GS&P DIALOGUE - "Healthcare"

Crystal Balling Healthcare Reform

Fri, 04 May 2012 07:47:42 GMT

Sitting on pins and needles as you await the Supreme Court rulings associated with the constitutionality of the Affordable Care Act? Baby Boomers have been entering the Medicare program this year at a rate of around 7,000 each day. By 2014, millions of Americans will find themselves newly eligible for Medicaid or exchange-based private insurance due to the coverage expansion provisions of the Patient Protection and Affordable Care Act – providing the Act is enacted as planned. Meanwhile, the individual insurance mandate may or may not be found constitutional.

Improve Quality of Care While Reducing Operational Costs

Fri, 04 May 2012 07:47:21 GMT

Improve quality of care, reduce costs – does that sound familiar? These days, hospitals across the country are increasingly being asked to do more with less and are expected to improve their level of care while cutting expenses. I recently participated with a team of designers at GS&P in developing a design response to Kaiser Permanente’s Small Hospital Big Idea competition which challenged the design community to propose meaningful change in support of how this notion could become a reality.

Designers To The Rescue: The Role of Hospital Design In Improving Patient Safety

Tue, 24 Apr 2012 15:09:58 GMT

As a healthcare researcher, patient safety – and its relationship to hospital design – has been one of my primary focuses over the years. The link between the physical environment and health-related outcomes is undeniable, and the healthcare industry is directing more and more time and energy to understanding how successful design can improve patient safety across the board. And as the medical community turns to architects and designers for answers, evidence-based design takes center stage.

The Rise of Mobile Technology in the Healthcare Arena

Mon, 02 Apr 2012 13:57:32 GMT

My colleague Jack Weber recently reminded us in a GS&P Dialogue post that, for most things design-related, "there’s an app for that." In the healthcare arena, this statement is also becoming more of a reality every day as our healthcare clients grow increasingly interested in emerging technology trends. So what does this mean for us as architects and designers?

Reflections on 2011: A Year In Healthcare

Mon, 19 Dec 2011 16:52:30 GMT

When asked to present reflections on 2011, I found my mind turning to my fine colleagues at GS&P and their many recent achievements. I have proudly watched my extraordinary colleagues repeatedly win competitions and awards such as the Healthcare Design 2011 International Architectural Showcase Citation of Merit Award presented to the Seoul National University Hospital Medical Mall team by the American Institute of Architects and Center for Health Design; the Kaiser Permanente Small Hospital Competition (shortlist of three finalist firms); and the Methodist Le Bonheur Healthcare Olive Branch Medical Center competition with its integrated project delivery approach; in addition to a host of others.

My mind also turned to the encouraging signs of economic recovery that are steadily emerging and of the dramatic change that is sweeping the national healthcare industry. During 2011, we've witnessed a healthcare revolution materialize in direct response to medical error rates and the costs of healthcare. We've listened as our federal legislators have called for healthcare providers to accept accountability for the quality of care and the costs. Federal legislation has encouraged the creation of accountable care organizations, where providers and payers are joining ranks to deliver higher quality, more efficient, lower cost care. We've observed the continued emergence of regional super powers who have acquired a number of the struggling, but promising hospitals who in many cases do not have the balance sheets to sustain.

The Inaugural Harvard America-China Health Summit

Thu, 29 Sep 2011 10:29:30 GMT

Gresham, Smith and Partners has been working for the past three years with the Minghang District Health Bureau on the planning and design for the new Shanghai International Medical City – a 77-acre site which includes 5,000,000 square feet, 3,000 beds, five hospitals and specialty clinics. As part of that effort we're working closely with our client to help connect them with leading healthcare organizations across the world with whom it would make strategic sense to create an outpost for their organization within the Medical City.

Last week I traveled throughout the U.S. with Dr. Xu Su, Director of the Minghang District Health Bureau in Shanghai. We met with several U.S.-based educational healthcare institutions to talk with them about this first-of-its kind healthcare facility in China and how it aims to showcase the future of healthcare in the Country. As part of the trip, Dr. Xu was asked to participate in the inaugural Harvard America-China Health Summit sponsored by The Harvard School of Public Health China Initiative.

The Summit, attended by Chinese and international leading policy makers, experts, senior health executives, NGO and health industry leaders, served as a forum to share experiences, discuss lessons learned and exchange ideas regarding healthcare reform and public health initiatives within the two countries. While there may be numerous differences in the two countries, the conference focused on how the countries could learn from each other in an effort to reach a shared goal of creating an effective and efficient health system which combats diseases, improves health outcomes and increases access.

