How Environment and Technology Can Improve Health Care

Putting comfort of patients first yields surprising results.

Jose B. Perez is attached to a constant monitoring system at Rush University Medical Center in Chicago.

Jose B. Perez is attached to a constant monitoring system at Rush University Medical Center in Chicago.


Maija Eerkes was expecting her chemotherapy to take place in a drab, depressing infusion center like the ones she had seen at other cancer treatment facilities, reclining chairs lined up and separated only by curtains. So when the retired 59-year-old bank executive from Seattle sought treatment for pancreatic cancer at Virginia Mason Medical Center a few years ago, she was surprised and relieved to find herself in a peaceful and private infusion room with a pleasing view of the city. "I often had friends come visit during the infusions, and there was plenty of space for them," she says. "It was such a comforting setting, I really didn't mind being there."

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Improving patients' comfort and surroundings is one of the more obvious, consumer-friendly ways that Virginia Mason and a growing group of hospitals are retooling for the 21st century. Presented with data from countless studies showing that the physical environment affects outcomes, not to mention an explosion of high-tech innovations from "smart" beds to wearable devices that measure vital signs, these medical centers are aiming to deliver care that is safer, more effective, potentially less costly and a better customer experience.

Fixing medicine's worrying safety record (some 180,000 deaths each year are caused by medical errors, injuries or avoidable complications) requires more than changing procedures, experts have realized. The hospital itself has to change. Hundreds of decisions go into designing and outfitting these facilities, and "each one should make it easier to do the right thing for patients and harder to do the wrong thing," says Blair Sadler, a senior fellow at the nonprofit Institute for Health Improvement and past president of Rady Children's Hospital in San Diego.

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An early adopter of so-called evidence-based design, Virginia Mason focused closely on patient comfort and safety when it made over its cancer center, orthopedic unit and emergency department. Architects reconfigured the orthopedic unit to have parallel corridors, one for patients who may be taking their first tentative steps after knee surgery, the second for all other traffic. A new critical care unit will open next year with an imaging suite inside, so vulnerable patients don't have to leave the unit to get a scan. Not only is that much safer for patients, who may be on ventilators, but also it saves nurses' time. "We realized we were losing 14 hours of nursing care per week to travel with patients to get scans," says Deborah Cutchin, a specialist in the hospital's office of process improvement.

Rush Medical Center in Chicago

Building from scratch lets hospitals realize even grander visions. Rush University Medical Center in Chicago opened in its new butterfly-shaped incarnation in January 2012. Besides adding drama to the city's skyline, the design is intended to play a healing role, affording every room an expansive view; exposure to natural light and inviting landscapes has been linked to faster recovery and less need for pain medicine. Rather than sit at a central station, nurses keep an eye on their charges from small satellite work stations that offer a clear line of sight into several rooms at once. The building also contains the nation's first bioterrorism preparedness facility. In the event of a biological, chemical or radiological crisis, the ambulance bay converts into a decontamination area and panels hidden in the lobby's pillars provide access to oxygen and other gases and electrical lines

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Like Rush and other cutting-edge hospitals, Seattle Children's Hospital's new addition for critically ill kids and the new University Medical Center of Princeton at Plainsboro, N.J., put every patient in a private room, which data show thwarts the spread of infection. Foldout couches or beds allow family members to stay, too, and provide emotional support. The New Jersey hospital's rooms are arranged in a uniform way, so it doesn't take time to search for emergency equipment like oxygen, and beds face the windows. The Palomar Medical Center in Escondido, Calif., which opened in August 2012, boasts many of the same amenities as well as access to landscaped terraces on each floor and a 1.5 acre rooftop garden.

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