Doug King Project Management Advisors Inc.

Photo credit: Project Management Advisors Inc.

In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what has their attention and share their ideas on the subject.

Doug King is vice president and national healthcare sector lead at Project Management Advisors Inc., a program management/owner representative firm in Chicago. Here he shares his thoughts on why hospitals are adding more retail space, the role of FQHCs in providing health equity, and the use of AI and robotics for materials handling.

  1. Goodbye hospital cafeterias, hello stores and eateries

Taking a cue from vibrant coffee shops and revamped airport terminals, healthcare operators are developing mixed-use spaces that cater to contemporary tastes and needs. Hospitals are increasingly eliminating the traditional cafeteria and opting for retail, food, and shopping experiences that appeal to visitors, staff, and patients.

For example, Northwestern Medicine in Chicago removed its cafeteria to implement a robust multilevel shop and dine retail program that includes bookstores, gift shops, newsstands, and offshoots of popular local restaurants. The Peter Gilgan Mississauga Hospital in Mississauga, Ontario in Canada, will implement retail and dining options as part of its original design when it begins construction in 2025.

2. Amenity spaces that support patients and staff

New healthcare facilities are providing outdoor access for staff, patients, and families on multiple levels of the building, as research shows that access to outdoor areas and greenspace can help to improve patient outcomes, boost staff mental health and provide patient families with a calming space to decompress. For example, St. Francis OSF Hospital in Peoria, Ill., recently built a rooftop garden so that staff, patients, and the siblings of the children in the pediatric area and neonatal intensive care units have access to a shared green space. The Peter Gilgan Mississauga Hospital is also exploring the addition of accessible outdoor respite areas for its staff that will be located across multiple levels in the facility.

Additionally, childcare options are increasingly becoming a major consideration at healthcare centers, as it can be difficult for patients without adequate childcare to make their appointments on time. Missed appointments can affect revenue for the provider and interrupt the healing journey of the patients, so integrating daycare centers into medical settings can provide a positive return on investment for providers and help facilitate care provided for the patients.

  1. The future is now: Logistics automation and AI for materials handling

To mitigate staff shortages, decrease the risk of infection, and increase operational efficiencies, many larger healthcare facilities are exploring the use of logistics automation systems, artificial intelligence (AI), and autonomous robotic vehicles to handle certain repetitive service tasks, such as internal transfer of food or linens, previously done by service staff. As a result, many new healthcare environments will need designs that accommodate these technologies. For example, hallways need to be wide enough for autonomous vehicles or robots to move along without obstructing the flow of human traffic.

Currently, our team is engaged in a large hospital project where AI and robotics are a key aspect of the materials handling system. Automated guided vehicles (AGVs) and autonomous mobile robots (AMRs) use sensors, AI and machine learning to define their own paths through the hallways and carry everything from soiled linens and lab work to medications throughout the facility.

This approach requires considerable upfront attention to programmatic needs. Early planning is prudent because these systems are process-based, and their flow needs to be designed for. For example, early in the design process, determining whether selected elevators will be designated for AGV or AMR use can contribute to the end quantity of elevators in the facility.

  1. Centering holistic health

Many healthcare organizations are adopting a “Health in All Policies” (HiAP) holistic approach to the care and branding of their facilities. Originally coined by policymakers in the European Union in 2006, HiAP recognizes that population health is dependent on policies that go beyond the health sector. These health-related considerations include food and transportation access, ergonomics, infection control, accessibility, designing for an aging population, and other amenities that promote healthy living. Considering the needs of the population being served by the facility is crucial to meeting HiAP standards. HiAP recognizes that the built environment can help or hinder the health of a population. When building with a HiAP approach, health is infused within all built conditions. A HiAP approach to healthcare design can manifest in many ways, including ensuring all facilities are accessible through public transportation, providing options for healthy food on site, building in ramps and elevators to accommodate disabled and elderly patients and outfitting the space to be visually appealing with art and design that speaks to the interests and histories of the populations being served.

  1. FQHC’s role in addressing health equity

Federally qualified health centers (FQHCs) are healthcare’s best kept secret and a frequently overlooked approach to addressing rural health viability. These outpatient facilities receive enhanced reimbursements from the federal government to provide comprehensive, high-quality primary care and preventive services to underserved populations, regardless of the patient’s ability to pay.

Considering the location and design of these facilities is a necessary step in ensuring they best serve these populations. There is ample opportunity in converting old or unused retail or office space in centralized locations. For a project in New York City to address housing for the homeless, we explored converting a single room occupancy hotel into a shelter for the unhoused and adapting the ground floor, formerly used as a retail space, into a FQHC designated clinic to better serve the community.

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