Listening at the point of care: 4 key points from the first-ever Caregivers’ Forum

January 16, 2019 Brenda Bush-Moline

Healthcare Facilities Symposium conference discussion highlighted crucial issues impacting the effectiveness of healthcare providers in the field

 

At the center of healthcare delivery there’s a crucial connection between the caregiver and the patient. Understanding this connection and caregivers’ challenges is critical to the future of healthcare and healthcare design, especially during this time of rapid transformation in the industry.

Increasingly, we’re asked to look at ways of promoting operational and cultural change in healthcare design. The caregiver is on the forefront of executing and implementing these changes. Of course, as designers, we always seek input from end users in our design process. So, we as healthcare designers greatly benefit from hearing from the caregiver and understanding the day-to-day elements of their role when we undertake design. A chance to sit in when experts in caregiving get together and share concerns and resources? Count us in.

 

Our Lady of the Lake Medical Center, (Stantec + BBA Design Partnership, LLC)

 

At the recent Healthcare Facilities Symposium conference, I had the pleasure of moderating the Caregivers’ Forum, an event featuring Angie Cominsky RN, BSN (Global Healthcare Consultant, Humanscale Healthcare), Lisa DiAndreth, RN, MSN, MPH (Director of Quality Management and Research, Texas Center for Infectious Disease), and Candice Roth, MSN, RN (Assistant Vice President, Central Region Operations, Nursing & Quality, Levine Cancer Institute, Atrium Health).

Together, we engaged in a panel discussion to address crucial issues that affect the effectiveness of healthcare providers in the field on a practical basis and share perspectives on caregiving. Experts also had an opportunity to share resources and network. In asking expert caregivers about their concerns, the audience participants came away with a deeper understanding of the reality of delivering healthcare person-to-person. While the discussion was wide-ranging from common challenges to the design process, a number of themes emerged that are worth sharing.


1. Long-term projects need more than short-term advocacy

We know that achieving operational and cultural change in healthcare requires leadership and advocacy in shepherding design on healthcare projects. So, it is tempting to think that with a strong architect and a nurse advocate consultant at the table, we’re in a good position to make sure that design and cultural change work hand-in-hand with the caregiver stakeholders that are part of the planning process.

_q_tweetable:The future of health will surely benefit if we listen to those that deliver care._q_But the fact is that the individuals filling these stakeholder roles often change. Major healthcare projects can easily take five years to complete. With an average of 18 months in their role, nurse advocates and hospital leadership are unlikely to see a project through from its early days to ribbon cutting. So, who is going to advocate for the cultural change that a project was designed to foster? For healthcare designers, this poses a huge challenge in terms of delivering transferable design and to the caregiving team that inherits the built environment result.

Angie Cominksy had some suggestions for understanding team care that can see us through the long term. “Talk to the night shift, include them and involve them in an authentic way. These team members understand the importance of care team transitions, they become advocates for patients during times when family is not always present and experience unique workflow challenges.”

 

2. Make technology upgradable

Who uses new technology in the healthcare institution every day? Caregivers, of course. But are they given time to ease into a product or system? Rarely. Care never sleeps, so product design should allow for consistent usage and ease of upgrade.

Caregivers tell us that the new tech needs to fit where it was before and allow for a quick upgrade and training so as not to disturb shifts and patient care. Our new designs are often accompanied by innovative tech when change is necessary. When we are implementing new technology as we often are, we need to do so while minimizing disruption to staff and care.

And not all tech is appropriate at the point of care, as Lisa DiAndreth noted. “While wearing communication devices provides instant access to nurses, these devices often interrupt patient care and conversations with the patients. That’s detrimental to the therapeutic relationship and nurse’s ability to provide quality care.”

 

Our Lady of the Lake Medical Center, (Stantec + BBA Design Partnership, LLC)

 

3. Reverse mentoring builds culture and morale

Today’s healthcare workplace, like almost any workplace, is multigenerational. This can be a great challenge to leadership that desires care teams working toward a seamless continuum of care in an increasingly tech-heavy environment. But it also affords a great opportunity.

Younger people tend to be more tech-savvy while the older generation of caregivers understand the fundamentals of patient care and know the time-tested workarounds and processes. Reverse mentoring allows for an exchange of skills and knowledge—and that builds relationships informally. It behooves leadership to foster this, as it can increase retention and culture, which are key when nurses and caregivers are in demand.

Candice Roth noted that design has a significant role to play in fostering mentorship. “We need spaces where we can come together as healthcare professionals, share knowledge and skills, take time to be ourselves, get a coffee, even do some research. What we really need is more collaborative space, not just a lounge.”

 

4. Design for compromises we can’t see

We already design ADA-compliant spaces for those patients that use a wheelchair. But now we know that making the healthcare environment trouble-free is essential to population healthcare where eliminating barriers to care is so important.

So, what about the compromises we can’t see, from impaired vision to memory loss and PTSD? Are we designing spaces that impede or accommodate the compromised? Being alert to the adversity these compromises pose to health must inform our designs moving forward. With the senior population swelling in our North American sphere designing spaces for cognitively or visually impaired population makes good sense.

 

The importance of listening

After hearing from these caregiver thought-leaders, it’s clear that we can continue to learn more from the end users of the spaces we create by keeping the conversation going. Recognizing the vitality of this input is an important step in developing healthcare designs that respond to the day-to-day challenges of care. Alongside advancements in artificial intelligence/virtual reality, pre-occupancy operational consulting, and an approach that treats the health environment as a workplace, the role of the caregiver leader in the process of planning needs to be elevated and recognized by healthcare organizations. The future of health will surely benefit if we listen to those that deliver care.

The future of health depends on increased integration of caregivers in our processes.

About the Author

Brenda Bush-Moline

Brenda Bush-Moline is a healthcare design leader and focuses her efforts on integrated health design and creating places of healing and wellness.

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