Using Patient-Centered Care for Hospital Room Design

For Zeke Triana, the head of Facilities, Planning, Design, and Construction at Cedars-Sinai in California, planning the organization’s hospital room design was personal. With his own experience as a patient, he knew that a patient-centered care philosophy would be applicable to building a good hospital environment.

“The patient comes first,” Triana said in a recent interview with PatientEngagementHIT. “These are scary moments in their lives, right? We're trying to make it as pleasant as an experience as possible. The environment really matters, in contribution to that healing process. Obviously, that doesn't take away from the great care they're going to receive.”

But instead, hospital environment is going to supplement that care, Triana added. After all, environment is a critical measure in patient experience and satisfaction, landing a key spot in most patient sentiment surveys, including HCAHPS surveys.

So when Cedars-Sinai set out to rebuild is Marina del Rey Hospital, Triana knew the process was going to have to be both provider- and patient-centric. Creating a hospital room is so much more than regular construction; instead, it requires buy-in from an entire team of patients, their advocates, providers, and architects to create a space that is functional and can promote healing.

“Healthcare is a team sport, both in the care of patients, but also in the design and construction of these facilities,” Triana explained. “It takes a very integrated and collaborative team to achieve these outcomes.”

Triana gathered that team, which included all of the above-mentioned stakeholders, foremost around a two-dimensional drawing of what he and the architectural team envisioned for the new hospital rooms. These drawings are helpful for seeing the overall hospital layout, as well as standing up walls and seeing where certain plugs will go or gasses will be stored.

“However, it's been our experience that most caregivers are unfamiliar with what they're looking at in a two-dimensional drawing,” Triana said. “So, then we take it a step further and we create a three-dimensional rendering, or sometimes we'll do a fly through the space. Again, my experience says that helps the process, but it’s still just a virtual tool.”

Triana has struggled to give patients and providers a truly engaging picture of what a hospital room might look like using that virtual tool. It’s something like holding a virtual meeting versus an in-person meeting. The Zoom meeting will work to get stakeholders to the table, but it’s going to be a lot richer in person.

The healthcare organization decided to use a new way of rendering hospital rooms, this one entirely more concrete. This is a once in 50- or 75-years event, Triana reasoned, so it was essential he and his team were able to execute well.

“Why not take the opportunity to build what I'll call model rooms or a model home that one walks through so that people can experience the space” he posited. “These model rooms are exactly like what the hospital would be built like, but we haven't built it yet. So, it's an opportunity to get feedback from a variety of stakeholders from nurses, doctors, all kinds of groups, patients.”

That feedback has been essential for his design and construction team, Triana added.

“Everybody's looking at it from a different lens,” he noted. “So that's always important. And we want that diversity of thought as we put these together.”

From the provider perspective, the team was able to get insights about where certain room features should go from a logistical and safety standpoint. Take the sink, for example. The sink needs to be in a central location close to where the provider might walk into the room so that she can wash her hands immediately.

But too close to the door, or with too big and shallow of a basin, and that water splashes into the hallway, creating a hazard.

“Those practical things are really important,” Triana explained. “Cabinetry door handles, where to place gloves in the room, where to place the rail, because as you walk into the room, you want to make sure that you're washing your hands and so forth.”

But from the patient and patient advocate perspective, things were more centered on comfort.

To be clear, Cedars-Sinai has not been able to bring actual patients through these model hospital rooms because of the threat COVID-19 has posed.

But with the help of the organization’s patient experience team who advocated for patients, Triana and the design team got to hear about the design elements that would be comforting for patients and their family visitors.

And that’s where his personal experience came in. When Triana visited Marina del Rey Hospital as a patient himself, it wasn’t just the clinical quality that helped him get better, although that of course was crucial.

It was also the peaceful atmosphere he had in his own room.

“One aspect that was really important to me when I was a patient, was having a view,” he explained. “And in my particular case, I had a view of a tree. It was nature, and it really helped calm me down. My blood pressure improved and it was just having something to focus on other than being in the room. So that experience of being able to look out the window and focus on something else really was very helpful to me.”

Triana said he wanted to give that experience to other patients.

Starting with the high-rise hospital’s nine floors, Triana set out to make sure there was a good view from every window. While on most sides, the hospital is surrounded by the beautiful vistas of Marina del Rey harbor and the Santa Monica Mountains, Triana noted that the parking lot created a sticky situation.

Of course a hospital needs a parking lot, and a big one at that, considering the role parking plays in affecting patient experience.

“But we didn't want the parking lot to just be a parking lot,” Triana pointed out. “We wanted to create a park-like environment, so that when patients looked out their windows, yes, they'd be in that direction, they're looking at the beautiful Santa Monica mountains, but if they look down, we didn't want them to look at a sea of cars.”

The design and landscape teams created a canopy of trees throughout the hospital parking lot, helping to provide shake and make the space look more akin to a park than that sea of cars.

“When they look down, they're not going to be looking at an asphalt parking lot,” Triana said. “They will be actually looking down on the canopy of trees. It should be quite lovely.”

Those views extended onto the walls of the room, too, Triana added. Usually, hospital rooms have a lot of artwork designed to soothe and calm patients and their family visitors.

But that art is also usually hanging above the bed, a place Triana concedes could be a natural fit for hanging, except for one thing: the patient can’t see it. The design team found different locations throughout the room that allowed the patient to enjoy the art, too.

All of that boiled down to Cedars-Sinai’s primary philosophy: the patient comes first. Through careful design plans and creative problem-solving, the organization has been able to create a brand-new hospital that suits patient needs, something that Triana said can be enjoyed for years to come.

“If you're in a pleasant environment, we believe that that aids in the healing process and our patients and that patient experience is really everything that we do,” he concluded. “And we've organized the entire hospital around that. Services are being brought to the patient. The patient is not being moved around from space to space. It's really putting them at the center of the experience and the care.”