Straightening Out Priorities – Design of the Medical Facility

The reality is that most people spend more waking hours at work than anywhere else. For those that work in the medical field, the majority of that time is spent in a medical facility such as a hospital, clinic, surgical center, urgent care clinic, specialty treatment facility, medical practice, or diagnostic center.

Even though so much time is spent in the work environment, how we feel about that space is usually subliminal and not something we consciously think of. Where you work is just a fact of life.

Though some may grow frustrated working in an inefficient facility or confined to a space that is too small to “do the job right”—and they might even gripe from time to time—most eventually accept their workspace and figure there isn’t much they can do about it. The truth is that the importance of this space, and its contribution to a business’ success or demise, is consistently underestimated.

The most important consideration in designing a new medical facility is planning how it should function before you start drawing. This crucial step is one that will save you headaches and lost revenue because if you don’t get it right, you don’t get a chance to go back and do it over. We’ve seen plenty of practices stuck with a poor design once a build out is finished simply because they didn’t hire a professional to help them map out the functional requirements of the facility first. If it doesn’t work for the physician, staff, and patients, you will pay the price for a very long time. So start off right from the get-go, and get your priorities in order.

Figure 1 is a guide to help you prioritize the functions of a healthcare facility space—the Priority Pyramid

1. The Physician. The doctor is the reason the facility, staff, and patients are there in the first place. Concentrate on eliminating steps and time between patients for providers.
   
   Often we find that managers/administrators start worrying about how long the doctor is in the exam room. It’s not their, or our, prerogative to tell a doctor how much time he or she should spend with a patient. The physician knows best. What we have discovered is that any lost time during the patient visit pales in comparison to the physicians’ lost time when the space design is not efficient for flow. If the doctors have to walk down a long hallway to a desk or counter space, or if exam rooms are far apart, the clinicians end up taking many steps that would otherwise be unnecessary. These steps equate to considerable lost time and lost revenue at the end of the day.

2. The Staff. When staff time is misused, either more staff members are required or staff members are not available when the doctor needs them, and the doctor’s time is misused.

3. The Patient. We have found that by concentrating on the doctor and staff flow patterns and time utilization, the patient benefits by the practice functioning more smoothly and running on time. Every patient wants to get in soon, get through quickly, and get good care—efficient space planning can help with all three.

Everyone in the practice is important, and the priority pyramid is not a level of importance—after all, without patients there is no need for either staff or physicians. We all need each other. However, if the physicians’ needs aren’t met, their production isn’t optimized, and everyone pays the price. The physicians ultimately provide the care that produces revenue to keep the practice going.

Excerpted from The Patient-Centered Payoff: Driving Practice Growth Through Image, Culture, and Patient Experience by Judy Capko and Cheryl Bisera.