April 2021 — Health Care & Senior Housing Quarterly — Page 11 HEALTH CARE — DESIGN T he changes outpatient health care clinics are making, whether in direct response to the pandemic or to make patients feel safe and secure upon their return, involve both physical design and facility opera- tions. Let’s look at what we’re currently seeing in ambulatory care settings: • A strategic reprioritization of safety in addition to patient experi- ence; • First impressions being about more than aesthetics; • A need for distancing and sepa- ration between visitors, as well as one-way flow; and • Increased use of technologies for preregistration, check-in and wait- ing. During a recent webinar on the future of health care post-pandem- ic, panelist Miranda Morgan, senior medical planner at EYP Architec- ture & Engineering said the biggest impact she has seen on her clients’ facility planning is the reduction in scope of certain areas. “Health care clients want to capture nonrevenue- generating space back for patient- care space,” she said. While the tone for ambulatory care environments still aims to be friendly and comfortable, Morgan said, health care clients are look- ing for an increased capacity for safe distancing, and ways to quickly segregate contagious visitors as well as providing all patients with faster, more efficient care. “This is the world we now live in,” she said. “People want closer, smaller, leaner clinics, so they can be in and out of the space quickly and efficiently.” In a post-COV- ID-19 world, the entire intake pro- cess is evolving to become more vir- tual, said Akshay Sangolli, senior medical planner and managing principal, EYP. Just as frequent fli- ers can check in virtually before their plane trip, patients soon may be able to check in for their medical appointment on their smartphones. “We are already seeing an increase in the number of digital check-in kiosks and a reduction in the number of physically manned registration and check-in desks,” he said. “A patient would drive up to the facility and be notified via an app when it’s time to head to their doctor and even how to get there.” Let’s start with the front door of the clinic: the reception/waiting area. “This has basically always been a threshold space between getting out of your car and getting in to see your health care provider,” said Sangolli. “But it is also the place where people get their first impressions of the facility: Is this a good, orderly, safe space?” No one wants to sit shoulder to shoulder in a crowded waiting area for an extended time, no mat- ter how aesthetically pleasing the surroundings: not now, not pre- pandemic and not post-pandemic. Waiting, it seems, was never a val- ue-added proposition. “The notion of waiting is so inter- esting,” said John Smith, EYP design principal. “This is usually where our clients are looking to quickly and effectively set a tone and establish their brand, their entire story, in that instant. Now, that message has changed a bit. We still want to sig- nify welcome, comfort and a home- like atmosphere. But we also want to emphasize cleanliness, safety and open space for social distanc- ing.” Already, the notion of the grand entryway was being challenged since a lot of resources – in both square footage and money – were being dedicated to that space. Now, “We are building in flexibility,” said Smith. The design goal still may be to create the look and feel of a well- ness home with wraparound care while being a responsible steward of resources. This can be achieved through design elements such as local art, creative décor, exposed mass timber beams and stone, nat- ural light, and comfort touchpoints. Once a patient checks in, opera- tional efficiency aided by the built environment should function like a lean machine, Smith said. Balanc- ing these elements is the challenge. “The human connection, positive distractions, and places for con- nection and reflection are all still important,” he said. The emphasis is less on establish- ing a common space for patients to relax and linger, said Hailey Roberts, EYP interior designer, and more on a linear acceleration from check- in to destination. “We’re seeing a movement toward more intimate settings, smaller groups of seating, and an intention to have less inside waiting,” she said. Roberts also is seeing a difference in what clinics are requesting for reception desk design. “Whereas many clinics used to have one big registration area behind a large, fixed communal desk, we are now seeing clients requesting multiple smaller desks. By providing physical distance between desks and incor- porating decorative glass dividers between check-in stations, it allows for multiple people to check in at once, helps with privacy and pro- vides peace of mind for guests.” A clinic’s functionality, however, doesn’t negate patients’ desire for a homelike, pleasing environment. “Health care facilities are cozier than they were before,” Roberts said. “People want to feel comfort- able and at ease. There are ways to do that while still making the space feel safe, bright and clean.” Today’s patients are used to effi- ciency as well as hospitality and aesthetics. “Consider frequent fli- ers at airports,” said Sangolli. “They want comfort and convenience as well as digital check-in.” Translating that to a health care clinic, patients may desire just-in- time care as well as quality coffee and local art. “We have to under- stand our health care clients’ pri- orities and the patients’ desires,” said Sangolli. “It’s a balancing act for architects and designers as you work collaboratively, trying to cook a complex dish with all these fla- vors. A jambalaya is how I’ve come to view it.” s Streamline ambulatory care but keep its appeal Mary Loftus Senior manager for health sciences content, EYP