April 3rd, 2017
Lowly lobbies and stark, noisy waiting rooms are history. As healthcare organizations work to improve the patient experience, these spaces are evolving into destinations for education, engagement, and solace.
It’s a necessary evolution, too, driven by a competitive market that offers more choice to patients in where they receive care and is influencing healthcare systems to view patients as customers as well as users of services. “The important element in everyone’s mind is creating a patient and a family experience that’s memorable and helps set a healthcare organization apart,” says Jocelyn Stroupe, director of healthcare interiors at CannonDesign (Chicago).
And that effort begins as soon as visitors step into a facility. “The whole notion of arrival—finding where they’re supposed to go, the appearance of the waiting area—all of it can be quite impactful on the patient’s perception of their level of care,” says Saul Jabbawy, principal and director of design at EwingCole (Philadelphia). Design solutions in play to address this challenge include adding hospitality touches both aesthetically and through amenities offered, providing variety in seating and elements of distraction, and considering operational flows and programming that makes the best possible use of public spaces.
A warm welcome
Ubiquitous entry points, lobbies no longer simply serve to funnel people from a parking garage or drop-off area into the interior of a building. Instead, hospital leaders have become savvy about the benefits that a hospitality-styled experience can have on patients, reducing stress and creating a positive first impression. Amenities and services located in entry spaces increasingly mirror those commonly found in hotels, including a concierge or staff member to meet and greet visitors at the front door. “Helping guide patients to their locations sets the stage for the overall experience,” says Maureen Carley-Vallejo, principal and senior healthcare interiors leader at Perkins Eastman (New York).
Additional hotel-like features making a statement in lobbies include artwork, which can help bring a human touch to the environment, and high-end materials and finishes. For example, White Plains Hospital Center for Cancer Care in White Plains, N.Y., with interior architecture and design by Perkins Eastman, showcases a terrazzo floor in its lobby, an addition during a recent renovation and expansion that came with a specific goal in mind. “The first impression from an aesthetic point of view is one of quality and care,” Carley-Vallejo says.
Farther in, interiors solutions for waiting rooms today bear little resemblance to the bus station-style layouts of old. Gone are the rows of connected chairs and wobbly tables, shrub-shrouded windows, and televisions blasting talk shows. In their places are comfortable couches, educational kiosks, and soaring views that bathe visitors in natural daylight. “We’re changing the rules of the waiting game,” says Ana Pinto-Alexander, principal and director of health interiors at HKS (Dallas). Her firm is even tossing the word “waiting” from its vocabulary, preferring instead to repurpose the waiting time to better engage, educate, prepare, and relax patients. “The size, space, and aesthetics of the environment change when you stop thinking about it as just wasted waiting time.”
Others, such as Northwell Health, are introducing a homelike setting to set patients at ease. Recognizing that cancer patients at its Imbert Cancer Center in Bay Shore, N.Y., often spend a significant amount of time obtaining treatment over numerous visits, Northwell wanted its public spaces to “be calm and promote healing,” says Sven Gierlinger, vice president and chief experience officer at Northwell Health (Great Neck, N.Y.). “We wanted them to have a feeling of being welcomed.” Opened in October 2016 and designed by EwingCole, the facility’s aesthetic is based on a living room concept, with homelike furnishings, warm colors on the walls, floor lamps, inviting chairs, and ottoman-style tables.
Beyond providing comfort, the design of public spaces can also reduce stress by offering patients and visitors choice in how they experience the environment. “Different people need different sorts of physical conditions,” Jabbawy says. For example, some visitors do better when completely distracted, either through their mobile device or by exploring the hospital’s educational material about treatment options and wellness topics, while others prefer a quieter space. Designing multiple layouts using a mix of seating and table types within a single area gives individuals the ability to make themselves comfortable and offers flexibility. “Some lounges allow people to do their work, to eat with family members, or to cocoon while looking at a video,” Jabbawy says. Flexible seating arrangements that can be pulled together or moved apart support a more customized experience and empower patients and visitors to make the space fit their own definition of waiting.
Lobbies and waiting areas are expanding their roles, too, with healthcare providers increasingly introducing amenities such as cafés and retail spaces that allow users to do more with their time there. “Whenever someone needs to go to the hospital or outpatient facility, it’s a huge disruption to their daily life,” Stroupe says. “We want to make it possible and convenient for those people to do many other things at the same time.” So alongside traditional coffee tables, designers are adding seated-height surfaces where visitors can plop down their laptops and power outlets in easy-to-reach places. “The idea that it’s just a passive state, that people sit and wait, is going by the wayside,” Stroupe says.
Children, especially, benefit from distraction: A bored youngster can become unhappy or rambunctious, which can make even a short wait seem like an eternity and drive up the stress levels of other patients. “You really want to engage the children who are coming there, along with their family members,” says Laura Dyer Hild, vice president at HKS (Richmond, Va.). Children’s Hospital of Richmond addressed this issue at its new outpatient pavilion, which opened in March 2016, by adding interactive elements, such as a digital floor projection where children (and their parents) can entertain themselves by creating ripples in the digital water and watching cyber fish swim around their feet.
Positive distractions are also finding a home in healthcare environments for adults. For example, Minnesota Health Clinics and Surgery Center in Minneapolis, designed by JLG Architects in association with CannonDesign, offers a strategic use of technology. “Within the shared waiting spaces we have discovery bars with iPads where patients can explore research opportunities and healthy patients can also look at educational material,” says Dr. Lynne Fiscus, executive medical director at the University of Minnesota Health Clinics and Surgery Center, which opened in February 2016.
Best use scenario
Patients and visitors don’t always behave the way they’re expected to, either—a fact that’s driving some new solutions. Mary Frazier, principal at EwingCole, says a recent study conducted by her team revealed that waiting areas inside inpatient units see less use than anticipated. With the addition of seating and other amenities inside patient rooms, visitors are choosing to stay with loved ones and rarely use designated spaces outside.
In response, designers are shifting the focus of inpatient units away from large, central waiting areas, opting instead for lounges that offer specific activities and provide destinations for visitors who need a change of pace. “We’re incorporating areas within the building that could be a caregiver respite zone with access to social workers, financial counselors, and a massage therapist,” Frazier says. Waiting areas disguised as dedicated play spaces are also gaining traction, allowing family members to take restless children out of patient rooms so others can continue to visit. Huddle zones and similar nearby places give loved ones a spot to have quick conversations with hospital staff without straying too far from the patient.
Hank Adams, global health director and senior vice president at HDR (Dallas), says facilities should take flow into account, too. Efficiencies can be created by mapping out how patients might access and interact with staff members, the space around them, and even technology. “Providers need to think through the sequencing of each and every interaction,” he explains. Registration kiosks—already a popular way for airlines to quickly and efficiently move people through the check-in process—are gaining ground in healthcare, but poorly planned placement may not produce the desired results. “Patients entering the clinic are confronted with a decision, and more often than not they choose the registration staff because it’s the easier choice,” Adams says, so it’s important to locate kiosks in visible places that are part of the natural traffic flow.
Facilities can further strengthen patient engagement and create a positive experience by introducing additional amenities in public spaces, such as places to get your blood pressure checked or enjoy a quick yoga session—simple solutions that bring much more value to lobby and waiting spaces that once had very little. “The goal is to create connections with a patient on more than one level, and to use this additional time to educate, engage, and inspire,” Adams says.