Last month, Kate Damato moderated a MNCREW panel discussion about the Changing Landscape of Healthcare. The goal of the conversation was to illuminate effects of mental health and the COVID-19 pandemic on the design and delivery of healthcare throughout the state of Minnesota.
The panel of experts included:
Sara Aulizia, LEED AP, director of design and construction at Ridgeview Medical Center
Jacqueline Lloyd Cunningham, MBA, vice president of marketing & communications at YWCA Minneapolis
Jill Rasmussen, CCIM, SIOR, principal at Davis
Prior to the COVID pandemic hospitals and emergency departments were experiencing more patients needing mental or behavioral health services. The challenge is in thoughtfully caring for these patients while being mindful of their safety and that of the staff and providers. Some creative solutions include:
Converting spaces within the emergency department to function as behavioral health safe rooms, while being easy to convert back quickly if the need arises.
Converting rooms within the emergency department to be available for comfortable overnight stays.
Separate consultation rooms for families.
Forming partnerships with mental health providers to offer same-day and walk-in appointments on the hospital campus to allow space for medical emergencies in the ER.
Privately owned mental and behavioral health practices are being intentional about site selection for their offices to be within the communities to specifically meet their needs.
The COVID-19 pandemic has revealed to us that not only can we work remotely, but there has been some success in utilizing telehealth. A recent JLL National Healthcare Capital Market report states a .17% use of telehealth in March 2019. That number jumped to 7.5% in March 2020. The report states the benefit is that telehealth will reinforce care, not replace in-person care in the future.
The concept of telehealth is not new to healthcare; however, the pandemic forced a quicker implementation for many providers, patients and payors. Pre-COVID, insurance companies were not compensating providers for telehealth visits. After witnessing the success, many insurers are now paying at the same amount as an in-person visit.
Some other interesting utilization of technology in the delivery of care include:
Virtual community healing events – YWCA has partnered with large corporations within the Twin Cities to host conversations around racial injustice and diversity initiatives in their company.
YWCA is offering virtual fitness classes for their members to encourage healthy habits while they cannot visit the fitness center.
Ridgeview Medical Center provides tablets for hospitalized patients and their families to visit virtually.
Beyond delivery of care, the space needs and challenges within clinics and hospitals has changed dramatically as a result of COVID.
Clinics and hospitals have increased space requirements to allow for the separation of patients and the care they seek (for example, well visits are separate from other patients with respiratory visits).
Increased needs for PPE storage.
Space specifically for COVID testing sites.
Rethinking how to utilize a lobby and the operational procedures around rooming a patient. Possibly increasing the number of smaller waiting rooms instead of a large lobby.
Providing rooms for patients and families that do not have access to technology at home for telehealth so they can still ‘see’ their provider or family member in the hospital receiving care.
With more telehealth visits, the space needs for those clinics is going down.
More operating costs in enhanced cleaning protocols, PPE and staffing due to COVID.
Considering HVAC system design change. Can the current system be improved (for instance, use of better filters) or is the solution to utilize more or different PPE? One question lingering with the design and development teams is if the building code will change to require building owners to upgrade existing systems.
Looking forward to the next couple of years it is still too early to determine how the COVID pandemic will affect healthcare design and development. We do know that 76.5% of patients are not comfortable going to the ER or hospital at this time (Physicians Realty Trust).
Over the past 5-10 years the trend has been to move clinics out of the hospital campus due to increased costs, and physician and patient preference. We will continue to see more development a mile or more away from a traditional hospital campus. This will be even more true as patients now desire a health environment away from a large hospital campus with less exposure to various illnesses. At this time, however, many health system expansions have been put on hold, and hospitals and clinics are being flexible with their current assets to meet the current demands.