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What’s the ROI for Designing Choice into Patient Rooms?

Sara Marberry


By Sara Marberry

I was surprised at how many people commented on the post I wrote last week, Why One Size Fits All Patient Rooms Don’t Work.

Apparently, I struck a chord when I called for designing choice into patient rooms. I was lamenting the fact that not all patient chairs, beds, and patient room bathrooms fit all sizes of patients. Last week, I saw this firsthand when my 5’2″ mother was hospitalized.

Among other things, I wondered why hospitals couldn’t offer a selection of patient room chairs to accommodate different body types.

Dean Russell wrote in response to my post, “Creating choice is an admirable goal. Unfortunately the cost of building and designing healthcare facilities is astronomical.”

“How do you propose creating a more tailored experience without adding cost? As a designer I would argue this isn’t a design issue, it’s a financial issue…Cash fixes lots of design problems.”

Money, Money, Money

Does it always have to come down to money?  If that’s the case, when will healthcare decision-makers understand that investing in design makes good business sense? That a patient who is comfortable in her chair may not call for the nurse so often? Which means that the nurse may not take as many steps during her shift, causing her to be less stressed, leading to greater productivity and less turnover?

Assumptions yes, but there have been studies that show how unit layout contributes to more steps and nurse fatigue. And do you know how much it costs to replace a nurse? $36,000-$57,000, according to HR firm Streamline Verify.

$36,000-$57,000 would buy lots of different kinds of patient room chairs.

Why Haven’t We Made the Business Case Yet?

After all these years, we’ve yet to collect convincing data to make the business case to invest more in design. People have tried (see my post, Fable Hospital Story Still Needs to be Told), but I really haven’t heard much about it recently.

Why is that?

Well, for one thing, collecting that kind of data takes a lot of time, money, and effort. And healthcare leaders in the U.S. have had their hands full with all the changes that are happening as a result of health reform.

They are all looking at their HCHAPS scores, though.  Because they don’t want to lose their Medicare reimbursements. If we can make the connection between the physical environment and HCAHPS scores, then maybe we can begin to talk about ROI again.

Here’s some good news. The American Society of Healthcare Engineers (ASHE) and the American Hospital Association (AHA) just published a guide that shows how the design of the physical environment affects HCAHPS scores.

I’m encouraged by this. Because if it gets into the right hands, the guide could shift the conversation at some hospitals.

This column originally ran on Sara Marberry’s blog on April 15, 2016. 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.