architecture and design - Urban Planning and Design

The Healthcare and Paradigm Shift, Image © Gensler

This post is part of a series related to Uniting Healthcare + Community.

Amid the hustle and bustle of the hospital lobby at University of Maryland Medical Center (UMMC), a healthy man spends many of his days with strangers-made-friends—the security guard, the little lady that runs the gift shop, and the customers at his favorite cookie stand. He’s there not out of obligation or necessity—he’s neither sick nor a hospital employee. He’s there for community. A few years back his wife had passed; he came back to the hospital to feel a connection to her. In doing so, he created community, through an unconventional way and in an unexpected place.

Up to this point in this blog series, we have been looking at trends at a macro level to understand the future of health & wellness and its underlying relationship with the community during this time of unprecedented change in healthcare. Industry shifts transferring more control to the patient—from fee-for-service to value-based-care, in conjunction with federally required accountability and transparency—present an opportunity for the built environment to play a greater role in the business of care through patient satisfaction. We now zoom in to ask: How can we, as architects and designers, refine our process of engaging with healthcare providers and systems to improve their patient and staff experiences? What can healthcare providers do at the micro level to be engaging and reflective of their local communities?

Image © Gensler

We met the man mentioned above through a discovery and concept study with University of Maryland Medical Center (UMMC) to understand how the main lobby can better enhance patient experience prior to care delivery. To help us build a complete picture of UMMC’s mission and values, we spent more than ten hours observing the lobby to get a firsthand experience of the space and its inhabitants—noting behavioral cues within the space as well as physical obstacles and work arounds.

As architects, we have a vision of how the spaces we design will affect and influence behavior, but it is most informative to observe how people find their own paths and shape their experiences within the spaces they occupy. It was fascinating how the different visitors interacted with the lobby environment in so many different ways—taking control and personalizing their use of space—reinforcing that it is no small challenge to design a welcoming space that strikes a balance between providing for patients and families as well as the urban community it serves.

Understanding the User and UMMC - User and Environmental Collisions Diagram, Image © Xavier Caré / Wikimedia Commons / CC-BY-SA

As a part of this project, we also joined UMMC’s President Patient/Family Council to discuss the patient experience and patient attitude towards the lobby—leading an “Ideal Experience Exercise” with patients and families to get their feedback on first impressions, important amenities as well as barriers within the lobby. What we found was that the local community is very invested and is constantly seeking ways to give back and feel the institution is part of the community’s identity. We heard stories about how they have experienced the best and sometimes hardest events of their lives in this building. One council member shared his memory of seeing his daughter for the first time in this hospital, another spoke of loss and emotional connection to the place. Through it all, they were grateful of the treatment they got during their stays and felt that level of care and support was something that should manifest and proudly be shared at the public spaces like the lobby and main hospital concourse.

UMMC Community Interviews, Image © Gensler

Three Key Takeaways

During every task completed from report review to interviews, three high-level key priorities were consistent:

Relationships reign. The first priority is focused on the importance of cultivating strong relationships between staff and patients and visitors. Positive processes of greeting, security and wayfinding with first touch staff at the main entry can significantly impact patient and visitor opinion of their relationship with UMMC.
Time is our most valuable commodity. The second priority relates to valuing patient and visitor time. Efficiency in the arrival process is as important as efficiency through admitting, diagnostics and discharge.
Cleanliness is next to godliness. Both perception of cleanliness and actual cleanliness is critical in a patient and visitor’s perception of care.

Understanding local communities within the larger macro trends helps us to create better environments of care, tailored to the local identity, challenges and visions. We have a great opportunity in front us to shape a built environment to play a greater role in the business of care through patient satisfaction.

Want to be a part of this conversation on the future of healthcare? Join us for a provocative discussion of your role in the future of health and healthcare in Gensler’s DC office on Tuesday, June 13, at 5 pm. Dr. Mark Rowe, an Irish physician and author, will begin the evening with a presentation based on his recent book, A Prescription for Happiness. His talk will be followed by a moderated discussion with a diverse group of panelists covering view points from telemedicine and algorithmic medicine to genomics and community health. Panelists include representatives from Johns Hopkins Sibley Innovation Hub, Inova Center for Personalized Health, Medtronic, and Unity Health Care. Email Us for an invitation. Space is limited.

Stay tuned for our next post in this series which focuses on patient experience and what healthcare customers crave.

Migena is an architect in Gensler’s Baltimore office. She brings a diverse level of experience and a strong commitment to good design that focuses on enhancing user experience. Migena’s experience includes healthcare, commercial office buildings and mixed use projects, ranging in size from small renovations to 460,000 GSF of new construction. She has conducted research on Whole Person Health and the impact WPH has on the design of healthcare facilities. Migena is committed to improving the role of designed environments to support mental, physical and social wellbeing. Contact her at migena_dilloli@gensler.com.