Patient-Centered Lean: The New Gold Standard in Hospital Construction
In healthcare, “patient-centered” lean design is the holy grail of lean design. While the traditional lean approach is about trying to make every process efficient, patient-centered lean design is about making only those processes that are important to the patient efficient.
Why does this matter? As hospital revenues become increasingly tied to patient satisfaction rates, designs that place a premium on real patient concerns will provide hospital administrators with better results than designs that fail to take patients’ needs into account.
How Does Patient-Centered Lean Design Work?
1. Designing Hospital Laboratories
Lean Labs: When designing a laboratory using a traditional lean approach, you’d begin by optimizing your design for the lab tech. You’d observe his routines and generate designs that make his processes and work day simpler. For example, you might place the blood draw area right next to the lab, since this would be the most efficient way for him to get blood samples to the lab.
Patient-centered Labs: If you’re starting with the goal of patient-centered design, you would optimize around the patient’s needs. For example, you may learn that a majority of patients don’t want the lab to be located in the hospital basement because they find this to be inconvenient. Suddenly, you’re designing a system that places specimen collection in areas that are convenient for the patient and solving the transportation logistics issues by, for example, collecting specimens periodically throughout the day. With this approach, patient satisfaction skyrockets because small inconveniences are removed from the equation.
2. Optimizing Hospital Billing Processes
Lean Billing: If looking at billing only from the hospital’s perspective, you would optimize the invoice so that everything is standardized. You’d spend your time ensuring that all services are billed in the same manner, with the same protocols and forms to make processing, accuracy and review simpler for hospital administrators.
Patient-centered Billing: When optimizing billing around the patient’s needs, you might find that what patients want most is to receive the entire bill before they leave the hospital. This results in a completely different billing process than you may have implemented using the first set of criteria, but your end-user – the patient – will be much happier.
3. Designing the Perfect Waiting Room
Lean Waiting Rooms: In exploring waiting room design from the hospital’s point of view, you may consider elements such as the view, quality of the artwork and color of the furniture.
Patient-centered Waiting Rooms: If you ask the patient what he wants from a hospital waiting room, he may say the most important thing is a short wait time. Rather than focusing on artwork and chair fabric, you’re now tasked with optimizing the hospital’s appointment scheduling process or a variety of other factors that impact wait times. Although more difficult initially, making these changes in place of building comfortable waiting rooms may get you closer to the end goal of shorter wait times.
Before launching a lean design-led construction project, you should evaluate whether you’re truly optimizing for the right things. If you discover the answer is no, then you’re not really doing lean.
The key to a successful patient-centered lean design strategy is the ability to see the design through the patient’s eyes. According to healthcare architect Rick Hintz, this is actually easier than it sounds. “Everyone in healthcare is also a consumer. Everyone knows what’s needed on the consumer’s level. Healthcare providers are just so involved working within this complicated structure that isn’t set up to do things in a patient-centered way.”
“Think about arriving at the E.R.,” Hintz says. “What’s the first thing you want? You’re not interested in the aesthetics of the lobby. You’re interested in getting immediate care. You want help, you want your pain managed. If designers and hospital managers make those things efficient, suddenly everything else becomes efficient. And hospitals achieve higher levels of patient satisfaction.”
