The Power of Design in Retail Health: 5 Flips to Consider

One Fillmore Place. Image © Ryan Gobuty

Flip the Clinic is a Robert Wood Johnson Foundation project invented to transform the patient – clinician experience. In their language, “flips” are actionable ideas for change. They offer over 60 flips on their website and here are two of my favorites: #57 Reach the Parents, Serve the Kids - which speaks to attaching clinics to elementary schools and the need for engaging the parents. #33 Provide context, improve understanding, and generate empathy between physician and patient – which resulted in a current twitter campaign (#IWishMyDoc and #IWishMyPatient) to increase shared understanding. I encourage you to engage and tweet your own thoughts on this topic.

As a designer, the campaign got me thinking: what other ways could healthcare providers leverage design to flip their clinics? Because the Affordable Care Act (ACA) has led to an increased number of newly insured patients, there is now a marked increase in the retail clinic model. Is there a way for existing healthcare providers to make the ‘flip’ to retail health that will increase health in our communities?

Before moving to Chicago from Washington, DC, I oversaw the programming, design and delivery of five unique Federally Qualified Health Centers (FQHC) and their Community Health Center (CHC) counterparts in that region: Arlington Free Clinic, Community of Hope, Unity Health Care Center at Brentwood Square, Pediatric Specialists of Virginia and Whitman-Walker Health.

In brief, according to the National Association of Community Health Centers, the retail clinic model involves a small site, inside a retail store, that is staffed by a nurse practitioner and treats simple acute conditions. Variations of the retail clinic models for FQHC’s and CHC’s exist, but all five of the Centers listed above chose to focus on providing their services in a convenient location (but not in a retail store).

Below are five flips that are actionable items to consider when designing retail health strategies for Health Centers and were gathered from this experience.

1. Know the Financial Driver

At Whitman-Walker Health, the COO indicated that the success of their pharmacy was critical to the success of their Center. Period. Previously hidden within their clinic waiting area, their old pharmacy was crowded and not very retail focused. Knowing this, the design team placed the new pharmacy adjacent to the front door of the clinic. It was given significant retail “presence” in its branding with happy colors, and is visible from the active urban street. The results – increased foot traffic and sales the first week of opening – which has also driven an increase in clinic visits. Strategic design drives financial success.

Twin Cities Habitat for Humanity. Image © Jasper Sanidad

2. Align the social brand with the physical brand

The Arlington Free Clinic had always been very caring and community focused. What it couldn’t imagine was that their physical space could and should align with this vision. It just hadn’t occurred to them it was possible within their means. Moving to a new location provided just that opportunity to re-imagine possibilities. With clear medical planning, right sizing their pharmacy and providing a healthy workplace for staff, their facility--now four years old—continues to inspire not only patients but also more than 500 clinic volunteers. A patient survey indicated that “100% responded that the new clinic space is light-filled and uplifting.” The project was accomplished on budget, was recognized for its sustainability by the Washington Business Journal, and was published in numerous design journals. All to say, design can be inspirational and affordable.

Star Clinic and Housing for Health, DHS Housing. Image © Ryan Gobuty

3. Education Drives Health

When the CEO of Community of Hope was asked to open up a clinic in Anacostia, an under-served area in SE Washington, DC, she recognized the need for community outreach and education along with providing a medical home (physical, mental and dental care). The initial test fit diagram given to us decentralized the educational program within each service line. To support community outreach and education, and stay within their established square footage, the educational elements were gathered together at the front of the building on the first floor to create one educational / conference area– visible to the community and passersby. This physical shift has allowed Community of Hope the space to host the Mayor, hold fund raisers, and offer community health educational venues. Community of Hope accomplished more than it set out to accomplish because design enabled it to invent a social incubator for health.

Halliburton North Belt Child Development Center Lobby. Image © Ryan Gobuty

4. Flexibility is Key

Creating a universal patient room was the contributing success factor for both Unity Health and Pediatric Specialties of Virginia. Through sketches, renderings, mock-ups and testing, we established a universal room size and shape that would accommodate 99% of their needs: exams, dental operatories, behavioral health consultation rooms and pediatric care. This standard module provided for extreme flexibility in their staffing and operational models, which in turn allowed them to expand capacity and increase throughput, both of which are requirements in the new retail health model of care. Design provides opportunities for operational improvement.

UCLA Malibu Physician’s Office. Image © Ryan Gobuty

5. Pay it Forward

The beauty is that all this learning is being carried forward. Our current work with UCLA, UCSD, Northwestern Medicine, Children’s National Health System, Children’s Pediatricians and Associates, and Mary’s Center benefit from these learnings. Our clients talk to each other, they compare results, they tour and determine if aspects of these Centers will align with their own operational and cultural lens. They measure, they look at our research, they determine their service lines, and their decisions impact the health of our communities. Design shapes healthy communities.

One size does not fit all when designing for retail health. Healthcare is uniquely personal and the care model as well as the facility itself should cater to each specific clientele. Log on to the flip the clinic website and engage. Let’s continue to develop and share actionable items for retail health change.

Tama Duffy Day is a Principal and Firmwide Health & Wellness practice leader. She is dedicated to raising the awareness of the impact that design has on health. She can be reached at tama_duffyday@gensler.com and @TamaDuffyDay.

Comments

[Bennett Hall]

Tama...
I really like the piece you are organized. Educational health care content deployed specific to each practice area is mission critical as you outline.

However, I believe a section as missing - what we call "Authentic Placemaking". We achieve this through a combination of exhibits, artwork and signage which are hyper-localized to the community and health care team. Historical, educational and contemporary images are localized, and personalized to the facility. This is transformative for the patient, family and caregiver experience, and also disruptive to the traditional decor-centric model of facility design. Let the images curation be based on their communication value. Aesthetics with respect to aligning with the design vocabulary is relatively easy to coordinate once strategy is defined.

Your thoughts?

[Tama Duffy Day]

Hello Bennett and thank you for your comments. You are correct that placemaking is an important part of any design project, especially community health. Each of the five projects mentioned above had culturally relevant art and photography throughout their spaces.

As an example, please read about the excellent work of Fitzgerald Fine Arts and the art program at Community of Hope. Represented are works of art from “Life Pieces to Masterpieces,” an organization of young, disadvantaged, African American men and boys, who encourage their participants to invest in the arts. You can read more here: http://ffinearts.com/?ffa_portfolio=conway-health-and-resource-center

Please stay connected. You've inspired me to write another post on the power of art in support of health. Tama