Steve Jobs may have changed technology forever but, with the design of his iconic Apple Stores, he also left his mark on the design of physical spaces.
Now his legacy is being felt in an unlikely place: a hospital.
The University of Minnesota Health Clinics and Surgery Center in Minneapolis, which opened earlier this year, was inspired by the Apple Store, designed to be more experience than ambulatory site.
The similarities are obvious: No lines. No intake desks with authority figures. Instead, visitors find concierges at the door and a wide-open floor plan with walls of glass. Patients can find appointment information online, in advance, to save time and hassle, as they would before checking in at an airport.
“We took a really big risk here,” Mary Johnson, the organization’s chief operating officer, told STAT.
It’s a $165 million risk, to be precise. But the bet is that the approach will increase patient satisfaction and staff efficiency, all with a design footprint that’s smaller than other academic medical centers with similar patient loads and staffing levels.
The smaller footprint has allowed the university to save $25 million in construction costs, Johnson said, with more savings in lease payments and maintenance.
The facility isn’t tiny, though. The five-story, 342,000-square-foot building houses an inpatient surgical center and several adult clinics, and can serve more than 2,000 patients per day.
Unlike at other academic medical institutions, nobody at the center gets an office. The center’s design firm, Boston-based architectural firm CannonDesign, said that research shows private doctors’ offices are literally a waste of space, sitting empty 90 percent of the time.
Instead, staff members are given desks along broad banks of windows upstairs, conference rooms, and a three-story open-air staff lounge space. (Patient-care rooms are clustered at the building’s center.) Office materials are designed to deaden sound, and the HVAC system infuses the area with white noise for privacy.
“We’re asking staff to make quite a huge culture shift,” Johnson said.
David J. Allison, the director of Clemson University’s Graduate Studies in Architecture and Health program, said the decision to forgo dedicated office space is in keeping with trends seen in commercial buildings, where the notion of “hoteling” means that no one has permanent working spaces.
The approach can work especially well in a health care environment, he said, given that it compels medical team members to interact more frequently and directly.
“More and more care is being delivered by collaborative teams that need to work in concert,” he said. “That’s going to be the future.”
Patients have had to reorient themselves, too, including in ways that might test their comfort levels.
When they arrive at the clinic, they are given badges embedded with wireless technology that tracks the their movements through the facility, as well as how long they’ve been waiting in any given room. If the system detects that a patient has been alone in a room for 10 minutes, staff members receive an automated alert, directing them to check in.
Staff members will also get the badges, so they can find each other more quickly.
Other patient-centric design touches include chemotherapy stations. Whereas some chemo rooms are open-air expanses filled with recliners, the chemotherapy clinic at the new facility includes a handful of infusion bays with wall panels that can slide closed for privacy or open for socializing.
“It can’t hurt to have a nice facility, but there are some people who can’t afford to get in the door.”
George J. Mann, Texas A&M University
Johnson said the design might improve patients’ outcomes as well, since they may bring a more positive attitude to their chemo treatments.
Some design experts aren’t so sure.
George J. Mann, a Texas A&M University architecture professor specializing in health care design, said he is skeptical of the trend toward expensive, amenity-filled hospitals, and theories about how design can promote healing.
For 25 years, health care companies have tried to compete in multi-hospital markets by building more facilities with private rooms, open corridors, fancy lobby furniture, and enormous atriums that cost a lot to heat and cool, Mann said. Those costs are passed down to patients.
“Sometimes it’s implied that the amenities will help them get better, but I don’t think so,” said Mann, who has not yet studied the Minnesota facility. “It can’t hurt to have a nice facility, but there are some people who can’t afford to get in the door.”
Johnson said she is confident that this particular design won’t suffer the same flaws. The university, she said, will analyze metrics from patient and staff badges and satisfaction surveys, and will publish results in academic journals.
“We really feel like this will lower the cost of health care,” she said, by increasing efficiency and patient satisfaction, and diminishing the need to return to the center for care. “The data will be really important.”