How to maximize intergenerational healthcare workforces
The American Hospital Association reports that more than 60 percent of employers are experiencing tension between employees from different generations. This is a pretty startling statistic, especially in light of the healthcare industry’s ongoing “talent war” and tight labor market. More than ever, attracting and retaining a happy workforce is paramount to a healthcare system’s success.
This topic was a recurring theme at this year’s Healthcare Design Conference and Expo, and I was fortunate to moderate a panel about the generational issues facing healthcare organizations from both a patient and workplace perspective. As a follow-up to the post I wrote about generational issues in the workplace, here are some of the big ideas that resulted from the panel discussion.
Encourage cross-generational partnerships
Despite the contrasts between generations and how they work and interact with others, successful teaming models have emerged that intentionally partner individuals of differing generations, harnessing the strengths and limitations of each. In addition to formal partnership models, informal relationships can be created by designing spaces that naturally bring employees together, such as shared support zones, outdoor staff areas, cafes or gyms. These communal spaces have the inherent ability to spark conversation among employees and foster serendipitous interactions.
Focus on similarities rather than differences.
Although providing multiple workspace options for multiple work styles sounds ideal, doing so is not always possible or reasonable. Instead, health systems can focus on workplace themes that employees value across generations: access to natural light and views, work areas that properly address ergonomics, and a workplace that creates a sense of community, to name a few.
Offer variety via flexibility.
Rather than providing one workspace option and asking employees to conform to that option, provide flexible options that can adjust based on work and generation type. Rather than providing many options, provide a few agile options that can be reconfigured to best suit preferences across the spectrum of work types: concentration, collaboration, socialization and education.
Respect your elders.
According to the American Association of Colleges of Nursing, the average nurses’ age is 47. The American Nurses Association goes onto report that the largest age group of employed RNs falls in the range of 50-54. Further, in response to a shortage of healthcare workers, many health systems are trying to retain its workforce well beyond retirement age. The physical limitations that come with the baby boomer+ age group require a workplace that is responsive through proper ergonomics, supportive seating, safe patient handling and limited travel distances.
Co-create with employees.
The only way to create a space that facilitates shared prosperity for an intergenerational workforce is to include an age-diverse group of employees in the design and planning process. Beyond simply holding an occasional user-group meeting, it’s important to “co-create” with this group, meaning that designers should work alongside these employees to develop and test solutions until an ideal state is realized. Doing this makes certain the final solution is grounded in actual, cross-generational employee needs.
Learn more about designing for Generation Z in the workplace >
This Sunday, I’m moderating a panel at the Healthcare Design conference about some of the generational issues facing healthcare organizations from both a patient and workplace perspective. Here’s a few pre-panel thoughts on some of the issues healthcare providers face when it comes to creating a workplace designed for a multi-generational workforce.
For the first time in U.S. history, there are four generations coexisting in the workplace—the Silent Generation, Baby Boomers, Generation X and Generation Y (Generation Z, those born in the mid-’90s to early ‘00s, is right around the corner). Each of these generations bring different expectations when it comes to employee engagement, motivation and general work practices. This diversity calls into question the manner in which care is delivered and the way health professionals work together, while a shortage of healthcare workers underscores the importance of recruiting and retaining the best healthcare talent.
Much has been written about the “generational gap” and the differences between generations when it comes to values and beliefs, but there aren’t vast bodies of research focused on designing spaces that satisfy cross-generational needs. Why? Because much like there is no one managerial style for a multigenerational workforce, there is no one way to design a multigenerational workplace. Research shows that there are evidence-based design strategies that span generations when it comes to employee wellbeing (e.g. access to nature, natural light, areas for respite and relaxation, etc.), but when you’re talking about designing spaces to encourage multiple generations to work seamlessly and collaboratively together in one space, the strategies aren’t always as cut and dry.
Project: Kaleida Health & SUNY Buffalo, Gates Vascular Institute
Based on my experience, the key to designing for a diverse workforce is to design spaces that respect the inherent value each generation brings to the workplace. To do that, it’s important to provide choice by offering a variety of workspaces that can flex and adapt based on workstyles. Although there are four main types of work—concentration, collaboration, socialization and education—each generation carries out that work somewhat differently. Providing agile environments made of unique groupings of workstations, informal meeting areas, conference rooms, social hubs and private enclaves enable all employees to do their work in a space that is best suited to their individual preference.
