Healthcare Design - August 2023 - 32

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Partners in Frisco, Texas, implemented a self-rooming approach that eliminates
the need for a waiting room to not only improve patient perceptions
and experience but also optimize its throughput. This self-rooming system
enables patients to book appointments from the comfort of their homes,
signal their arrival through an app, follow guided steps to their designated
space, and access additional information and scheduling options conveniently
at their fingertips.
Upon arrival, patients are notified through the clinic's integrated
app that their exam room is available-providing its location and directions
so that patients can make their way to their designated suite. Exam
rooms are organized into pods off a main corridor with five exam rooms
in each. Secured doors separate off-stage activities including scheduling,
charting, and provider collaboration while maintaining staff access to the
exam areas.
With a deliberate focus on reducing time and space constraints, Village
With the increased responsibility placed
Health Partners' self-rooming model seeks to eliminate disruptions that
typically occur during the patient journey. For example, instead of a conventional
experience where patients navigate through multiple rooms
for various procedures, such as vital sign measurements, lab tests, and
examinations, the self-rooming model simplifies the process. Check-in is
completed online prior to being assigned an exam room and all necessary
tasks, including blood tests, temperature measurements, identification
and insurance verification, vaccinations, and scheduling, are conducted in
a single exam room, reducing decision points for both staff and patients.
By circulating delivery of care around a centralized location, staff operations
become more efficient, leading to optimized throughput, reduced
wait times, improved patient management, and a decrease in patients who
leave without necessary follow-up care (known as " elopers " ). For those
who prefer a more traditional experience or lack access to the necessary
technology, a check-in desk is available to provide support and accommodate
special needs. Family spaces outside patient rooms offer welcoming,
intimate environments that can serve as reception areas or waiting spaces
for accompanying guests.
Efficiencies in patient navigation and operations are further enhanced
by strategically locating commonly used amenities. Recognizing, for example,
that most patients require lab work, Village Health Partner's facility
situates the lab closer to the front of the facility, cutting walking time
and speeding patient progression.
Integrated technology verifies that patients have completed necessary
steps, including paperwork, prior to their arrival in the exam room, thereby
adding predictability to the process and eliminating disruption and confusion
as patients progress through their journey. Patient records, scheduling,
charting, notes, and insurance information follow them and eliminate
the chore of filling out repetitive and time-consuming documents.
WAYFINDING AND SAFETY CONSIDERATIONS
While facility design typically plans for one physician per five exam rooms,
the new model allows for standardized pods, which can add flexibility for
doctors during peak times. In the model at Village Health Partners' Plano
location, each pod comprises five exam rooms and a patient restroom. By
standardizing the pods layout and each of the exam rooms with a predictable
set of furnishings and equipment complemented by a supply cart, physicians
can flex between pods should the patient volume require additional
exam space. These rooms can be quickly adapted to meet facility needs and
volume, cater to unique patient requirements, accommodate alternative
examination or appointment formats, or adjust to physician availability.
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on patients to navigate to their designated
areas, enhanced and layered communication
between staff and clients is essential to
ensure patients arrive at the right place and
time. Simplifying decision points and providing
focused wayfinding is important to reduce
stressors. At Village Health Partners' Plano
location, the clinic's layout is formatted after
general street grids, and even introduces local
street names into the pod designations. Intersections
off the main corridor (Main Street)
to the side hallways were identified as key decision
points. Built-in banquettes and various
furniture clusters provide a space for loved
ones to wait should privacy be required during
the exam, while also serving as an additional
means of wayfinding.
The increased agency given to patients also
necessitates additional considerations for security
and access. To account for patient wandering
and balance security needs, a defined
separation is created between on-stage and offstage
activities. At the Plano facility, patients
have access to the primary corridor, side hallways,
and exam rooms. Each pod is accessible by
staff via an access-controlled door. All off-stage
areas are connected, so staff can fluidly circulate
throughout the clinic without disruption while
controlling their interaction and engagement
with patients. By providing a range of restriction
levels and locations tailored to the specific
population mix and needs of the facility, staff can
effectively balance security requirements with
patient independence.
THE WAIT IS OVER
The implementation of self-rooming not only
addresses the immediate concerns of long wait
times but also fuels an already accelerated trend
toward a healthcare experience that prioritizes
patient satisfaction.
With the goal of maximizing ease of access to
care for patients, Village Health Partners identified
waiting rooms as not only a choke point
in their throughput but also provided less value
than exam rooms. The design solution responds
to this challenge by removing it completely. By
empowering patients to control their healthcare
journey, the self-rooming model reduces
the sense of powerlessness often associated
with traditional waiting rooms and encourages
a sense of agency. 
Jordan Gill is vice president at Corgan (Dallas). He
can be reached at JORDAN.GILL@CORGAN.COM.
http://www.HCDMAGAZINE.COM
Healthcare Design - August 2023

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