Sara Marberry: 4 top health industry issues impacting healthcare facilities

Sara Marberry

Sara MarberryHow is your business going to thrive in the new health economy?

That’s the question everyone in the healthcare design industry is trying to answer. For some insights into what’s going to have the most impact this year, check out PwC’s Health Research Institute’s excellent report, “Top Health Industry Issues of 2016: Thriving in the New Health Economy.”

Of the 10 issues identified in the report, four have direct impact on healthcare facilities. Here they are, in no particular order.

1. Care in the Palm of Your Hand

One of HRI’s main findings this year is that the adoption of health-related smartphone apps have doubled in the last two years. And that millennials actually prefer virtual communication for interactions about their health.

As a growing share of care is delivered remotely, how facilities are used and what type we’ll need will change. Spaces at home will become the exam room and patient room — except for the most critical cases. We’ll need virtual care centers that support audio and virtual technology to provide care whenever and wherever patients want it.

2. The Year of Merger Mania

We’ve already gone through several years of merger mania in the U.S., but HRI thinks this is going to increase in 2016 because interest rates are low and capital is inexpensive. Healthcare systems are betting that greater market share improves operating efficiency and increases profitability.

Which makes branding critical. And branding starts with the most visible asset — the building. It’s what patients see and experience first — after they’ve visited your website or patient portal. But you can (and should) tell the story of your facilities online, too. It’s all part of the package.

3. Care Moves to the Community

As the move away from inpatient care continues, HRI sees acquisitions, new types of facilities, and partnerships as new strategies for health systems to deliver low-cost care.  Moving patients from “mothership” hospital to community hospitals brings them closer to home, opens up beds for critical patients, and improves their bottom line.

As for new types of facilities, we’re talking about bedless hospitals that offer many services except inpatient care and those virtual care centers I mentioned before. Both of which require a capital investment.

4. The Medical Cost Mystery

As healthcare consumers demand more cost accountability, HRI predicts that primary care services and lab testing will move to more “affordable, price transparent, convenient locations, making billions of dollars in traditional healthcare provider revenue up for grabs by new players.”

So, architects and designers, your next healthcare client might not be a hospital or health system. It may not even be any company that currently exists.

Want to Read More?

There’s so much more interesting information in this 16-page document — including findings from a survey of 1,000 U.S. healthcare consumers. Download the free report, ‘Top Health Industry Issues of 2016,” on PwC’s website.

This column originally ran on Sara Marberry’s blog on Jan. 29. Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.

Sara Marberry: 5 New Healthcare Design Resources You Should Know About

Are you feeling lost in a sea of information?

Here’s five terrific new healthcare design resources (in alphabetical order) that you should check out if you haven’t already:

1. Center for Health Design Website

A redesigned version launched right before the Healthcare Design conference in November. What’s new? CHD has streamlined and organized much of its content so that it is easier to find and easier to digest.

Under the “Topics” tab, you’ll find all sorts of tools and information on these topics: Communication, Healthcare Reform, Infection Control, Noise, Patient-Centered Medical Home, Perception of Cleanliness, Population Health, Impact of Aging, Safety, Sustainability, Technology, Emergency Department, and Clinic Design. The “Insights” tab offers even more resources, including research reports and issue briefs, interviews, case studies, design strategies, lessons learned, infographics, key point summaries, and webinars.

Unfortunately, not all of it is free. You have to be a CHD Affiliate member to access much of this new content. Which is okay, because creating this stuff takes time and effort.

Check out the new CHD website>>

2. “Clinic 20xx: Designing for an Ever-Changing Present, CADRE,” August 2015

Sponsored by JE Dunn Construction and HKS, this report is an excellent piece of research the trends driving clinic design. According to CADRE Executive Director Upali Nanda, the report is an “attempt to look deeper into our market to understand what is driving the latest trends and two of our key constituents (patient and physicians). Patient surveys focused on baby boomers and millennials – largest constituents of the workplace and healthcare marketplace today.”

