WEST MICHIGAN — For many patients and visitors, the next trip to the hospital could soon offer some of the same posh atmosphere as the trendiest hotels, not to mention improved care and faster recoveries.
Health care systems on the west side of the state are no stranger to the latest innovations in technology, room design and service models. Spectrum Health, Mary Free Bed Rehabilitation Hospital, Bronson Methodist Hospital, Borgess Health and Holland Hospital are all in the process of physical facilities upgrades.
Coupled with an increase in senior and long-term care facilities being built because of the state’s aging population, and it comes as no surprise that health care facilities — like patients — are getting a healthy dose of treatment.
The prescription: good design.
Analysts, research institutions and health care professionals attest that the current internal and external investments are in part a reaction to the changes to Medicare and new insurance mandates. Still, it’s patients that are the ultimate impetus behind the changes.
“Yes, there is an (industry) trend,” said Lorissa MacAllister, president of Enviah. “But it’s really patient-driven. These are demands of a new generation coming up.”
In 2010, MacAllister started Enviah, a Grand Rapids-based research-based design consultancy that focuses on health care environments, after serving as Progressive AE’s health care strategic business unit leader. She is currently working on getting her Ph.D. from the Georgia Institute for Technology in evidence-based design and how it can inform behaviors and outcomes. MacAllister is also involved with the Samueli Institute in Washington, D.C., a nonprofit service organization that pushes scientific research in wellness and healing processes.
Her research with the Samueli Institute is aimed at studying “salutogenic” approaches, which value human health and well-being over the factors that lead to disease and disease treatment. First introduced in 1979 by Aaron Antonovsky, an Israeli-American medical sociologist, the salutogenic model describes the relations between health, stress and coping.
At North Ottawa Community Hospital, an 81-bed acute care hospital in Grand Haven, MacAllister, through a grant from the Robert Wood Johnson Foundation and the Alliance for Health in Grand Rapids, is helping the health system implement new operational improvement tracking.
The goal of the program is targeted at improving patient satisfaction, improving workflows and patient empowerment.
“We are working with several local vendors to improve and study how the physical environment impacts healing and wellness at the hospital,” MacAllister said. “Privacy was a big piece, reducing sound transmittance in patient rooms to nurse stations.”
With the help of Grand Rapids-based Acoustics by Design Inc., the hospital implemented sound panels that reduce reverberation without having to alter the open work environment. Emergency department rooms were also outfitted and standardized by Herman Miller.
At Mary Free Bed Rehabilitation Hospital in Grand Rapids, the organization is embarking on a $51.3 million renovation and expansion project, in which MacAllister is also involved. The design includes all private “smart” rooms with integrated environment controls for the patient, large windows and terrace green spaces.
Holland Hospital is working on a $10.7 million renovation and Spectrum also plans to open a new 100,000-square-foot East Beltline facility that will house neuroscience, women’s health, urgent care and primary care offices.
Also coming into play: performance-based contracts with insurers, like the one signed between Trinity Health and Blue Cross Blue Shield of Michigan that covers 12 hospitals across the state that serve patients in 31 counties, including Mercy Health Partners in Muskegon and Saint Mary’s Health Care in Grand Rapids.
In a move away from the fee-for-service model, performance-based participating agreements are designed to improve the coordination of care for patients as they move through the system and to better manage patients’ health, particularly those with high-cost, chronic conditions such as asthma or diabetes. Basing reimbursements on outcomes aims to raise quality and control costs by financially rewarding hospitals and doctors with higher reimbursement payments.
As of October 2012, up to 30 percent of a hospital’s Medicare score, which dictates private insurers’ payments, will be based on patient satisfaction, according to the article “Spaces that heal” in the December issue of Fast Company.
Layer this stimulus with a growing amount of research indicating that homeopathic treatments — including exposure to nature, art and music, among other factors — help reduce pain and encourage faster, less complicated recoveries, and it’s no surprise more health systems are turning to architects to get improve their performance metrics.
What’s more, the patient pool across the region isn’t increasing, according to Lody Zwarensteyn, president of the Alliance for Health, a Grand Rapids-based nonprofit coalition that focuses on health care quality and costs. Patient numbers appear to be holding steady as hospitals try to draw patients from farther away. To do this, hospitals need to distinguish themselves as providing the latest and best in medicine, he said.
While improving hospital facilities is primarily related to cutting down hospital-acquired infection rates, readmissions and increasing patient safety, the upgrades are equally important to talent attraction and retention, Zwarensteyn said.
“There are some tremendous pressures in the future for hospitals to be more efficient and cost-effective and a greater value for customers,” he said. “At the same time, they have to try and have facilities that will appeal to potential new staff — nurses, physicians and technicians.”
All these positions face serious shortages in the coming years, he added.
In Michigan by 2020, there will be a shortage of 8,000 to 12,000 physicians, of which 4,000 will be primary care physicians, according to the Association of American Medical Colleges. This shortage will only grow when more than 1 million uninsured Michiganders will be eligible to receive coverage thanks to changes enacted with the passage of the Affordable Care Act.
With knowledge of the shrinking talent pool in the backs of their minds, hospital chiefs of staff have another hard pill to swallow when they need to pony up the cash for new projects. As the Fast Company article points out, the Institute for Healthcare Improvement’s research suggests amenities such as bigger windows, cleaner air systems, decentralized nursing stations and larger single-patient rooms can add $30 million to the $350 million cost of a typical 300-bed hospital.
One architecture firm that is cultivating new health care work is Progressive AE. The firm is actively involved in the Alliance for Health and has a dedicated team of engineering and design experts committed to health care systems. In December, the company even hired away Spectrum Health’s director of facilities planning, design and construction, Lon Morrison, who will lead Progressive’s health care practice.
“What we are finding with our health care clients is that demands in health care metrics and performance, along with consolidation of competition, is forcing them to make these investments,” said Jim Horman, senior team leader and architect with Progressive AE. “They can’t hold off anymore. There has been a pent-up demand for renovation and our health care partners are continuing to reinvest in their facilities.”
The architecture firms in West Michigan are well-versed in those design concepts that translate into a better patient experience, Zwarensteyn said. Whether it’s incorporating healing color palettes, expanding outside views or improving workflows, sightlines and sterile environments, the health systems in West Michigan understand the value of these designs, which Zwarensteyn said is summed up by three words — “quality” and “cost-containment.”