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Thankfully, the old, paternalistic model of healthcare design and construction has been turned on its head. Gone are the days when a handful of hospital administrators made decisions in a vacuum. As Michael H. Covert illustrates in his article, the new design model, known as co-design or participatory design, is an iterative, interactive, and inclusive process. It harnesses creativity and sparks new solutions by engaging all stakeholders-patients and families, providers and staff, and the community.Co-design is best started well before the actual design process begins, and it should not end when the ribbon is cut on a shiny new building. Done well, it can support the delivery of exceptional patientand family-centered care for many years to come by breaking down barriers, embedding process improvement practices, encouraging engagement, and fostering a culture of excellence.The manifold complexities of planning, designing, building, and funding a new healthcare facility in today's environment are well articulated in both feature articles. In this commentary, we highlight some of the priorities and practices our organization found to be most useful in constructing our awardwinning children's hospital.To Build or Not to Build?In 2008, Fairview Health Services broke ground for University of Minnesota Children's Hospital (formerly University of Minnesota Amplatz Children's Hospital), which opened in 2011. Our children's hospital is part of University of Minnesota Medical Center, which Fairview operates in collaboration with University of Minnesota Physicians. As an academic medical center, we serve a large population of acute patients-many of whom have hospital stays that last weeks or months. The decision to build a new facility was driven by the fact that our pediatric units and programs were scattered among various buildings on the medical center's two campuses, located across from each other on the banks of the Mississippi River in Minneapolis.Several staff members who worked closely on this project described it as "blessed"-everything came together, and it was completed on time and slightly under budget. The credit rests squarely with the steering committee; the executive project manager; the clinical and operational planning leads; and the hundreds of stakeholders, including patients and families, who devoted themselves to achieving our overarching principle: Create the best environment to receive and provide children's healthcare.How We Did It Develop Guiding PrinciplesAn essential first step was to develop guiding principles that would set the direction and framework for the planning, design, and construction of our children's hospital. The four-page document that was produced details specific guidelines related to care, research and education, building design, image, community involvement, and capital stewardship. Far from being some pro forma document that sa\t in a file cabinet, it helped shape decisions, large and small, throughout the process.Some of these guiding principles mirror the design principles applied by Palomar Health, as outlined by Covert. Whereas Palomar Health's focus seems to have been divided among a number of considerations, such as maintaining expandability and flexibility and managing costs in addition to creating a more patient-centric culture, our focus was trained squarely on the patient and family experience. It was our first guiding principle-"Optimize the patient and family experience through a plan and design that fosters patientand family-centered care"-and served as a touchstone in countless decisions throughout the hospital, not just in patient rooms. (See more details in the "Focus on Patients and Families" subsection.)Another guiding principle was the safety and security of patients, families, staff, and physicians. We brought in a national expert in safe-room design to advise us. Like Palomar Health, we also chose to install same-handed rooms, rather than mirror-image rooms. … |
