by Rhonda Skallan

Change isn’t going anywhere. Keep people at the center to find success.

The Challenge

If we’ve learned nothing else during the pandemic, it’s that change is constant, and the need to keep pace and maintain flexibility has never been greater. Healthcare is no exception. Healthcare services and delivery methods are evolving, especially in light of the pandemic. When Centers for Medicare & Medicaid Services (CMS) lifted regulations regarding telehealth, healthcare organizations had to adjust quickly or risk becoming obsolete. Limits on the ability to see patients in person required a heavier dependence on telehealth, leading providers to take a hard look at their facilities and space requirements and ask hard questions about their space needs. 

As organizations began to revamp their facilities in response to the pandemic, many found themselves needing to pivot in the middle of a space planning project. Consider the case of an Oregon healthcare network. The organization was in the planning stage of two construction projects and in the process of submitting revised drawings for permits just as the pandemic hit. The organization quickly realized it needed to shift to an environment that relied more heavily on telehealth and remote work. Given where they were in the project, they wondered, “Was this possible?” The answer was yes, and the team found they only had two months to make those changes.

As they evaluated operations in a COVID-19 world, the clinic found that 85 percent of their team members were working from home, and 90 percent of patient appointments were virtual. This was a huge change for everyone—physicians, staff, and patients alike.

Given this new reality, the design team began a rapid assessment of what was working and what wasn’t, encouraging two-way communication to solicit those insights. Feedback centered around meeting patient preferences: Do they want to come into a clinic? Meet at a local community center? Do they prefer home visits?

Based on this input and evolving needs, the team evaluated clinic space, asking hard questions. Do you need waiting room space? If so, what does it look like? Do you want to separate healthy people from sick people when they arrive? If so, why have a waiting room? Could you have patients wait in their cars and then escort them directly into an examination room? The information garnered from these questions allowed for significant opportunity to reduce space.

Next, planners evaluated telehealth needs. Would providers need a dedicated space? Could providers work remotely? How would this space address privacy concerns if providers worked in shared space? The answers pointed to the clinic still needing physical clinic space in addition to remote work.

As planners discovered, everything needs to center around the human: the design, the process, the digital. The decision-making is easier when you know “people are my number one thing.” It’s your signpost in the ground you always come home to.

The Bottom Line

Change is constant and will continue to accelerate at speeds never seen before. Implementing flexibility and putting humans at the center of change are keys to any space planning and design project, which can reduce the costs of future renovations and the impact of construction projects on the organization’s processes and culture.