March 22, 2018

We are often challenged during the design phase of a healthcare project to incorporate features that will help facilitate new processes that hospital leaders want to implement. The new construction of a department or an entire facility, for example, is the framework in which that change will be expressed. Staff-focused change management in new healthcare building projects can be either process- or culture-oriented in nature. Some changes are purely functional and are driven by efficiency, such as case-cart flow from central processing to surgery, or “Just-in-Time” stocking of supplies by materials management personnel. Others can deeply affect patient care, such as family involvement in caring for patients in intensive care units. In today’s post, through the lens of a 120,000-square-foot clinical expansion effort, I explore how GS&P is implementing new design strategies to foster staff-focused change management methodologies that will ultimately improve the overall staff and patient experience.

Change Management Through Design

Most recently, I served on the design team tasked with expanding a midsize hospital’s existing emergency department from 34 treatment spaces to 78 treatment beds and recliner chairs due to unexpected and rapid growth. Improving the operational efficiency of their current triage process proved to be a significant challenge as the existing flow of patients was unsystematic, leading to a multitude of processes that were simply inefficient. Without employing change management through architecture in these instances, staff can become used to such processes and will continue to work that way.

“Low Acuity Pod”

The new arrangement of the emergency department’s “Low Acuity Pod” for rapid evaluation is just one way in which GS&P’s design strategies improve existing processes for both staff and patients. Along with the challenges that the existing triage process presented, the ED’s number of emergent cases far outnumbered the planned capacity of the facility, and patients were often assigned to exam spaces that were not commensurate with their level of acuity. Therefore, expanding and arranging the department’s “Low Acuity Pod” into open bays became a key driver in the design of the front end of the ED. Keeping a patient vertical, sitting in a recliner, gives them the sense that their condition is somewhat minor. Likewise, the zoning of acuities in the ED facilitates the level of care expected and required. With the new design, the further a patient penetrates the emergency department, the more severe their condition is, and the more likely they will be admitted. The “Low Acuity Pod” patient can be treated and released much faster in this area as they will be closer to the ED exit point.


GS&P’s design of the new front desk lobby area also promotes new processes. For example, the new front desk incorporates passages through it, which improves patient and staff flow, and allows staff easier access to patients by removing the physical boundaries between them. Prior to the expansion, staff was forced to triage across the “barrier” of the existing front desk. With the new configuration, patient flow is channeled through the front desk to an alcove that enables a confidential triage process.

Specialty Suite

GS&P’s design also incorporates a new specialty suite unit within the ED that treats geriatric patients. To create a quieter, less confusing space, the unit was situated away from the entry. Patients admitted to the ED are designated by a specific entry age, which allows specially trained staff to better accommodate geriatric patients than if they were admitted with the general population. Admission to the specialty suite automatically triggers certain protocols applicable to this specific patient population. Architecturally, material finishes and lighting play an important role in how these rooms aid in the care of these patients.

Another good example of culture-oriented change management through design is the integration of staff and physicians’ lounges, which was a key client goal from the onset of the project. This type of integration not only opens the door to better communication and social interaction, but also results in better patient care, enriching the overall culture of a health organization.

These represent just a few examples that illustrate how change management methodology can be employed to improve design and ultimately enhance patient care. As healthcare designers, we are always endeavoring to provide spaces that are not only physically appealing but also provide a level of functionality that contributes to the overall mission of our clients. Willingness to employ change management of staff behavior through architecture is an important element in creating a successful space. And it is extremely rewarding to work with clients who value collaborating with us to provide spaces that challenge the status quo to arrive at a positive outcome.