Contract - October 2013 - (Page 84)

practice The Impact of the Affordable Care Act on Healthcare Design Experts affiliated with The Center for Health Design describe strategies and interventions for improved outcomes through design By Upali Nanda, Ph.D., Eileen Malone, RN, MSN, and Anjali Joseph, Ph.D. The impact of the 2010 Patient Protection and Affordable Care Act on healthcare delivery has been widely discussed and debated. But what does it mean for the design industry? In this era of big data, cloud computing, and sophisticated analytical tools, the ability to manage and measure has increased, and healthcare models are changing based on these abilities. With the Affordable Care Act, the onus to manage and measure will be even greater because it will be linked to reimbursement models with strong fiscal implications. The Affordable Care Act and evidence-based design Politics aside, the enactment of the Affordable Care Act will transform just about every aspect of healthcare delivery. Sweeping reform legislation targets nine essential components, ranging from access to affordable care to the improvement of patient safety and care quality. One of the fundamental components of the law is the transformation of the reimbursement system. Instead of only paying hospitals based on the volume of care provided, the Affordable Care Act shifts the reimbursement model to one based on care quality. Hospitals are now financially rewarded for improving the patient experience as measured through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Beginning in Fiscal Year 2015, through the Hospital Value-Based Purchasing Program of the Centers for Medicare & Medicaid Services (CMS), hospitals will also be reimbursed based on their ability to reduce patient harm as a result of hospital-acquired conditions. Through the use of evidence-based design findings, designers create important solutions that can help to address these pernicious problems. So, what solutions can designers provide as part of an integrated approach to improve the patient experience, reduce patient harm, and—as a consequence—potentially realize increased CMS reimbursement? There are two items on the HCAHPS’s inpatient survey that pertain to the built environment—noise and cleanliness—both of which can be improved with good design, as noted in the table on the next page. Key patient safety targets, typically tracked by hospitals, 84 and simple interior design solutions that can help to achieve these targets based on robust evidence and best practice precedents are also listed in the table. In fact, a large body of evidence indicates that the physical environment impacts many essential healthcare outcomes including patient and staff safety, patient stress and satisfaction, staff effectiveness, the quality of care, sustainability, and healthcare cost. Just as medicine has increasingly moved toward “evidence-based medicine,” where clinical decisions are informed by research, healthcare design is increasingly guided by rigorous research linking the physical environment to healthcare outcomes, and is moving toward evidence-based design. The underlying assumption is that the built environment provides the stage for all care delivery, and consequently impacts care delivery outcomes. Accountability in design The evidence-based design process relies on using credible research to inform design decisions and then clearly articulating the potential impacts of these design decisions on a broad range of healthcare outcomes. By measuring healthcare outcomes pre- and post-occupancy, and then sharing the results, not only is the team held accountable, but it also contributes to the growing body of knowledge. Accepted by designers and facilities alike, this accountability is evident in the growing number of hospitals that are part of The Center for Health Design’s Pebble Project, which is committed to measuring, tracking, and sharing outcomes. Design firms with in-house research departments focused on human and organizational outcomes and design and health professionals who are getting their credentialing via Evidence-based Design and Accreditation (EDAC) and Lean Six Sigma training also contribute to accountability. The EDAC and Lean Six Sigma training allows professionals to become well-aware of the methods to integrate research into design and to then undertake systemic approaches to improve processes based on reduced waste, increased efficiencies, and enhanced collaboration of caregivers. contractdesign.com october 2013 http://www.contractdesign.com

Table of Contents for the Digital Edition of Contract - October 2013

Contract - October 2013
Contents
Editorial
Industry News
Columnist: Winning Work at the Interview: It’s All About Chemistry—Part II
Product Focus: New Classics
Product Briefs: Health and Wellness
Cedars-Sinai Medical Center Advanced Health Sciences Pavilion
Banaji Pediatric Dental Specialists
Seattle Kids Dentistry
Healthcare Environment Awards
Spaulding Rehabilitation Hospital
Olivia Newton-John Cancer and Wellness Centre at Austin Hospital
Seattle Children’s Building Hope: Cancer, Critical and Emergency Care Expansion
Dale & Frances Hughes Cancer Center
Kent Campus Expansion, Phase 2 Pavilion
Horizon Blue Cross Blue Shield of New Jersey
Camp Southern Ground
Poetic Living
FOUND: An Adolescent and Young Adult Cultural and Wellness Center
The Impact of the Affordable Care Act on Healthcare Design
Book Review: Sustainable Healthcare Architecture, Second Edition
Designers Select: Healthcare
Sources
Ad Index
Perspectives

Contract - October 2013