Wilsonart Healthcare Trend Report by Wilsonart

TREND REPORT For the Healthcare Industry

By Sally Chavez, NCIDQ, LEED AP ID+C, Wilsonart Senior Designer

HEALTHCARE TREND REPORT The practice of healthcare, the advancement in technology and new innovations in architecture have converged. This convergence highlights the need for healthcare design that not only supports physical tasks needed by those seeking care, but also the psychological and emotional needs for all who use the space. This focus on addressing not only physical but also psychological and emotional needs is a major paradigm shift in the goal of healthcare; the focus has gone from merely treating injury or illness, to encouraging a lifestyle that results in ongoing wellness. Minimal design attention that only provides a pleasant, clean, and sterile environment are long gone. Facilities must provide a supportive environment for healing that also encourages healthy choices leading to faster healing and wvwvongoing wellness. Identifying and implementing trends that shape the next generation of healthcare design is a slippery slope. Trends adopted too early can become quickly outdated. Trends adopted too late could lead to having to play catch up. How do you know what’s “just right?” While there is still no magic way to predict the future, we can learn to recognize important elements vital to continued development in the evolution of healthcare. We’re going to explore just 5 of the trends impacting healthcare design today.

1. Philosophical Changes in Healthcare 2. Retail Approach to Healthcare 3. Demographics 4. Materials 5. Future Proofing

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PHILOSOPHICAL CHANGES IN HEALTHCARE There have been many philosophical changes in healthcare. The focus on a positive patient experience is one of the most important changes affecting healing environments today. This one change alone has led to significant improvements in patient satisfaction, outcomes, and reduction in cost of care. What is a positive patient experience? This is a focus on meeting basic human needs and an acknowledgment that there is a partnership between the patient and the healthcare professional. Basic needs include: being able to receive good treatment in a comfortable, caring, and safe environment; delivered in a calm and reassuring manner while being spoken to; being listened to as an equal; and being treated with honesty, respect, and dignity. Having access to the information needed to make informed choices gives patients what they need to feel more in control. Healthcare has become an active process where patient participation is vital to a return to normal health and wellness. Not only are patients expected to be an active member of the healthcare team, they must lead the charge as an advocate in their healthcare experience and healing process. Ultimately, itâ&#x20AC;&#x2122;s up to the patient to improve their recovery outcomes and create ongoing health. Decisions to choose better, healthier food and a more active lifestyle have wide reaching benefits. Research has shown that even an active social life can provide a number of benefits to physical and mental health.

A 2010 analysis found that people with stronger social connections were 50% more likely to live longer than those with weaker connections. That makes the impact of friendlessness is comparable to that of smoking.

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THE RETAIL APPROACH TO HEALTHCARE Many doctors’ offices are only open on weekdays during business hours. This also happens to be when most adults work and when children attend school. As more and more families have shifted to dual income households, retail health clinics have become a primary source of care because of the convenient hours they offer. These types of clinics are typically located in retail stores, supermarkets, and pharmacies. They treat uncomplicated minor illnesses and provide preventative health care services. They are sometimes called “retail-based clinics,” “convenient care clinics,” or “nurse-in-a-box.”

Retail healthcare gleans insights on how retailers are crafting in-store and online experiences to engage consumers with their brand. This type of data provides deeper insight into how to better engage with their patients and community, while offering friendlier and more personalized service. This ultimately improves the perception of quality at any type of facility. As with any successful retailer. From the first online check in to the design of the facility, healthcare design is able to provide a significant positive impact on the ability to not only provide excellent care, but attract and cultivate patient relationships.

Consumers are becoming savvier in all marketplaces. According to research done by Gensler titled “Retail Health, Retail Medicine, and the New Healthcare Experience”, people expect convenience, quality, and transparency when choosing how to spend time and money outside of the healthcare arena. Consumers are now seeking the same from their healthcare providers. Retail health is emerging as a means to deliver quality and convenient care to millions of consumers has become a model for healthcare systems providing services to new and existing patient populations.

Infographic by Gensler www.gensler.com | http://bit.ly/2fvwUHk

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DEMOGRAPHICS The patient population continues to change. Population size, age, race and ethnicity all affect the healthcare resources needed, cost of care, and even conditions associated with each population group. Healthcare organizations will have to adapt quickly to meet their patient’s changing needs - all while addressing healthcare reform requirements. The shortage of health professionals trained to care for older adults is well documented in what has been called “The Silver Tsunami.” The number of Americans ages 65 and older will more than double from 46 million today to over 98 million by 2060, and the 65-and-older age group’s share of the total population will rise to nearly 24 percent from 15 percent in that same time period. Additionally the older population is also becoming more racially and ethnically diverse. Between 2014 and 2060 the share of older adults that are non-Hispanic white will drop by 24 percentage points, from 78.3 percent to 54.6 percent.

