The S/L/A/M Collaborative (SLAM) presented at the 2016 Planetree International Conference on patient-centered care in Chicago on October 31. The presentation titled “Creating an Interconnected Ambulatory Environment: Implementing Innovative, Cost-Effective, Patient-Centered Design” discussed design trends in ambulatory care facilities as they relate to Stamford Hospital’s recently completed outpatient medical office building. Karrie Frasca-Beaulieu, IIDA, senior associate and healthcare interior designer and Tracy Caisse, AIA, associate and healthcare architect at SLAM presented on designing spaces that optimize interactions with patients, families, and staff to increase the focus on each patient’s care needs, all while minimizing the potential budget implications that can arise.
The presentation discussed the ways in which SLAM, working closely with Stamford Hospital, delivered a collaborative care model within the facility that aligns with Stamford Hospital’s Planetree commitment to personalizing, humanizing, and demystifying the healthcare experience for patients and their families through patient-centered care. The new facility highlights Planetree’s principles of care delivery including valuing human interactions; creating tranquil healing environments; providing visibility and familiarity; alleviating fear and anxiety; and providing comfort and reassurance throughout the healthcare process.
It was Stamford Hospital’s vision to provide collaborative care and co-locate physician practices of many specialties to improve the patient experience and provide convenient integrated healthcare. The building includes clinical “pods” comprised of multi-purpose exam/consultation rooms; integrated collaborative work areas for staff; centralized common areas; and shared conference rooms for staff training and patient education, allowing for enhanced communication amongst providers to ensure a more informed patient experience.
Prior to the planning stage, a series of workshops were held to gain feedback from users. Full-size mock-ups were created to simulate a typical day in the clinic with a primary focus on the patients’ experience. All participants filled out a survey evaluating the flow of spaces in a variety of organizational care models. Another feedback session took place in the form of a vendor fair where a mock-up of the exam rooms and offices were created using furniture and equipment supplied by vendors so that users could evaluate the furniture and simulate how they would work in the room. As a major component of LEAN design, the mock-up process allows the concept to be continually tested and evaluated to ensure successful results.
Based on the feedback from the mock-up process, SLAM created a hybrid model of care which included features from both a traditional linear organizational model and an “on-stage/off-stage” organizational model. The “on-stage/off-stage” model enhances patient privacy, staff productivity, efficiency, and team-based collaboration amongst practitioners. The “off-stage” aspect provides physicians with private spaces for staff meetings and collaboration, as well as shared clinical “touch down” areas to input and receive electronic patient care information. The implementation of the new hybrid organizational model also introduces a semi-private collaboration area between exam rooms where patients can effectively communicate and partner in their care with their clinicians. By utilizing a LEAN planning module throughout the design of the facility, the project was completed at an amount significantly less than the average fit-out cost for medical office buildings in the Fairfield county area.
Following the opening of the facility, a post-occupancy survey was performed evaluating criteria including communication with physicians, departments and patients; optimization and efficient use of space; privacy; interior design aesthetic; performance; and wayfinding. The facility was successful in meeting project goals of establishing a stronger institutional identity, maximizing the value of the facility through efficient space planning, and implementing Planetree design principles to improve the healing environment and overall patient experience. Patients also indicated that the new facility has enabled them to cluster their appointments in one visit, allowing patients to coordinate their care in all areas of the facility, providing a “one-stop shopping” experience to healthcare.