Guest Blog: EDAC Raises the Bar for Evidence-Based Design

Tue, 12 Jul 2011 09:17:33 GMT

I'm happy to introduce GS&P Dialogue's first guest blogger – Sara O. Marberry, EDAC. Sara is executive vice president and COO of The Center for Health Design (CHD) – the organization which created the EDAC (Evidence-based Design Accreditation and Certification) program.

As a firm, GS&P has long been a proponent and practitioner of evidence-based design. We're supportive of the efforts of The CHD (in 2010 we became the first EDAC Advocate Firm to fulfill its commitment of having 25% of our healthcare team to be certified) and asked Sara if she'd share with us some background on the evolution of the EDAC program, how it aims to benefit the Healthcare industry and how you can take part.

VanderbiltHealth at One Hundred Oaks is a {Green} Star!

Thu, 07 Jul 2011 08:28:27 GMT

There was a great turn out for the Middle Tennessee Chapter of the USGBC's recent Green Star Awards event. The recognition event was held downtown just around the corner from our Nashville office at the Rymer Gallery. While the peer to peer event was about celebrating this year's award-winning local projects that have had a positive impact on the environment, there was a true sense of respect among those in attendance for the impact we are making on our community through our collective efforts.

Five projects were honored with awards in varying categories – and I was proud to represent GS&P for our work on VanderbiltHealth at One Hundred Oaks (OHO) which was awarded in the Existing Building category. Bobby Otten, Vanderbilt's project manager, and I made a short presentation to the group which hit on the highlights of the project, while also paying special attention to the details the jury (comprised of members of the East Tennessee USGBC Chapter) noted in their selection of the project to receive an award.

"If I were in your shoes" - Designing for the Alzheimer’s Patient Clinical Experience

Tue, 07 Jun 2011 08:20:45 GMT

It is estimated that there are more than 5.1 million people in the U.S. today who have been diagnosed with Alzheimer’s disease. If you have not had the opportunity to spend time with a family member or friend who is suffering from Alzheimer's disease or related dementia, it is an eye opening experience. My initial exposure to the disease was during a typical annual trip up north to visit my grandmother. At first, it seemed as though she was behaving normally. She was excited to see me - smiling, talking, and moving about without difficulty. She appeared to be taking care of herself quite well. However, it was during our later conversations about the past, while perusing old photos, and discussing more recent events that I noticed she could not retain simple details we had talked about just 5 minutes prior. The answer seemed simple to me; to just speak more slowly, repeat my answers to her questions. I thought I understood what she was experiencing.

Protecting Patients From Themselves, and More

Wed, 18 May 2011 08:30:18 GMT

A distraught patient admitted to a behavioral health unit at a major teaching hospital is found hanging from a closet door, having committed suicide sometime between 15-minute security checks. This scenario is all too common. Approximately 1,500 suicides occur each year in inpatient hospital units. Suicide is the leading cause of violent deaths in the United States, and ranks as the 11th most common cause of death in our country. In fear, we lock our car doors when driving through the “bad part of town”, often without realizing that nearly twice as many people die from suicide than homicide each year. Keep locking your doors, but don’t dismiss the fact that suicide is a real threat for many in our population, both young and old, suffering from addictions, unfortunate circumstances, or mental illness.

The Pros and Cons of Single Family NICU Rooms

Wed, 30 Mar 2011 10:30:12 GMT

For no apparent reason my son, Noah, was born five weeks early. That may seem like no big deal, but when you’re a first-time parent and your tiny baby is in the neonatal intensive care unit (NICU) attached to all sorts of devices… it's a REALLY big deal. I gave birth in what is known as the “baby factory”, a metropolitan hospital in the southeast which delivers approximately 18,000 babies each year. The care we received was outstanding. The neonatologists and NICU nurses were incredible. I’ll never forget Nurse “Q” as she cuddled my son and affectionately called him Boo Boo.

In spite of the high quality of care we received, I was uncomfortable in the NICU environment. As I passed by, I glanced at the other NICU babies (although I knew I shouldn’t stare), some much smaller than my own. I was intimidated by the tubes and needles and beeping alarms all around. I felt uncomfortable trying to breastfeed with just a privacy curtain separating me from the others in the room. The nurses recommended we provide our baby with skin-to-skin contact (known as “kangaroo care”), but that too felt awkward given the limited privacy, so I didn’t do it much. As my son’s condition improved over the next several days, he was moved into a room that housed only three infants, and I was more comfortable in that environment. Of course Noah was healthier too, so that eased my mind.

