As ambulatory care assumes a larger role in healthcare, the design of ambulatory care facilities is taking on greater importance. These facilities can provide a high-quality, cost-effective, convenient and comfortable experience for patients, their families and caregivers. Designers are working with healthcare organizations to create buildings that support efficient operational models and new services, and will respond easily to the future healthcare needs of any population. These are the latest developments in ambulatory care design:
New operational models: It’s increasingly clear that efficient operations are key to the effectiveness of any facility. By defining Lean operational parameters, an organization can minimize the amount of space it requires for outpatient care now and in the future.
New methods of patient care require new types of spaces. To facilitate group visits, also known as shared medical appointments, an outpatient facility must include both individual clinic rooms and space in which groups of patients with the same medical condition can meet with caregivers.
Telehealth services are another new option for outpatient care. A patient need not come to the facility for an e-visit, but the facility must be properly designed to support this type of care. Space with the appropriate equipment, lighting, acoustics and privacy protections needed for caregivers to communicate effectively with patients or other health professionals through electronic means (e-mail or Skype, for instance) is essential to the success of a telehealth program.
Implementing either of these new care models will have an effect on patient throughput. Space and staffing requirements should be adjusted accordingly.
Combined services: As more physicians become hospital employees or combine resources to form large group practices to manage the billing requirements of national health reform, the opportunity for standardization in outpatient facility design increases. Hospital or large group practices lend themselves well to efficient, modular clinic designs. Since collaboration is a priority for these practices, space for caregivers to work together is also important in hospital or large group outpatient facilities.
Hospitals and health systems can benefit by including urgent care services in an outpatient facility. Urgent care patients can’t wait for an appointment to see a physician, but their conditions don’t rise to the level required for emergency treatment. An urgent care department within the outpatient facility can relieve pressure on the hospital emergency department by diverting these patients to the proper care setting. This type of service is also valuable in introducing and attracting new patients to a hospital or health system.
Future needs: Proper design can help healthcare organizations manage change, allowing their investment in a facility to continue to pay off well into the future. Industry benchmarks can help determine how much and what type of space an organization will require. Standardization and modular clinic design can make it much easier to adjust the size or location of clinics within a facility as needs change. If the organization plans to offer group appointments or e-visits, space to accommodate these services should also be included.
Population growth and movement is another important consideration for the future of outpatient care. A hub and spoke arrangement, with hospitals in city centers and ambulatory care facilities in the suburbs, has been the customary model for inpatient and outpatient care. As the U.S. population becomes more urbanized, providers need to consider the outpatient needs of city residents. A modified hub and spoke model that includes outpatient facilities within the city limits will likely be more appropriate moving forward.
Depending on population shifts, some ambulatory care facilities may need to receive inpatients in the future. Facilities designed with this thought in mind will be more easily adapted to this purpose.
To better serve their Fort Worth clients, most of whom are uninsured or underinsured, Moncrief built a 65,000-square-foot facility ambulatory care center on a 3.4-acre site that provides cancer prevention and screening services as well as room for population research.
— Jeffrey Stouffer principal and practice leader of healthcare design at HKS.