Design and the Future of Healthcare

Submitted by Martin Valins, RIBA, AIA, Principal (Philadelphia, PA)

Last month I attended a two half-day roundtable on the state of cardiovascular care hosted by The Advisory Board Company, a healthcare research and consultation organization. The roundtable occurs once a year and is attended by senior hospital and healthcare executives. In contrast to other healthcare conferences, its focus is on the business of healthcare rather than on design or clinical research.

The discussion began by reviewing the state of healthcare reform in the US and its potential effects on healthcare delivery. Forum participants made it a point not to profess personal or political opinions on reform but rather to review the facts of the situation and reflect on what they mean for the industry.

First, the group cited statistics that indicate something isn’t working quite right in the American healthcare system since the US has the most expensive healthcare costs but is ranked #7 out of the top 7 industrialized nations in illness rates, life expectancy, etc. Meanwhile, the Netherlands and the United Kingdom, two countries with a universal healthcare model, take the #1 and #2 spots. While, again, no judgment was made about that model per se, it caused the group to examine what a shift to universal healthcare might mean for US hospitals.

The discussion provided a number of insights for those of us in healthcare facility design. The biggest change would be a focus on prevention, primary care, and outpatient services.

A key consequence will be a further fall in the demand for inpatient beds, with the time spent in a patient bed also continuing to decrease. Interestingly, it should also lead to a fall in demand for emergency room visits as a significant proportion of ER visits are by non- or under-insured patients using the ER for nonemergency care.

Yet looking across healthcare design conference agendas and healthcare design magazine articles, which continue to focus on, for example, the patient room as the fulcrum of healthcare design—and then comparing this with the priorities of clients and the direction of healthcare reform as described at the roundtable—it seemed to me that as a profession we may be looking in the wrong direction.

It, however, also reinforced my enthusiasm for Stantec’s commitment to healthcare design research. I am fortunate to work at a firm that has always encouraged original thinkers to challenge the design status quo—and instead creatively align with our clients' strategic needs. It’s all the more rewarding to now have a network of healthcare planning and design colleagues across the globe whose expertise and insights enable us to test norms and think differently.

The lesson I learned from the roundtable was that by connecting with the strategic and financial goals of our healthcare clients, we will continue to ensure that we can optimize our clients' potential for sustainable success. Their success is our success.