s)
Facility Design and Construction , Facility Design and Construction/economics , Health Facility Environment , Organizational Case Studies , Safety Management/organization & administration , United StatesABSTRACT
The buildings in which customers receive services are inherently part of the service experience. Given the high stress of illness, healthcare facility designs are especially likely to have a meaningful impact on customers. In the past, a handful of visionary "healing environments" such as the Lucille Packard Children's Hospital at Stanford University in Palo Alto, California; Griffin Hospital in Derby, Connecticut; Woodwinds Health Campus in St. Paul, Minnesota; and San Diego Children's Hospital were built by values-driven chief executive officers and boards and aided by philanthropy when costs per square foot exceeded typical construction costs. Designers theorized that such facilities might have a positive impact on patients' health outcomes and satisfaction. But limited evidence existed to show that such exemplary health facilities were superior to conventional designs in actually improving patient outcomes and experiences and the organization's bottom line. More evidence was needed to assess the impact of innovative health facility designs. Beginning in 2ooo, a research collaborative of progressive healthcare organizations voluntarily came together with The Center for Health Design to evaluate their new buildings. Various "Pebble Projects" are now engaged in three-year programs of evaluation, using comparative research instruments and outcome measures. Pebble Projects include hospital replacements, critical care units, cancer units, nursing stations, and ambulatory care centers. The Pebble experiences are synthesized here in a composite 3oo-bed "Fable Hospital" to present evidence in support of the business case for better buildings as a key component of better, safer, and less wasteful healthcare. The evidence indicates that the one-time incremental costs of designing and building optimal facilities can be quickly repaid through operational savings and increased revenue and result in substantial, measurable, and sustainable financial benefits.
Subject(s)
Health Facility Environment , Hospital Design and Construction/standards , Hospital-Patient Relations , Air Pollution, Indoor , Decision Making, Organizational , Environment, Controlled , Evidence-Based Medicine , Hospital Design and Construction/economics , Humans , Organizational Case Studies , Patient-Centered Care , Safety , Social Support , Stress, Psychological/prevention & control , United StatesABSTRACT
The medical arms race is back. Hospitals are competing vigorously around new technology, spending millions on da Vinci surgical systems, Gamma knives, and high-tech heart implants. Many new technologies require large investments in specialized facilities and technology, pushing up capital investment and health costs. But other technologies have migrated from the inpatient to the outpatient, pushing costs down with shorter inpatient stays and rapid recoveries, like arthroscopic surgery.