The report is long (104 pages) and detailed, but there’s a great summary that begins on page 66, if your time is limited to read stuff like this. Read more and download a copy>>

3. “Healthcare Industry Trends: Rethinking Care Delivery & Outcomes as U.S. Healthcare Evolves,” Mortenson, 2015

Mortenson has been doing surveys of healthcare and design professionals at industry conferences for the past few years. Its latest survey at the 2015 ASHE Planning, Design, and Construction Summit found that 76% of healthcare providers are “very optimistic” and “optimistic” about the future of U.S. healthcare facility design. 68% also believe that facility improvements have a “substantial” impact on the patient experience.

Other questions explored acceptance of the Affordable Care Act, improved outcomes as a result of improved facilities, clinic care, improving the user experience, energy efficiency, project delivery, and project team effectiveness.

Even better, this 23-page report is presented in an easy-to-read graphic format. Download>>

4. “Modern Clinic Design: Strategies in an Era of Change,” Wiley, 2015

As more healthcare services move out of the hospital, this book, by by Christine Guzzo Vickery, Gary Nyberg, and Douglas Whiteaker is timely. It offers a fresh, condensed look at ambulatory care design and the trends shaping it now and in the future.

Read my review of it in Contract magazine>>

5. “Nurses as Leaders in Healthcare Design,” Herman Miller and NIHD, November 2015

Co-edited by Jaynelle F. Stichler and Kathy Okland, one-of-a-kind book was the idea of Phyllis Goetz at Herman Miller Healthcare (who also was the force behind Kirk Hamilton’s book that Herman Miller published a few years ago). Stichler and Okland and 18 contributing authors tackle this subject with intensity and detail that you won’t find anywhere else.

Read more and find out how to request a copy>>

This column originally ran on Sara Marberry’s blog on Jan. 8  Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.

Sara Marberry: Is Generative Space in Healthcare A New Concept?

Have you ever heard of generative space? I heard Wayne Ruga talk about it earlier this month at the Healthcare Facilities Symposium in Chicago. Up until then, I’d only read a little about it, but never thought much about generative space.

Ruga’s definition of generative space is “a place — both physical and social — where the experience of the participants in that place is one that both fulfills the functional requirements of that place and it also materially improves the health, healthcare, and/or quality of life for those participating in that experience in a manner that they can each articulate in their own terms.”

Three projects were given the Generative Space Award this year at the Symposium — Bridgepoint Active Healthcare in Toronto, Town Hall Apartments in Chicago, and Humanscale’s Denver office.

I wrote an article about Bridgepoint last year for Healthcare Design. So I talked to many people on the project team.  But not one of them mentioned generative space.

One of the architects on the Town Hall Apartments team also confessed to me that they didn’t really design it with generative space in mind either.

Does that mean these projects aren’t worthy of a Generative Space Award?  Not at all.  It just means that the concept of generative space wasn’t the driving force for these projects.

What was, then?  When we first started talking about evidence-based design, healthcare architects told me that it wasn’t anything new — that they had always designed their projects based on past experience and available evidence. I think it is the same for generative space.

In fact, Ruga’s definition of generative space is very similar to the outcomes that a healthcare project designed using an evidence-based design process should achieve.  By expanding it across the “full range of life’s contextual situations,” he opens it up to more than just healthcare facilities.

The idea that a generative space is also a place that progressively and tangibly improves over time seems kind of new, though. What healthcare spaces do you know that do this?

For several years, Ruga’s organization, The CARITAS Project, has partnered with the AIA Chicago Healthcare Knowledge Community and Assa Abloy to do a student charrette at the Symposium. This year, five teams were tasked with using the concept of generative space to develop an ambulatory/outpatient/community environment to address behavioral health issues.

Again, in looking at their designs, I see similar concepts that are not just associated with generative spaces. Connection to the community. Access to nature. Sensory stimulation. But something cool is happening by engaging these students to go through this process.