Project: University of Minnesota Ambulatory Care Center
As an example, CannonDesign designed the back-of-house workspaces at the University of Minnesota’s new ambulatory care center to be completely agile and reconfigurable. There are actually no private provider offices in the building—research shows that these offices remain unoccupied 90% of the time and take up 30 to 40% of a facility’s real estate. Instead, we designed a communal collaboration space filled with a variety of flexible, modular furniture options, and workspaces that can be reconfigured based on the work that needs to get done. Beyond being able to cater to multiple generations, this space harnesses the power of an interprofessional approach to care—fully leveraging the collective knowledge of the entire multidisciplinary care team.
To ensure this collaborative space actually encouraged collaboration across professions and generations, we created a fully finished mock-up of the space so that users could simulate typical activities and explore possible furniture configurations. User feedback revealed preferences for privacy screens, adjustable-height desks, task lighting, and virtual collaboration tools. The simulation exercise also revealed that to fully realize the potential gains of the collaboration spaces, ongoing transition planning will assist users to work in new ways.
Designing agile work environments is just one of the many ways healthcare facilities can be designed to address generational issues in today’s workforce. Join me and a panel of experts this Sunday to learn more.
The St. Louis Children’s Hospital Specialty Care Center received the user-centered award in the 2015 Symposium Distinction Awards presented by Healthcare Facilities Symposium & Expo and FacilityCare. The Specialty Care Center is the only project in the nation to receive this year’s award, which recognizes a “healthcare design project or facility that best reflects and balances the requirements of patients, their family and practitioners.”
Project: St. Louis Children’s Hospital Specialty Care Center
The Specialty Care Center is one of only a few stand-alone, comprehensive outpatient facilities in the U.S. focused exclusively on patients up to the age of 21. Prior to designing the new facility, our design team spent a considerable amount of time conducting research to understand how children at different cognitive levels interact with space.
Because most children lack the ability to understand the health benefits of seeing a doctor, the entire process is often stressful and uncomfortable through their eyes, said Jocelyn Stroupe, director of healthcare interiors. To help alleviate this sense of uneasiness, we took the time to understand how children interact with and perceive healthcare spaces, and how the design of the new Specialty Care Center could be leveraged in therapeutic ways.
“The big takeaway from the research and patient profiles was that children are rather sophisticated in the way they understand space and have multi-sensory interactions within environments,” added Natalie Petzoldt, St. Louis health practice leader. “This led us to develop design strategies that moved beyond creating simplistic, static visual environments to creating dynamic environments that engaged multiple age groups.”
Highlighted user-centered features, include:
- To enhance the patient experience, patients are given a special “passport” when they arrive. As they “travel” to different departments throughout the building or undergo tests or procedures, they get their passport stamped, turning a once-dreaded experience into something they can look forward to.
- The building’s theme—imagination and discovery—is evident in every patient space. Splashes of color, playful seating, vibrant artwork, expansive wall murals, and floor-to-ceiling windows overlooking gardens provide opportunities for children to explore and imagine.
- The team surveyed clinicians to gather information about the way children are positioned during treatment in order to understand the placement of graphic elements. Graphic elements on the walls, ceilings, and floors provide positive distractions at the right place at the right time. These graphics are often accompanied by narrative text to engage different age groups.
- Therapy areas incorporate benchmarks and milestones in the design. For example, graphic elements in the flooring are used as destinations for children working to improve mobility.
- Each department or clinic follows a different Missouri-specific theme and has its own distinctive entry portal and color. Iconography matching these themes is used throughout each area, aiding in wayfinding.
- To put children and parents at ease, all therapy and procedure rooms are amply sized for family involvement. The building also includes classroom space for parenting courses, a resource station that connects families to personalized child health information, a café, and a safety stop shop that provides child safety gear and home safety consultations with trained technicians.
Learn more about the St. Louis Children’s Hospital Specialty Care Center >
How leading organizations are using new ambulatory care centers to re-brand for the future of healthcare
Reputation won’t get you very far – at least on its own. That is one of the key findings coming out of the Advisory Board’s 2014 Primary Care Consumer Choice study which found that attributes related to “reputation” ranked surprisingly low out of a range of the factors that patients rely on to make decisions about their healthcare. What topped the list? Attributes related to access/convenience, cost, and service. Top providers across the country are grappling with this reality right now. Historically, they could grow market share based upon reputation and quality alone. Now, they have to assure that in addition to being associated with the highest level of care – they are also known for convenience, accessibility, and an excellent patient experience.
