The Patient or the Caregiver? Part 1: Designing for the Caregiver | Operational and Spatial Considerations I By: Kelly Hiskey, Associate AIA, ASHE

Patients are to healthcare facilities like water is to fish. The latter couldn’t exist without the former. So it’s no surprise that a designer’s first inclination is to focus on designing for the experience of the patient. Through the principals of patient-centered care, designers create environments that encourage healing, empower patients and mitigate stress.  However, if the basic goal of any healthcare facility is to aid in a quick and full recovery of its patients, shouldn’t an equal focus be placed on the individuals tasked with providing this care?Part I of this series will focus on how architectural decisions can affect the efficiency and quality of work of caregivers.

 Designing for the Caregiver | Operational and Spatial Considerations

Lean design

Broadly speaking lean design focuses on reducing waste while improving efficiency and quality (if it isn’t adding value, eliminate it). If we were to relate this concept to the caregiver, lean design might include the implementation of a decentralized or hybrid model of storage. A decentralized model refers to each patient room being equipped with a supply closet, which in turn, decreases the travel distances of nursing staff (every mile cut equates to 20 minutes of time that could be devoted to direct patient care). Hybrid models provide a supply area for a group of patient rooms (approximately 10) which still helps reduce the travel distance of staff while promoting communication and collaboration (a criticism of the completely decentralized model).


Acuity-adaptable Patient Rooms

The acuity-adaptable model allows patients to remain in a single room throughout the duration of their hospital visit while bringing the appropriate acuity care level to them.  Such a model requires nursing staff to have a broader set of skills, which could encourage growth, learning and communication among staff, or it could put staff in uncomfortable situations (acuity levels that they are not interested in dealing with).  Being able to have the same team of caregivers tend to a patient throughout the duration of their stay can greatly reduce the frequency of communication related errors and increase the rate of patient recovery.


Standardization of Patient Rooms

The same-handed patient room places each piece of equipment in the same location in all rooms. This consistency is thought to increase staff efficiency in high-pressure situations because they don’t have to think about where each piece of equipment is located; it becomes part of the caregivers muscle memory.