Whether the concept of generative space will ever gain much traction in healthcare is hard to tell. Even though it was introduced in 1999 (about the same time as the term evidence-based design was coined), it’s still relatively new.

What’s your take on it?

This column originally ran on Sara Marberry’s blog on October 30.  Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.

Sara Marberry: At the Corner of Happy & Healthy: Biophilic Design Coming Soon to a Walgreens Near You?

It’s hard to imagine a pharmacy brought to life using biophilic design. But that’s what the project team at VOA Associates did with the one it designed for Northwestern Memorial Hospital’s Galter Pavilion in Chicago.In a nutshell, biophilic design is design of spaces that re-connect us to nature. It’s not new. Google it and you’ll find many books, papers, and even a documentary film on the subject.It’s not new to healthcare either. Designers have been abstracting nature in healthcare settings for many years using artwork and other architectural design elements. But I’m not sure I’ve ever seen it done in a pharmacy before. Or this good.

The two-story store has retail on the ground floor and the pharmacy above, connected by a staircase.  Taking inspiration from the Chicago’s lakefront parks, the space features elements that simulate trees, their shadows, and the lake itself.

To reach the pharmacy level, you go up a grand staircase resembling stacked tectonic plates. Floating light fixtures above, symbolic of sky lanterns, represent health and happiness. On the second floor, the pharmacy represents being figuratively up in the sky, amongst the clouds. Traced on the floor are the shapes of the tree canopies below.

“We wanted it to be more tactile, not just a poster on the wall,” said Michael Siegel, AIA, Associate Principal, VOA Associates, in a presentation at the Healthcare Facilities Symposium and Expo at Navy Pier in Chicago this week. Achieving that without making it look like a Rainforest Cafe was the goal.

Walgreen-System-Pharmacy_VOA-300x219And here’s an interesting stat. Since the store opened in late 2014, same store sales have improved 20-30%. Part of this is because the store tripled in size, but patients, staff, and people in the surrounding Streeterville community love it, says Robin Kosiek, Director, Healthcare Asset Development for Walgreens.

Does this mean biophilic design will be coming soon to a Walgreens near you? Probably not, according to Kosiek (too expensive, perhaps?). But my guess is that the company learned a thing or two from this project that may influence the design of its stores and retail clinics in the future.

This column originally ran on Sara Marberry’s blog on October 9.  Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.

10 reasons to attend the Healthcare Design Conference this year!

As I write this post, there are 58 days, 5 hours, 54 minutes, and 34 seconds until the Healthcare Design conference begins in Washington, D.C.  If this sounds familiar, it’s because I wrote a similar post last year.

But heck, HCD is a great event, and if you’re haven’t made up your mind about attending, here’s 10 reasons why you should:

1. Networking: With 4,000 attendees, it’s the healthcare design industry’s biggest conference.  Everyone will be there. Well maybe not everyone, but a lot of people you know.

2. Learning: A whopping 13 tracks with 110 educational sessions round out this year’s program. There’s also deep-dive workshops and pre-conference clinics. Plus, you can earn up to 23 continuing education credits.

3. Facility Tours:  Seven of the area’s best acute and ambulatory care facilities are on the Saturday schedule — including a clinic that serves impoverished residents and one for the LGBT community. Make sure you pre-register, though, as tours sell-out.

4. Professional Contacts:  Nine professional associations and nonprofit organizations are holding events at the conference, including AAHID, ACHA, AIA, ASID, CHD, HCI of IFMA, IIDA, IPCD, and NIHD. Alphabet soup, I know — look here to see when and where you can connect with fellow members or supporters.

6. Credential Exam Prep:  Wanting to get a credential, but don’t know where to start? There are sessions to help you study for the ACHA, CHID, and EDAC exams.

7. Exhibits: No where else will you see all the latest and greatest in products for healthcare spaces in one place. Preview the best of the best products at the Nightingale Awards exhibit.