Standardized Environments and Same-Handed Rooms; The Debate Continues

Wed, 09 Mar 2011 08:50:57 GMT

Throughout my professional career I've been focused on designing healthcare environments. Over the past several years, I'm glad to say that I've seen a steady increased interest in correlating how facility design can directly impact healthcare and healing environments. With this week marking the 9th annual National Patient Safety Awareness Week, I thought it appropriate to stir the debate on standardization and same-handed room design. This is a topic on which everyone seems to have an opinion.

The Hype and Fervor Over Accountable Care Organizations (ACOs)

Wed, 23 Feb 2011 08:46:37 GMT

In a recent interview for a keynote speaking opportunity, a State Hospital Association VP quickly moved to their desired agenda. “It’s all about ACOs! What are all the magic numbers? What is the required size (covered lives) of the community? How many primary care providers do we need? How do we measure risk?” The hype and fervor over Accountable Care Organizations is undeniable, but for most unwarranted.

For the vast majority of hospitals, planning for your transition to an Accountable Care Organization is like a high school coach planning on taking his team to the Olympics. While there may be one or two individuals with the potential to compete at that level, they are years away from being ready. The journey will require more training, new measures of performance and the ability to accept some loses.

Tackling Toilet Issues: The ADAAG Toilet Room Dilemma

Mon, 31 Jan 2011 09:30:20 GMT

I realize that I am not the only daughter in the world to think that her mom is the most amazing person that ever lived. My mother, a coal miner’s daughter from the hills of east Tennessee, was fiercely independent, selfless, kind, funny, gracious, and… well, simply amazing. Our family and friends painfully watched as she was robbed of her abilities to care for herself. The culprit, a rare neurodegenerative disease called progressive supranuclear palsy took her life one year ago. Living nearly 700 miles away, I was unable to help care for her to the extent I wished, but during my frequent visits I helped her get dressed, put on her earrings, brushed her hair and assisted her in the bathroom. In my parents’ home, the toilet is located between the vanity and the tub, and the bathroom is not large enough for a walker or wheelchair. There is little room for an assistant to stand alongside to help. My mother fell in the bathroom on more than one occasion. This difficult design problem, however, is not unique to 1960’s ranch-style homes, but exists even in our healthcare institutions – in hospitals and skilled nursing facilities where we care for patients who need assistance with toileting.

Gardens in Healthcare Facilities: Growing Healing, Hope and Restoration

Wed, 01 Dec 2010 11:50:12 GMT

On Easter Sunday, at the age of 26 years old, I was diagnosed with an aggressive form of non-Hodgkin’s lymphoma. At the time, the odds of surviving the disease for 5 years or more were 54%. That was 16 years ago. I spent nearly a week in the hospital following my diagnosis in the emergency room, and was encouraged by the many friends and family members that came to see me. And I will never forget the rooftop garden. The flooring, in patterns of color, was made from recycled tires. The plants, both young and mature ones, were full of life. At the risk of personifying, they were joyful, reaching out as if to embrace me. It was in the garden where I cried, reflected on my young life, and contemplated the future. I spent time there alone and also with others. It was an escape from the dull, cold walls of the hospital – a place of respite, a creation abounding in benevolence.

Over the past decade or so, gardens in the hospital and long-term care settings have increased in popularity. The term “healing garden” refers to either indoor or outdoor gardens that offer restorative properties and elicit other positive influences on patients, staff and visitors . They provide opportunities for connecting with nature – a place to walk, read, eat, or just sit or meditate. There is evidence that spending time in gardens can lower stress, boost a person’s mood and improve satisfaction. Gardens may provide an “escape” from adverse hospital environments.

Health Care Reform: If You Fail to Plan, You Plan to Fail

Tue, 29 Jun 2010 12:43:32 GMT

Too many hospital administrators continue to squander the precious present, while they wait for some documentation or signal from Washington, D.C. that the future of health care has been decided. These are the same individuals who were waiting for clarity with the passage of the healthcare reform bill. It has now been longer than three months since Vice President Biden sent up a flare and notified us what a big deal this truly is. By now we have had the opportunity to read numerous interpretations and insightful implications of the bill. The challenges are significant and for many unsettling, but the direction is clear. The sooner we get past the anger and fear, the sooner we can arrive at responsibility and intention.