By Brian Adams, AIA, Senior Healthcare Planner
Telehealth visits, plexiglass partitions, taped-off waiting room chairs, hand sanitizer stations, and masks are just a sample of the changes we have experienced in the last year while visiting our healthcare providers. At the same time, providers were strapped with lost revenue, escalating costs to quickly initiate safety protocols for staff and patients, and the effects of full implementation of new technology.
While some of the changes within the healthcare delivery model have been progressing slowly over the last couple of years, the pandemic spurred implementation into warp speed. Now that we are starting to get used to these changes and have implemented stop-gap design solutions, what have we learned to create a design vision for the healthcare clinic of the future?
As we look toward the future healthcare delivery model, we will certainly see increased implementation of freestanding/outpatient access sites within the community. Like the recent urgent care construction boom, these new sites will be placed in consumer-/retail-centric areas to be as accessible as possible. These centers will also extend well beyond the urgent care/primary care model to be adaptable to include specialty care, outpatient behavioral health, dialysis treatment, and infusion. Instead of visiting your doctor in a hospital or medical office building, where you encounter many people in the lobby, elevator, and waiting room, the clinic of the future can be a standalone building that provides different experiences based on the reason for your visit:
- No appointment, urgent visit, or financial general consultation
- Scheduled appointment or visit
- Testing or basic lab services
No Appointment, Urgent Visit, or Financial General Consultation
Patients arriving for an unscheduled visit, urgent visit, consultation, or to pay bills arrive at the front of the facility. Signs located at the front of each parking space (like those for to-go orders at restaurants) direct visitors to call or text a phone number. Staff inside the building will buzz in the visitor when an exam or consult room is available, eliminating the need for waiting space and providing a safe, almost touchless experience.
Scheduled Appointment or Visit
Patients arriving for a scheduled visit are assigned a specific exam room with an arrival time. Parking spaces and building signage show patients where to park through simplified graphics/wayfinding that align with their exam room number. Using technology/smartphone apps, patients are provided with a QR code or texted a PIN for door security access into the facility, with a dedicated door leading to the private exam rooms. This design eliminates the waiting room, giving the patient the flexibility to sit in the privacy of their car or an exam room. Vitals, registration, exam, and the co-pay and financial discussion all occur within the dedicated exam room.
Testing or Basic Lab Services
In lieu of our typical process for lab services where we register in the lobby and sit in the waiting room, a drive-thru process can be used for these basic services. Patients arrive at a drive-thru canopy for either scheduled or unscheduled testing or basic lab services, vaccinations, or shots. For tests that require a toilet, one is provided directly accessible from under the canopy. This new process will allow for services like blood draws, EKGs, and vaccinations to be provided quickly within the patient’s car or inside a small room within the drive-thru canopy space for more private and discreet testing such as drug screening or urine samples.
Exam Room Specifics
In the future health clinic, exam rooms are built around a staff work core that provides a dedicated entry directly into the exam room, which separates provider and patient/family circulation. For the patient, the exam room door unlocks once a passcode is entered. If a patient needs to enter the core interior of the clinic, signalization or door locking will notify them of others in the corridor or restroom. The layout of the exam room, corridor, and exterior wall is designed to allow for modular off-site construction techniques. The interior design is based on contemporary design practice to allow for both traditional exam room space and telehealth functionality.
As our healthcare providers look to continue to develop robust ambulatory/community-based healthcare solutions, the design needs to be able to respond to numerous clinical adaptations. The quantity of exam rooms is scalable, and the interiors can be customized to accommodate different specialties. An urgent care, primary care, or specialty care clinic can include imaging capabilities and a drive-thru canopy for testing and diagnostics. As an outpatient behavioral health clinic, the facility can include a scalable amount of consultation rooms as well as a community group room. A dialysis center can have private dialysis rooms, while an infusion center would have private infusion rooms.
With the rising cost of healthcare construction and the need to initiate quick “speed to market” solutions, the clinic of the future requires a design that is adaptable and provides a fast, positive return for our client’s investment. The design of the clinic of the future must provide the adaptability to allow for both new construction concepts and re-use and renovation of existing spaces. The current state of the global retail economy has led to an abundance of empty freestanding retail sites, and the design can be adapted quickly to fill in empty strip retail locations and/or abandoned prime properties formerly occupied by restaurants or retail. These sites are typically positioned in consumer-centric areas, which makes for perfect adaptive reuse solutions and takes advantage of great site access and the parking required for successful clinic use.
While some solutions may require traditional methods for construction, the design concept has been developed to utilize modular techniques as much as possible. The modular framework can be quickly adapted to final site selection and allow for quicker construction times. The exam room module can be standardized and built in its entirety off-site and dropped into the existing building. Using the modular framework will improve the patient and staff experience, reduce ongoing operational costs, and minimize upfront construction costs through reduced design time and fees.