8. Interactives: Small-group sessions where you can interact with others and dig deeper into issues.  Used to be called Roundtable Discussions. All talk — no PowerPoint. Gary Vance and I are leading one on boomer design on Monday, November 16 at 9:45 a.m. that’s a follow-up to the discussion we started last year.

9. Conference Venue:  Love ’em or hate ’em, the Gaylord resort and conference centers are one of the few remaining venues where HCD can all be held under one roof.  Keeping conference attendees together is a good thing. And the Gaylord in National Harbor, MD, just down the road from D.C. is one of the newest and nicest properties. You can get out from under the dome by taking the nearby water taxi over to Alexandria, VA.

10. Changemaker Keynote:  Roger Ulrich, known as the “father of evidence-based design,” is delivering this year’s Changemaker Award keynote address. Always interesting to hear what’s on the mind of this intellectual powerhouse who doesn’t take himself too seriously. Check out this recent post I wrote about his famous view through a window study.

Hope to see you there!

This column originally ran on Sara Marberry’s blog on Sept. 18. Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.

Sara Marberry: Hospitals as Hotels? Is this really what it’s all about?

Hospitals as hotels are back in the news. Or at least in a blog post I came across this past week on Quartz, which bills itself as a “digitally native news outlet for the new global economy.”Entitled, “Rather Than Turn Hospitals Into Expensive Resorts, Healthier Patients Require Happier Nurses,” writer Jayson Marwaha (who also happens to be a medical student) states that the changes hospitals are making are focused on adding amenities and creating “luxury” environments. He argues that they should instead be “fixing the dismal culture of the employees patients see the most: nurses.”Now, no one can argue that how nurses, physicians, and others who come in contact with patients treat them is the most important factor in the patient experience.  That’s the reason organizations like The Beryl Institute exist.But I would argue that the design of the physical environment reflects the culture of the institution and affects employee morale.  If you’re working in a crummy environment, you’re going to feel crummy. You probably will even act crummy.And what’s the definition of a “luxury” environment? I’ve toured a lot of hospitals and looked at hundreds of project photos and am not sure I’d term any of them luxury. Well, okay, there was that unit at Memorial Hermann in Houston. But it was specifically designed for VIP celebrity patients.Earlier this year, the Joint Commission opened the door for integrative therapies in hospitals by including non-pharmacologic strategies in its definition of pain management.  The “cushy services” like massage therapy, acupuncture, chiropractic therapy, relaxation therapy offered in many spas that Marwaha deems as expensive and frivolous.

The Joint Commission isn’t always right, but usually when it adds things to its standards, there are good reasons for doing so — like better quality care, reduced costs.

I agree with Marwaha’s argument that its dangerous to judge the quality of healthcare provided at a hospital with how it looks or the types of amenities it offers to patients.  Susan Mazer recently wrote an excellent post about this, too.

Using the Ritz-Carlton as an example, Marwaha argues that hospitals should follow hospitality’s lead and focus on the culture of its employees rather than investing in costly amenities. But if those amenities do help improve the patient experience (and thus, probably saving money), why can’t a hospital do both? That’s essentially what the Ritz does.

I think back to Planetree, which started the patient-centered care movement more than 30 years ago. It always included the design of the physical environment in its culture change formula.  Planetree’s “amenities” were kitchens on the unit for patients, families, and staff to use; artwork on the walls; and a resource library.

Maybe some hospitals have gone too far into the hospitality model. But I find it hard to believe that those who are doing it aren’t also looking at ways to support the staff so that they can do their best work. And I don’t think any hospital CEO in America has any intention of turning his/her facility into a Ritz-Carlton.

This column originally ran on Sara Marberry’s blog on Sept. 11. Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.

Sara Marberry: Do we really need another healthcare design summit?

This is the question I asked myself after talking with Tammy Thompson, Director of the Institute for Patient-Centered Design. Thompson’s Institute is holding it’s first ever Patient-Centered Design Innovation Summit, September 27-29 in Charleston, S.C.

