Non-emergent care has resumed in hospitals and physicians’ offices, but recent research shows that many patients are reluctant to return to business as usual. The American College of Emergency Physicians reported in April that 29% of adults have delayed or avoided medical care because they’re concerned about contracting the coronavirus. According to experts, assuring patients with safety measures such as mandatory mask wearing and disinfecting is crucial, but it’s equally important to create an environment where patients feel comfortable.
Sheryl McLean, president and creative director of design firm McLean & Tircuit, has worked with dental and medical practices on creating spaces where patients not only feel safe but have a pleasant experience. She said it’s more important than ever to pay attention to the psychology of design and the perception healthcare consumers will have walking into a provider facility.
“Right now, we’re all traumatized thinking about going into a medical facility for anything,” she said. “This is a time when I think aesthetics are even more important [than before the pandemic].”
Some organizations may simply remove some chairs to ensure social distancing, put up plastic barriers between patients and staff and place signs on the doors with new policies for patients, such as mask wearing. But those moves can feel jarring to a patient and create anxiety. Now more than ever, hospitals and physicians’ offices should feel like they’re “more about wellness than sickness,” McLean said.
Creating an aesthetically pleasing space that supports necessary safety measures can be inexpensive, but the first crucial step is determining those measures and the processes that support them.
“Every office is going to be different, but I think workflow has to be looked at first,” she said.
Waiting and check-in areas
In the waiting areas, the priority should be to keep patients from staying too long, if at all, McLean said. Removing chairs to enforce social distancing is a good idea, but what should come first is measures such as taking people with suspected coronavirus directly to a patient room, McLean said. Doing so will keep patients and staff safer and eliminate the need for some chairs. Encouraging patients to use telehealth options, asking patients to wait in their cars and staggering patient appointments also can free up space in the office. She encourages clients to think about space planning and design around those needs.
“[Space planning] doesn’t necessarily mean more money,” she said. “It just means we have to come up with new ways of thinking.”
Tim Hendrix, medical director for AdventHealth Centra Care, the urgent care arm of the AdventHealth system based in central Florida, said his clinics have not only implemented safety measures but been actively encouraging other businesses in their area to take the same precautions.
“This isn’t about going and buying fancy UV sterilizers for your business. It’s all about the basics,” he said. Patients and staff at AdventHealth’s urgent care sites receive temperature checks at the door and are moved into an exam room as quickly as possible. Staff are required to wear face masks as well, helping stop the spread and letting patients know they’re safe, he said.
“During the pleasant months of winter in Florida, it was OK to ask a patient to wait in their car instead of the lobby. That’s not practical anymore, so we’ve had to reformat our process,” he said.
Once it’s determined what an organization will need in the waiting area, there’s the matter of which existing items should stay and what additional items are necessary, McLean said.
For example, the CDC has laid out guidance for cleaning and disinfecting in businesses and other public spaces, which could change a healthcare organization’s process and schedule. And many of the fabrics typically found in waiting areas will not stand up to the products that kill the coronavirus. McLean recommends putting existing furniture into storage and temporarily replacing it with something more durable, but inexpensive, like vinyl.
Planters or tables can be placed between chairs to provide a natural barrier between waiting patients, and plexiglass barriers can be included in the planter design, so the presence of the barrier doesn’t feel as jarring. Colorful wall art can be soothing and make patients feel good about where they are, she said.
For some organizations, the budget for such a redesign is low if it exists at all, but McLean said it’s still possible – and important – to consider the aesthetics of the area. The objective is to create a space that is both safe and welcoming.
“I’d rather have [a planter] be my divider than just empty space of looking around and feeling like I’m in a void,” she said. “Sneeze guards are important, but you don’t want to turn around and feel like you’re robbing a bank when you go up to the counter.”
Clinical and staff areas
Clinical areas also can be redesigned to some extent for patient and staff safety, particularly regarding traffic flow, McLean said. If there are two doors, one can function as the “in” door and the other the “out” door to avoid bottlenecking.
In patient rooms, uncluttered counters can give the impression of cleanliness and reinforce that whatever is touched must be disinfected, McLean said.
“The only things that should be on the counter are the things you’re using at that particular moment,” she said.
In addition, each staff member that needs a piece of equipment such as a blood pressure cuff should have their own if possible, she said.
All about the basics
“The thing about COVID-19 is, this has been a constant moving target,” Hendrix said. “Trying to keep up on all the changes and the science has been a challenge, but that’s simply because we learn more about the behavior of the virus.”
It’s important to stay current, but some basics still apply, he said.
- Perform temperature checks of staff members and guests. A fever is the most common symptom of the virus, and although it’s not a perfect screening system, it can enforce the idea that people who are sick should stay away, Hendrix said.
- To fight the spread of the virus by asymptomatic people, a face mask requirement can significantly reduce risk.
- Keeping people at least six feet apart provides a third line of defense, Hendrix said.
- Surfaces should be regularly wiped down, and hand sanitizer should be available everywhere.