Older patients are more likely than their younger counterparts to have one or more impairments that need accommodation. Combine that with the proliferation of highly specialized hospitals that primarily handle the highest-acuity cases and you have a gap between providers, hospitals, and specialists. Establishing a partnership to address these changes is important in understanding the impact that these demographic changes have on managing an aging population. Additional demographic concerns include culture, religion, and obesity. These concerns are playing a larger part in the quality of healthcare. As seen in demographic analysis, racial and cultural diversity is increasing. Obesity is also probably one of the biggest challenges in healthcare today. Obesity rates among older adults have been increasing, starting at about 40 percent of 65-to-74-yearolds in 2009-2012.

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DEMOGRAPHICS Health-care professionals must become cognizant of these differences within their patient community. It is important that healthcare professionals develop skills to communicate clearly to all patients in a respectful manner, regardless of their demographic category. From patient age and size, to religious preference and gender, diversity isn’t going away. The once “one-size-fits-all” notion of health care has all but dissolved. Hospitals and other health-care organizations have to continually assess and plan to meet the needs of a changing patient population. The challenge for all involved in the healthcare system is how to treat patients effectively, while meeting the needs of people of all ages and abilities. The concept of universal design is a promising start. Championed by architects, product designers, engineers, and environmental design researchers, this concept has the goal that design can be used by “all people, to the greatest extent possible, without adaptation or specialized design.” The point of universal design is seamlessness throughout a space to support patients and workers alike. The number of workers 65 and older in the general population will increase nearly seven times as fast as the total labor force. Workers postponing retirement account for this up-tick in the over 65 segment of the workforce. It is important to not forget about is the change in demographics in the medical workforce. The aging RN workforce has been recognized for many years. Now physicians, laboratory technicians, and respiratory therapists are experiencing similar trends in terms of aging professionals.

Experts say the medical workforce is already too small to handle the aging baby boom population and the shortage will only get worse with time. Not only will there be too few physicians to meet demand, but doctors coming on board today want more balance between work and personal time. Gen Xers and millennials who desire a 40-hour workweek are replacing the current generation of workaholic physicians. Encouraging older health care workers to remain in the workforce will require strategies to accommodate their changing abilities. As people age, their functional capacity is more likely to be reduced and affects their ability to accomplish certain workplace tasks. Efforts to retain the older workforce must incorporate a number of policies and procedures that address the promotion of health, education, career enhancement, and job sharing opportunities. An aging healthcare workforce will also require workplace facility accommodations to do their jobs effectively. Ergonomic and mechanical lift devices, along with additional training can help workers avoid injury on the job and in their interaction with patients. Changes to hospital planning can provide for improved design of patient units to avoid extensive walking, as well as addressing the need for appropriate furniture, flooring, and lighting.

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MATERIALS The choice of materials is moving beyond sustainability and function. Many believe that the design of healthcare facilities should alleviate stress, mitigate the spread of disease, improve occupant comfort, and produce better outcomes. Industries are moving beyond just environmental sustainability to the WELL Building StandardÂŽ. WELL advocates for health and well-being like LEED advocates for sustainability. The WELL Building StandardÂŽ is a performance-based system for measuring, certifying, and monitoring features of the built environment that impact human health and wellbeing. This is accomplished through air, water, nourishment, light, fitness, comfort, and mind considerations. WELL is the first standard of its kind that focuses attention solely on the

health and wellness of building occupants. The program is currently voluntary, although as industries look to improve the performance of their employees and facilities, programs like this could become more prevalent. These elements of the WELL standard can be implemented in any facility, to encourage positive lifestyle choices and gain wellness advantages. The physical environment is an important link in the chain of infection prevention and control. Contaminated environmental surfaces provide a potential source for transmission of healthcare-associated pathogens. The rapid growth of new technologies in material design continues to provide new methods to help control the spread of disease.

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MATERIALS On March 8, 2014, Malaysia Airlines Flight 370 was carrying 12 Malaysian crewmembers and 227 passengers from 14 nations when it went down in the southern part of the Indian Ocean with no survivors. This tragic story received considerable coverage in the news media. What if this type of tragedy occurred every day? Unfortunately, a similarly catastrophe does happen daily here in the USA. “Although there has been some progress, today and every day, more than 200 Americans with healthcare-associated infections (HAIs) will die during their hospital stay,” said Tom Frieden, MD, MPH, director of the Centers for Disease Control (CDC). Luckily, there is a range of solutions available to try and combat this startling fact. Lo-tech protection can be a simple solution to this costly challenge. When properly implemented, color-coding protocols use a system of reusable products (cloths, flat mops, etc.) in different colors. Each color represents a specific use for an exclusive area of the hospital, such as patient bathrooms, ICU, operating rooms, etc. These products are used for a specific area and never cross the threshold into a second room. Prior to being used again, they are laundered according to CDC guidelines for Blood Borne Pathogens. Hi-tech developments such as self-disinfecting surfaces and electrostatic technology are also promising new strategies in the fight against healthcare associated infections. Surfaces that contain heavy metals, such as copper or silver have innate antimicrobial properties. Science suggests that copper or silver have innate antimicrobial properties. Science suggests that copper or solid surfaces affect bacteria in two sequential steps: theffect bacteria in two sequential 7