But it’s not just another healthcare design meeting. Thompson says the intent is to bring together a diverse group of people representing health facilities, patients, design and construction, academia, and product manufacturing to explore new solutions for healthcare environments.

There will be no lecture-style sessions.  Instead, attendees will interact and talk about issues in a framed, organized format. Among other things, the agenda includes spending a day in the simulation center at the Medical University of South Carolina “kicking the tires” in ED, OR, ICU, LDRP, Med/Surg, and Ambulatory Care settings.

The idea, said Thompson, is “to create an environment where everyone has a voice and is able to contribute.”

This is a fresh approach that is sorely needed in the healthcare design industry. Especially for middle to senior level professionals. I can’t tell you how many times a design firm principal has said to me that there are very few new ideas presented at big industry conferences.

Well, okay.  There are plenty of people that do learn things at big industry conferences.  And there’s that networking thing.  But, if we’re stuck in the status-quo, then perhaps smaller events such as the Patient-Centered Design Innovation Summit (target attendance is 200), can help some of those new ideas percolate.

Having conducted several Roundtable Discussions at the Healthcare Design conference, I can say that it can be hard to break away from the traditional lecture format and get people to talk and share. You have to have the right topic and be a skilled facilitator. And not have a bunch of introverts in the room.

I’m confident that Thompson and her small band of volunteers can pull this off. The Institute is barely five years old, but has already produced two simulation labs and conducted interactive sessions about them in various locations. Like any small nonprofit, it has big ideas, limited resources, and a lot of passionate people behind it.

If a more interactive conference experience appeals to you, I encourage you to go to the Institute’s website and check out the Patient-Centered Design Innovation Summit agenda and discussion topics. I might just see you there!

This column originally ran on Sara Marberry’s blog on Aug. 7. Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.

Sara Marberry: Interior Design Industry is Good, Growing & Changing

Here’s some good news:  Research by the American Society of Interior Designers (ASID) confirms full recovery of interior design industry from the 2008 recession with continued positive growth.

At NeoCon in June, I heard ASID CEO Randy Fiser do a quick summary of ASID’s Interior Design 2015/16 Outlook and State of the Industry report. With business good and growing, the nation’s largest interior design association is understandably pleased to share these latest findings. Some quick numbers:

  • 60,824: total number of employed interior designers (both commercial and residential)
  • 13,257:  total number of design firms
  • $8.6 billion: total sales
  • $68.5 billion:  dollar value of specified products (35% increase since 2010)
  • 25%: percentage of firms of all sizes and specialties that intend to hire new employees in the next year

Most important macro-trends also relevant to healthcare design are:

  • Health & Well-Being:  interior design can help encourage a pro-active approach to this
  • Technology: its impact on design practice and spaces where we live and work will only grow
  • Sustainability: expanding beyond reducing environmental impact to include designing for healthy behaviors
  • Urbanization: increasing concentration of people in cities means interior designers must find creative ways to make the most of limited spaces
  • Globalization: design is no longer limited to a single location or culture
  • Resiliency: design has a big role to play in preparing, planning, absorbing, recovering from, and more successfully adapting to adverse events
  • See more at:

What new healthcare products did you see at NeoCon?

Judging by the long line at the Starbucks on the second floor of The Merchandise Mart, I’d say that traffic was up at Neocon this year.

And while the focus of the biggest contract furnishings trade show in the U.S. is on office design, there’s plenty to see if you’re only interested in healthcare products. Oh, and if you want to, you can go to some educational sessions and pick up some CEUs.

But most people come to Neocon to see products.

My one day at the show this year was definitely Neocon Lite. Using the Best of Neocon as my guide to the latest and greatest healthcare products, I hit the ground running on Monday morning, starting at the top on Floor 11 and working my way down through Floors 10, 8, 7, and finally 3.

Every healthcare product manufacturer I spoke with said business was good. Acute care projects are still their bread and butter, but ambulatory projects are increasing.

