Blog / Focus: Facility Design

COVID-19 challenges us to rethink clinical workflow

By Kurt Forsthoefel / Special to Healthcare Facilities Today
June 15, 2020

The evolution of payment and care models as a result of healthcare legislation. The focus on evidence-based outcomes and a value-based approach. The changing patient demographics. The integration of greater connectivity and digitization driven by technological advances.

The COVID-19 pandemic is also challenging all of us to rethink the point-of-care ecosystem. In just a few short weeks, many organizations have been forced to take a renewed look at patient-caregiver interactions and how care can be delivered safely and effectively to achieve improved outcomes.

It’s also a breakthrough moment for telehealth. In fact, nearly half of all physicians are now treating patients through telemedicine, up from 18% in 2018, when more than 75 percent of US healthcare organizations did not have an existing virtual care program as of January 2020.

Fortunately, advanced technology, greater connectivity and the push to create a more patient-centered experience over the past few years have fueled a rethinking of workflow design at the point of care and offered new approaches to the delivery of care. 

Regardless of the setting, whether it be urgent care, a large health network, a small private practice or a clinic located in a retail setting, the design, technology, furniture and equipment of these settings all have an undeniable impact on clinical workflow. When assessing the effectiveness of your facility’s workflow, especially today, there are certain factors that should be considered.

Designing flexible spaces

Well-designed healthcare environments can contribute to meaningful cost savings for healthcare organizations; which can then be invested back into the facilities to further enhance the delivery of care and the overall healthcare experience. For instance, some studies show that the integration of technology into design could result in $139-163 billion in savings by 2025.

Real-time locating system (RTLS) technology can reduce patient wait times and increase staff productivity by ensuring staff know the whereabouts of their patients, colleagues and equipment, thereby simplifying care coordination and communication. RTLS data can provide the operational intelligence needed to allow teams to better utilize clinical space effectively and add additional patients or caregivers when needed.

The concept of self-rooming supported by RTLS allows patients to check in for their appointment and proceed directly to an exam room or diagnostic sub-waiting location. RTLS-enabled self-rooming has more benefits than just improving wait times and patient experience—the elimination of the waiting room creates opportunity for the introduction of new clinic spaces that are more conducive to direct revenue-generating care delivery and reduces cross-contamination.

As outpatient services across the health system continue to increase, the growing patient population is putting greater strain on the typical linear design of ambulatory care environments that feature shared corridors and publicly exposed workstations. Hallways can often become crowded with equipment, patients and caregivers—privacy issues can arise and overall patient experience can be impacted.

The on-stage/off-stage model, which is more easily adoptable with new construction or redesigns, separates caregivers and patients, providing dedicated corridors to dual-entry exam rooms where patients enter at the front and caregivers enter at the back. Patient corridors and entries offer greater privacy and a calmer environment free from clinical clutter. The staff and clinician entry leads to a centralized clinical work area where caregivers can be highly collaborative with the entire care team. The clinical work area also provides a line of sight to all exam rooms for better flow management.

Balancing equipment + design

Since the exam room is where the majority of the patient-caregiver interaction occurs, it makes sense that the layout and configuration of this area can significantly impact the effectiveness of the clinical space. Many caregivers are embracing a patient-centered approach that focuses the clinical work environment around the patient to increase efficiency and help lead to better patient outcomes. When implemented correctly, this design view can offer efficiency gains and provide a number of benefits at the point of care for patients, physicians and staff.

Having the right type of equipment within the clinical environment can increase the level of efficiency, comfort and safety to enhance the delivery of care. For instance, the exam chair has evolved into a clinical hub where diagnostics, patient engagement and treatment intersect. Results can be gathered within and seamlessly transferred to the EMR. The right exam chair can help facilities achieve better workflows.

Another important equipment consideration for effective exam room design is how digital data is used in the space; whether through EMR, diagnostic devices or decision support tools. Mobile workstations provide the flexibility needed to support technology within the exam room, from room to room, when a space-saving solution is needed—or when it’s time to shift to provide telehealth services.

The use of workstations can also bring devices (desktops, laptops and tablets) within arm’s reach, decreasing the need for caregivers to move within the space and maximizing engagement with patients. Some mobile workstations currently on the market can provide the standard features and accessories needed to assist with a health system’s unique telehealth program—factoring in the proper working position needed without sacrificing eye contact with the patient. The ability to easily incorporate technology such as cameras while allowing providers to maintain an ergonomically correct working position, whether seated or standing, is a win-win situation.

As COVID-19 continues to reshape the healthcare industry and impact the design of all types of healthcare facilities, it is vital to ensure an effective clinical environment design that is conducive to the delivery of high quality care. Healthcare organizations must continue to look for new approaches, best practices and proven processes to improve the clinical space, specifically at the point of care.

Tomorrow’s clinical spaces must help healthcare organizations meet the demand for high quality care while providing enough flexibility to meet new challenges. Having an effective exam room design is a vital part of reaching that goal. Caregivers who understand how the combination of patient satisfaction, ergonomic principles, streamlined vital signs acquisition and the right equipment and room configuration can help improve the overall effectiveness of the clinical space will be in a better position to deliver efficient, high quality patient care with improved outcomes.

Kurt Forsthoefel is director of medical marketing for Midmark.

 

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