Jennifer Silvis

Earlier this month, the chief economist for the Associated Builders and Contractors (ABC), Anirban Basu, noted during a press conference that a recovery of the nation’s construction industry may be as far as two years away.

In even more deflating news, Basu predicted that nonresidential construction will likely see an even further delay.

Furniture—like heating and lighting—remains indispensible to delivering quality healthcare. These common objects are expected to support many healthcare tasks, such as providing patients and family members with support from stress and fatigue, enabling caregivers to work safely and effectively as a team, and reflecting a healthcare organization’s vision and brand. Together, it can be quite a tall order.

Beth Israel-Deaconess Medical Center (BIDMC) is a large tertiary care hospital, part of the Longwood Medical District in Boston. BIDMC is the result of two separate hospitals that merged in 1996, resulting in a campus that has two specific areas (East Campus is the former Beth Israel Hospital; West Campus isnthe former Deaconess Hospital) that are two blocks apart in a dense urban area. 

There is a virtual vise applying significant pressure on hospitals today. On one side is the desire to improve patient outcomes, which supports evidence-based design and can be a key criterion in pay-for-performance compensation.

On the other side there is increasing competition as users view everything from physicians to facilities through the eyes of the savvy consumer, requesting better care, more amenities, and the kind of customer service that has traditionally been associated more with hotels than hospitals.

As providers begin to understand the impact healthcare reform will have on their business, many hospitals and medical centers are looking to Lean process and design as a way to do more with less. Several elements of healthcare reform beg Lean solutions, such as the expected growth in outpatient care and more cost-efficient inpatient care, and, increasingly, designers are employing Lean strategies to create spaces that encourage Lean operations.

A major ongoing debate in the healthcare industry is regarding the expected transition of the sector to accountable care organizations (ACOs). Two aspects of this transition yield interest and apprehension alike. One is the process of care delivery, with the need for an extensive network of providers that must closely cooperate and coordinate during the care process to realize and share any savings. The second area of interest (and apprehension) pertains to the physical infrastructure, or built space.

Just over a year after the historic signing of the Affordable Care Act, the healthcare reform law remains as controversial as ever. Whether you are for or against it, one thing is certain: Hospitals and healthcare organizations will be affected. The question is, by how much and in what way?

Children entering the lobby at the historic Children’s Hospital Boston have a visual treat in store. They see an 18-foot-wide, 8-foot-high wall of carved glass depicting a child with upraised arms at one end and "wind" lines swooping across six panels. As they walk along, a butterfly-shaped kite materializes over the engraved child’s head in glowing blue lights and sweeps along with the wind to the far end of the display.

Years ago there were two worlds of outpatient care—what physicians provided in their office and what hospitals offered within a defined facility with limited outpatient services. There were a few exceptions to this model, but outpatient care was usually the add-on to already stressed inpatient departments. Little thought was given to convenience, cost control, or amenities. Now, the proportion of care delivered outside the hospital has grown and the demand for special ambulatory environments drives the healthcare market.