Price, power, and performance seem to be driving much of the clean, crisp, modern design aesthetic.

We’re starting to see “smart” features in patient chairs. Wieland’s new Accord recliner (which won a Best of Neocon award) has magnetic sensors to track straight down corridors or laterally in tight spaces.  Herman Miller Healthcare is partnering with EarlySense to incorporate sensors that can monitor things like heart rate and blood pressure while sitting in it’s compact, yet roomy Ava recliner, which it showed as a prototype at the show.

It will be interesting to see if healthcare providers want to pay for patient monitoring features. Certainly there are economic benefits, but they’ve been yet to be proven with patient chairs.

And what about smart flooring? To detect when a patient gets out of bed or a resident wanders? Nobody is doing this — yet.

Again, my day at Neocon was short, so I didn’t see everything there was to see. Steelcase Health, which made a big statement last year with its name change and showroom, did not introduce new healthcare product this year — but its new BrodyWork Lounge won a Best of Neocon award for Education Solutions.

Haworth Health Environments is still establishing a presence in the marketplace after buying Legacy Furniture Group two years ago. But I was intrigued by the possibility of using the mother ship Haworth’s technology products, Workware and Bluescape, in healthcare for remote consultation or teaching.

I miss IoA at these trade shows. Always great to see what new designs are coming out of this small company, which gave up exhibiting at trade shows several years ago to more directly market to customers.

Here’s a list of the 2015 Best of Neocon award-winning healthcare products:

J+J Flooring Group and Mohawk Group also introduced some new hard-surface flooring that has great healthcare potential.  I’m sure there was lots more flooring that I didn’t come across.

Best healthcare showroom design?  Herman Miller Healthcare/Nemschoff. The company did a really nice job of demonstrating and narrating how they are “Elevating the Human Experience of Care.” Love the postcards.

This column originally ran on Sara Marberry’s blog on June 19. Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.


What’s the missing link in the Patient Experience Movement?

In case you don’t know, the Beryl Institute is an independent nonprofit organization founded in 2006 by Paul Spiegelman, the former CEO of BerylHealth and now Chief Culture Officer of its parent company, Stericycle.

It’s mission, quite simply, is to improve the patient experience. Which it does by “elevating, expanding and enriching the global dialogue on improving the patient experience.”

Beryl defines the patient experience as: “The sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”

Which I think is good. Because interactions between patients and staff are the most important part of the patient experience.

But, the missing link in this definition is the physical environment. It provides the context for interactions and helps to shape culture.

Maybe this is implied in Beryl’s definition. Maybe not. And while the leaders at Beryl are aware of the importance of the design of the physical environment, I could only find one presentation at this year’s conference that directly addresses it. And it’s about the impact of the build environment on care for older adults.

Granted, I’m not at the conference, but from past experience, I’m guessing that no one else in Dallas this week — except maybe a few exhibitors — are really talking about this.

Promoting the design of the physical environment is not part of Beryl’s core mission. There are other organizations, like The Center for Health Design and Planetree that do that.

Which is all well and good, but if you truly are going to focus on the patient experience, the design of the physical environment has to be an integral part of the conversation.

So what, besides having more educational sessions on this topic at it’s annual conference, could Beryl do to put in this missing link? Here’s a few ideas:

* Include healthcare architects/designers on its leadership boards

* Publish more articles and white papers on the topic

* Partner with The Center for Health Design or Planetree to produce content or an event

* Incorporate language about the physical environment into its messaging

It’s been a while since I’ve spoken to the Beryl leaders about this, so maybe they have some initiatives under way. I hope so, because I’m looking forward to many more great things from this small, but powerful nonprofit.

This column originally ran on Sara Marberry’s blog on April 10.  Marberry is healthcare design expert who has written/edited five books and is regular contributor to Healthcare Design magazine. Marberry also is a former Executive Vice President of the nonprofit Center for Health Design.