Architects, designers collaborate with local medical executives on new buildings

In an era when providers are being forced to quickly adapt to profound regulatory and economic changes in health care delivery, the architectural and design communities who serve them have to likewise change along with the times, local professional leaders say.

That was the message offered this week by a panel of health care industry design experts speaking at an event at the downtown St. Paul offices of the architecture firm BWBR, sponsored by the Minnesota chapter of the American Institute of Architects.

With hospitals switching to a "population health" model that prizes cost-effectiveness, providers are looking to retool how their physical spaces are used. They are turning to architects and their design colleagues to help.

A prime example of how patient consumerism, regulatory changes and architects have joined together is the boom in construction of "mother/baby centers" in the Twin Cities market. For instance, Allina Health and Children's Minnesota alone has built no less than three such birth centers in recent years, with the latest being the Mother Baby Center at United and Children's-St. Paul.

Completed in 2016, the project included the addition of 30,000 square feet of new space housing triage, labor and delivery, operating rooms and postoperative rooms, while a new neonatal intensive care unit was also established next door.

According to the American Association of Birth Centers, part of the reason for the rise of these stand-alone facilities across the country is because of changes in what is now being reimbursed under the reforms of the Affordable Care Act — so there's a regulatory aspect to their coming.

For providers, mother/baby centers are a cost-effective alternative to hospital stays for low-risk pregnancies — thus satisfying their economic imperatives for lower costs. And finally, there's a consumerist element because the centers are specifically designed to please patients with touches making them feel less clinical and more homelike.

"The question is how we can bring wellness concepts into the design of health care facilities," she said. "This includes things like 'daylighting.' Generally, we need to make sure that the spaces we are providing are not only working for the providers but are also providing positive experiences for the patients from a wellness perspective."

Another major role architects can play in the rethinking of health care delivery is in designing spaces for the efficiency of workflow, fellow BWBR architect Rick Hintz told the gathering, drawing on his expertise in working on such projects as the new Hennepin Healthcare Clinic and Specialty Center in downtown Minneapolis.

As part of that project, BWBR and Hennepin County officials worked together on a data-driven approach to identify exactly where patients and workers were flowing, utilizing full-scale mock-ups and prototyping for testing the spaces. Computerized simulations were used to model different kinds of patient-care situations, and existing research was used to inform many of the design decisions.

"Outside social factors, such as serving a patient population which may not speak English, is one of the driving factors changing health care delivery," Hintz said. "On the Hennepin project, for instance, we designed exam rooms that were big enough to accommodate the patient, family members, a county caseworker and an interpreter.

"It's really just a small thing, but it's important because the research showed that if a caseworker is involved from the start, doing things such as helping the patient make it home after the visit, making sure prescriptions filled and following up, the cost of that patient's care actually went down in the course of a year."