At the 2015 American College of Healthcare Executive Annual Meeting earlier this month, I had the opportunity to present alongside Ken Price, ProHealth Care, and Whitney Austin Gray, Well Building Institute, on the lessons we are learning about cost containment in designing ProHealth Care – which is scheduled to open later this year.


Form Follows Experience

The first step in partnering with ProHealth Care, based outside of Milwaukee, WI, to design its new, freestanding ambulatory cancer center focused on defining performance goals and exploring how the design of the building could help achieve these goals. Two of ProHealth Care’s main focus areas  included reducing the costs of cancer care and promoting whole person health for all patients. Our exploration quickly uncovered these two are intrinsically linked. The best way to drive down the cost of care is to develop strategies that enable patients to avoid ED visits, inpatient stays and missed clinic appointments while also helping them develop strong support groups and increase their strength during chemo treatment. These collective efforts enhance the quality of care for patients and improve overall health and wellness.

The best way to drive down the cost of care is to develop strategies that enable patients to avoid ED visits, inpatient stays and missed clinic appointments while also helping them develop strong support groups and increase their strength during chemo treatment.

The result is a design emulating the idea that form doesn’t follow function, form follows experience – a cancer center designed from the inside out.  Together with ProHealth, we are collecting data to help us see whether this premise – that the use of health-centered design approach can help contain cancer costs – is validated by the outcomes ProHealth realizes after they occupy the building later this year.  While time will tell the ultimate impact of this approach on cost-containment, we have already seen the impact of this approach on the patients, staff and physicians as well as the design solution.

So what did we do differently with ProHealth and how did this impact the design? Two of the most impactful steps we took were:

  1. Reimagining the structure and engagement-level of the Patient Advisory Group, and
  2. Creating “Whole Person Health Design Team.”

In today’s post, I’m going to focus on the elevated role the Patient Advisory Group played throughout the design process.

Engaging Patient Advisory Groups

Patient Advisory Groups are one of my favorite aspects of my job. I’ve done many of them and they area great chance to meet those most impacted by the space and see issues from their perspective. However, the amount of new information you get from these is typically fairly minimal and can focus on comfortable furniture, better wayfinding, etc. That said, when we met with the cancer survivors, current patients, and family members that formed the Patient Advisory Group at ProHealth we approached it very differently. We started with a presentation on whole person health and asked them to help us define what whole person health means in a localized context. We know what it means to be a whole, healthy person in Waukesha, Wisconsin is different than what it means in Phoenix, Arizona or New York City. So we asked this group to define for us what whole person health means in their community.  They were transformed from their role as “sick people” into champions for making the community healthier.

Exam Consult RoomOne of the best examples of how this group influenced the design was in the creation of Multi-D Day Suites. We identified with the Patient Advisory Group that Multi-disciplinary Days – where patients come in and have more than one consecutive meeting with different specialists – can be exhausting for patients and therefore patients opt out of this superior care model.  They challenged us all to think about transforming that experience, instead of shying away from it. As a result, we transformed the consultation and exam room into a connected “Multi-D Day Suite” – allowing patients who have examinations and consultations with members of their multidisciplinary team (e.g., physician, navigator, social worker, nutritionists, financial counsellors, etc.) to stay in the their suite for these appointments with comfortable space for them and their families. When not used for a Multi-D Day visit, rooms can be used separately for individual exams and consultations.

Another important example is the creation of respite spaces for staff. The Patient Advisory Group’s definition of Whole Person Health included the following:

  • A need for peaceful environments without negative distractions from activity and noises.
  • A need to be able to internally focus, meditate, reduce stress, and support healing

The group was adamant these requirements apply to not only patients and their families, but also their care team.  As a result, we developed private outdoor patios directly accessible from every staff lounge that are isolated from patient outdoor areas.  These areas provide fresh air and respite for caregivers that work in very stressful professions.  The patients are very proud of their role in providing this gift to those who have taken such good care of them.

These are just two of the innovations that this group helped us develop after we empowered them to have a voice in the design process. It demonstrates the impact of taking a health-centered approach to design and how it can dramatically impact solutions. In my next post – I’ll share about another strategy we used – the “Whole Person Health Design Team” which was made up of staff that has interaction with patients in multiple settings on a daily basis.

Read PART 2: THE WHOLE PERSON HEALTH DESIGN TEAM >

Learn more about the UW Cancer Care Center at ProHealth Care >