Planning Efficient Healthcare Architecture: Design and Lean Six Sigma

Rod Collman AIA, sdg Architecture

Exciting and innovative technological and operational trends are driving the design of modern medical facilities by increasing efficiency and eliminating waste. Rethinking healthcare architectural design through the process improvement methodology of Lean Six Sigma, combined with modern technology and more comfortable environments, results in less employee turnover; more highly trained, engaged and satisfied staff; and happier, healthier consumers. Here are five ideas that positively impact staff, patients and visitors through Lean thinking:

Prioritizing Team Involvement

A critical factor in planning for the Lean Six Sigma process is the buy-in of the team. An ongoing series of team discussions and presentations involving architectural design professionals, staff, doctors, nurses, techs and support departments, provides input for the improvement of operational efficiency and facility design. Needs and solutions will differ for a doctor’s office, walk-in clinic, outpatient clinic, ER’s, ICU’s, exam rooms, procedure rooms and hospital patient rooms. Team involvement yields unique results for each organization.

Decentralization of Equipment, Supplies, Pharmacy

Medicare and private insurers pay a negotiated fee based on diagnosis, not a hospital patient’s length of stay. Poor efficiency of buildings and staff can lead to wasted days and negative impact on the bottom line. “Nursing Pods” with fewer beds in a single building unit operate with smaller staff teams, localized equipment, supplies and satellite pharmacies, the latter already common in ICU’s. The results are shorter travel distances, greater familiarity between patients and staff, better care, better patient safety and shorter hospital stays through less waste, delays and confusion – all goals of Lean.

Meetings of architects and stakeholders, including healthcare staff at all levels, provides a formula for future efficiency and promotes long term “buy in” by the team.
 
Small, decentralized pharmacies serving nursing areas with fewer patient rooms, eliminate walking distance, saving time and energy.
 

Prefabricated Exam/Patient/Procedure Rooms

A highly efficient process of remote construction of modular room units, manufactured and transported to the construction site, eliminates the time and waste of traditional construction buildout. Firms specializing in this process provide precision quality control beyond traditional construction methods, creating framing, walls, bathroom units, cabinetry, filtration and ventilation, designed to the environmental standards of an operating room. Pre-assembled head walls for patient and operating rooms eliminate clutter with flush mounted utility panels for gasses, power and data.

Wall and ceiling panels of stainless steel or aluminum are available in any color scheme desired and finished in durable, low VOC (volatile organic compounds) coatings. Gaps between panels sealed with silicon allow positive or negative pressure capabilities. Hands-free sensor-driven door openings, sinks and lighting help prevent the spread of germs and surface borne disease.

Furnishings in each patient room can include a comfortable chair that converts to an exam and therapy table. Such rooms can serve acute care patients who become sub-acute without relocation to another area of the facility.

Up-front values are savings in construction time, labor and wasted materials. Long-term results are facilities that are flexible and efficiently maintained, cleaned and disinfected, reducing waste and enhancing the safety of patients and staff.

Access to Natural Air and Daylight

Modern healthcare facilities are sealed buildings for good reasons, but fresh air is therapeutic. Outdoor gardens and walking areas at medical facilities are invaluable for natural air and light and beneficial to patients who would be able to access them. Waiting areas, wards and patient rooms with solar-powered units at daylight facing windows could purify, cool, heat and move outside natural air into a room and exhaust it through vents in the ceiling or high on opposite walls, helping to prevent the spread of air borne disease.

Multi-Tasking Procedure Rooms

Imagine an operating suite with repositionable overhead X-ray and CT Scan, Radiation Therapies, and other advanced technologies capable of use before, during or after a procedure. Brigham and Women’s Hospital in Boston, MA. pioneered a 5700 sq. ft. suite in 2013, named the Advanced Multimodality Image Guided Operating Suite (AMIGO), that makes multiple advanced imaging and surgical technologies available without moving the patient, including an MRI unit behind shield doors that moves from its own dedicated facility into the operating room during procedures. The facility fosters close integration of medical teams simultaneously focusing on one patient. This eliminates miscommunication, waste of staff time in transporting the patient from one area to another and unnecessary patient days in the hospital.

In an upcoming post we will consider the role of Aesthetics in Lean Healthcare Architecture. Daylight, open spaces, organic forms, natural materials and color drawn from the local environment can relieve the stress and anxiety of patients, family and staff, improving outcomes for all.

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