first is a direct interaction between the surface and the bacterial outer membrane, causing the membrane to rupture. The second is related to the holes in the outer membrane, through which the cell loses vital nutrients and water, causing a general weakening of the cell. During one study, the antimicrobial effect exerted by metallic copper surfaces was immediate and consistently evident with a significant (83%) reduction in the average microbial burden on the copper-surfaced objects. For spaces where a metallic surface may not be appropriate, there is a solid surface with a proprietary copper-oxide compound, which creates a Preventive Biocidal Surface™. EOScu is the first EPAregistered synthetic hard surface that continuously kills bacteria,* even after recontamination. In addition to copper, the antimicrobial properties of silver have also been known and used for centuries. The Ancient Egyptians used silver pitchers to purify their water. Silver is one of most popular antimicrobial agents as it is highly regarded for its proven effectiveness for inhibiting the growth of harmful microbes. Silver interrupts the bacteria cell’s ability to form the chemical bonds essential to its survival. These bonds create the cell’s physical structure, so when bacteria meets silver it literally falls apart.

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MATERIALS Electrostatic spraying systems are another option to comprehensively disinfect surfaces. This technology works through the use of a spray gun that charges the liquid particles of disinfectant which is then sprayed on an oppositely charged surface. The force of attraction optimizes adhesion of the disinfectant to the surface. These types of applications allow surfaces to stay disinfected for up to 90 days, regardless of human touch or recontamination. Another exciting evolving development in the fight against hospital-acquired infections is the increased use of UV light to nearly eliminate microorganisms on medical devices and high-touch, near-patient surfaces. There are three UV light wavelength categories: UV-A, UV-B, and UV-C. UV-A and UV-B are the light wavelengths that can cause sunburn. The UV-C wavelength utilizes short-wavelength ultraviolet radiation that is harmful to microorganisms. It may sound like science fiction, but UV-C light is effective in destroying nucleic acids and breaking apart germ DNA. With their DNA broken, germs can’t function or reproduce and the harmful organism dies. This technology is available today in sterilizers, vacuums, mops, and wands. They are designed to be highly effective, efficient, and portable for use in any space within a healthcare facility.

Already used in medical devices, Sharklet™ is a synthetic surface designed to mimic the bacterial-resistant properties of sharkskin. The most interesting thing about the Sharklet™ is that the antibacterial properties of the surface come not from the chemicals but rather from the shape and microscopic pattern alone. The company says that its surface is comprised of “billions of tiny raised bars arranged in a specific diamond pattern.” This technology can be embedded onto the surfaces of medical care equipment, furniture, and even finishes.

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FUTURE PROOFING Future Proof is a buzzword that describes a product, service or technological system that will not need to be significantly updated as technology advances. Nowhere is this more relevant than healthcare design. One of the past truths about healthcare design was that hospital buildings had a lifespan of about 50 years, meaning that after about 50 years, the cost of ongoing renovation to a facility equals or surpasses the cost of a full replacement building. With hospital construction taking more than 10 years from planning and design to construction and occupancy, planners can be proven wrong before the first patient ever arrives. That’s why “future proofing” is key to effective healthcare facility planning.

A well-designed healthcare facility has a profound impact on the level of care, the feel of the space and its usability. At the same time, poorly designed hospitals can have ramifications for the wellbeing of patients and staff. Badly designed spaces can lead to errors and safety issues. Cognitive psychologists have found humans are more likely to make errors or behave clumsily in a badly conceived and poorly designed healthcare setting. Built in flexibility has become a top priority to extend the life of a facility, allowing for improvement down the road as needed. Here are a few strategies that can be incorporated today for tomorrow.

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FUTURE PROOFING Universal rooms contain equipment and medication needed for the majority of treatments and procedures, and are generally larger than typical rooms. They are typically easier to construct due to the identical nature of the rooms. Because of this consistency in layout and equipment, universal rooms have shown to have reductions in medication errors and patient falls. Modular layouts are another strategy that can assist in allowing space to change to accommodate new services and activities. Modular layouts use a uniform grid and a system of core distribution that can be incrementally divided on an “as needed” basis. Open-ended corridors allow for potential expansion of the facility with minimal disruption to the existing facility. In some cases, they can also increase sunlight in corridors and expanded views. Planning for future surplus capacity during initial design and construction allows for the addition of technology, electrical, and support services. This can save on costly renovation and retrofit expenses as a building grows in the future. A “plug and play” approach for the design of healthcare facilities establishes flexibility and means that software or devices work perfectly when first connected, without reconfiguration or adjustment by the user. Facilities can also save time and money by using pre-developed prototype floor plans that can be connected or arranged as needed, selecting only those units that they need in their facility.

There is an old Chinese saying, “The best doctor is the one who tries to prevent his patients from getting sick in the first place.” As we examined here today, the goal of healthcare is no longer just to heal but to encourage healthy choices that result in ongoing wellness, reducing the likelihood of injury or illness. However, when treatment is needed, it is critical that the healthcare industry provide a nurturing and supportive healing environment through technology, design, and medicine.

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