The application of Lean thinking can have a significant effect on many aspects of healthcare design, and infection control—a top priority in the industry right now—is no exception. At the Healthcare Design Academy in Houston this past April, Pamela Redden, director of clinical operations for the University of Texas MD Anderson Cancer Center, and Laurie Waggener, research and evidence-based design leader for WHR Architects, spelled out their approach to this design challenge in “Planning Implications: Infection Transmission Prevention and Safety.”

MD Anderson took its inspiration from Virginia Mason’s well-defined Flows of Medicine: a way of assessing eight different processes within a healthcare setting—from the flow of patients through flow of medications to the flow of equipment—for more efficiency and effectiveness. In the HCD Academy session, Redden and Waggener walked attendees through each of the eight flows specifically in terms of infection control, pointing out ways in which the built environment could contribute to better outcomes.

For the flow of patients, for example, it’s all about dedicated space: the admitting lounge, corridor systems, elevators, and a pre-entry triage location. For the flow of staff, they stressed the importance of upfront spatial planning for hand-washing stations, which have an impact on patient room size and corridor width, and the opportunity to implement no-touch design features (e.g., motion sensors for doors, lights, sinks).

The flow of information is a big consideration in facilities today, as handhelds and other devices create new concerns about infection transmission. Redden and Waggener discussed the importance of understanding the current culture and protocol in managing the flow of information and making sure that design facilitates that existing culture—or, alternately, promotes a new process clearly and seamlessly. They also pointed out the importance of keeping staff handhelds away from patient surfaces (such as overbed tables), and suggested that designers create designated surfaces (along with easily accessible touch-down charging stations) for such devices.

There are questions that still arise and need answers in any Lean assessment, the speakers pointed out, relating to measures taken for infection control. Personal protection equipment is very important, for instance, but how much is enough? Redden shared that staff members go through hundreds of disposable gowns per day, and they take up a lot of space in the trash—and waste is antithetical to Lean thinking. “This is a problem,” she said. But the efforts to streamline and address infection control head on are well worth it: The cost of healthcare-associated infections in U.S. hospitals, the speakers shared, is $22 billion.