The evolution and future of outpatient facility design

Amy Dvorak, Associate AIA
Communications manager, Treanor HL

When Steve Carr, AIA, started working in architecture in 1977, health care was much different. Medical records were paper and care was reactive, focusing on sickness instead of preventative health. But as industries evolve, how does design adapt? Some 40 years later, Carr, principal at TreanorHL, navigates new design considerations as the health care industry – and its facilities – evolve to accommodate the modern-day health care landscape.

“Today, there is a greater focus on patient-centered and family centered care and the environments they’re in,” said Carr. “Hospital designs have evolved from institutional-looking facilities to more customer-friendly environments so people can relate.”

At Children’s Hospital Colorado North Campus in Broomfield, Carr is designing a renovation and expansion, which will become a 120,000-square-foot home for multispecialty outpatient care. There, you’ll find softer color palettes, playful textiles and movement in the lines of everything from light fixtures to ceilings.

“Hospitals are moving to a hospitality model, creating welcoming spaces for patients and family members that are no longer clinical, white spaces,” said Mark McComb, managing principal at technology consulting firm EDI Ltd. Yet today, it’s not just the interiors that have evolved. You can’t mention hospitality without it going hand-in-hand with technology. “We went from not caring about tech to it being important, to now transitioning to tech being integral to the patient experience,” he said.

Thanks to geolocation, augmented reality is allowing patients to navigate large facilities, making wayfinding efficient and even fun. Virtual reality is having its day in health care as well.

“Hospitals are now using VR as a distraction for kids, and they’re finding that they can significantly reduce painkillers and drugs prior to surgery,” said Conor Ryan at EDI Ltd. “Pumping kids with drugs is not comfortable and is scary. Using VR technology to transplant them into a new environment virtually is such an innovative way to do things better for the patient.”

Back at Children’s, the reach of specialty care has expanded through telehealth technology.

“There are not a lot of other pediatricians able to meet the wide scope and breadth that we do in the sevenstate region,” said Chris Martin, vice president of ambulatory services at Children’s Hospital Colorado. The facilities offer specialized care to patients across the country, yet through telehealth video capabilities, they are able to develop strong patient care teams with their local physicians. “We have some of the best researchers in the country, and in some cases the world, at the Anschutz Medical Campus, and our physicians are seeing cutting-edge treatment that in other states, physicians might not be privy to,” said Dan Coxall, vice president of support services at Children’s Hospital Colorado. “Now, we are able to reach rural communities through virtual technology.”

Other advancements are making their way into the operating room. Augmented reality surgery is occurring, and wireless sensors managed via an app provide physicians with live, data-driven information.

“I’m very intrigued by how various health care systems around the world are going to bring that information together for betterment of mankind and how that might change health care across the world,” said McComb. As generations become increasingly comfortable sharing data, technology in health care will be used as a preventative.

But between apps that sense atrial fibrillation and the advancement of custom, genomic drugs, what can we expect for the future of brick and mortar?

“Five years ago, they said hospitals were going away, but hospitals instead have become much more specialized and complicated,” said McComb. “And outpatient care used to be much more complicated and is now receiving hospital care. We’re seeing that transition from hospital-to-outpatient and outpatient-to-home continuing.”

And the facilities are adapting. Gone are the days of formal reception desks. At Children’s Hospital, check-in occurs via a kiosk, with a more relaxed, informal interaction from a nearby attendant. To accommodate telehealth, rooms are designed for conferencing and IT costs have become a bulk of the budget – and space – compared to the minimal resources required for it in years past.

Exiting the hospital setting, learning services and speech therapy are more common now in outpatient facilities, as well as gastroenterology procedures. It’s not only more convenient, but also the evolution of hospital services to ambulatory facilities is saving families time and money.

“Patient satisfaction is measured most by how soon you talk to a person, identify the problem and perform diagnostics,” said Carr. And there are times when that can only be done in person. “There are pieces of information that happen through physical exams – there’s no way getting around it,” said Martin. “With pediatrics, children and infants are not able to tell the story so well.”

While hospitals and outpatient facilities are here to stay, Carr predicts that in the future, hospital campuses will not become larger, but rather will adjust to specialized services. He also suspects that architects soon will be repurposing parking structures as driverless cars enter the mainstream. It’s a far a departure from those early space planning days when the biggest concern was physical records, but with it comes hope for continued advancements, and until then, the promise of easier, accessible and more comfortable care.

Featured in the January 2020 issue of Health Care Properties Quarterly

Edited by the Colorado Real Estate Journal staff.