Outpatient care is one of the first places healthcare organizations look to understand how they can improve on these factors. As new outpatient capital projects emerge, many of these organizations are seizing the opportunity to make convenience and accessibility intrinsic components to those projects, creating operational models and design strategies that can be tested, refined, and shared throughout the system. These environments are the perfect opportunity to redefine or evolve their brand.
There are many factors to consider when redefining or evolving a brand through an outpatient project. Below are some successful strategies used by leading healthcare organizations:
Boost Convenience by Moving Off (or to the Perimeter) of the Main Campus
Historically many outpatient spaces, especially for major academic medical centers, have been hidden deep in the trenches of medical center campuses. This has created challenges related to travel, wayfinding, and overall accessibility of care. More and more organizations are making the strategic decision to invest in a “hub” for ambulatory care outside of the main campus in a location that is more convenient for patients to travel to.
Recently opened St. Louis Children’s Specialty Care Center (CSCC) and Allegheny Health Network, Wexford, Health + Wellness Pavilion have zeroed in on the concept of a one-stop shop for outpatient care in a suburban location within 30 miles from the main campus. Both of these new facilities offer a full range of services, including same-day surgery. Similarly, academic medical centers such as Northwestern Medicine and the University of Minnesota Health are capitalizing on site location to create greater accessibility to new outpatient facilities that remain on or near the main campuses. These new settings are providing the perfect “blank slate” to begin to develop both operational models and physical environments focused on convenience.
Increase Patient Satisfaction by Testing Assumptions
While the “one-stop shop” is a growing trend, patient populations they serve can be extremely different. A one-size-fits-all approach will rarely be effective. Investigation into patient expectations of the outpatient experience can help define amenities, design solutions, and technologies that will most likely be successful.
Figure 1: In an effort to enhance the patient experience, the public spaces at the new University of Minnesota Health Clinics and Surgery Center, opening in February 2016, were informed by a patient survey on preferences related to arrival, scheduling, registration, and the use of technology.
As part of the design process for the University of Minnesota Health Clinics and Surgery Center, opening in February 2016, leadership commissioned a patient survey at the outset of the project to better understand where their patients’ priorities lie around topics such as arrival, scheduling, registration, and the use of technology (Figure 1). Similarly, at AHN Health + Wellness Pavilion, the design team conducted a research project that helped them identify ten guiding principles for medical malls related to user expectations of the patient experience. The designs of both of these facilities were driven by research.
Consider the Human Side of Healthcare
One of the assumptions that should be tested is the extent to which patients want do-it-yourself solutions. With the emergence of innovations such as self check-in and self-rooming technologies, it’s important to understand that patients may still place significant value on human interaction. Determining where and when to provide that interaction is important.
Figure 2: At the new St. Louis Children’s Specialty Care Center, colorful signage mark “check-points” where pediatric patients can obtain stamps on their “passport” when visiting different clinics.
At the University of Minnesota Health Clinic and Surgery Center, a concierge model will be used, where patients utilize valet parking and are escorted from the front door. From there, a combination of technologies are used to help guide their experience. At the St. Louis Children’s CSCC, children are given a “passport” they receive a stamp on every time they visit and/or move to a new department within the building – allowing for positive interactions with staff (Figure 2).
Include New Stakeholders in the Development of System Standards
System room prototypes and material and finish standards can help healthcare systems develop a consistent image across multiple ambulatory care sites. However, given the rapid pace of physician group acquisitions and system partnerships, outpatient projects often involve new players – whether that be physicians or leadership. These new stakeholders may feel their identity is threatened when brought under a new brand. Involving physicians and defining their expectations is a key factor to creating standards that align stakeholders rather than alienate them.
Stay Top-of-Mind by Offering Amenities That Emphasize Wellness
Bringing “patients” into outpatient spaces for purposes other than clinic visits is one strategy used to emphasize accessibility. The AHN Health + Wellness Pavilion features a demonstration kitchen, classrooms, a café, and staffed playroom (Figure 3). Two floors of the new Northwestern Medicine outpatient facility are dedicated to retail options that emphasize health and wellness. These facilities are becoming community destinations that people will choose to visit for reasons other than healthcare, making them more accessible and desirable options when they have healthcare needs.
Figure 3: The Demonstration Kitchen is one of many amenities that promote wellness at the Allegheny Health Network Health & Wellness Pavilion.
Although no one health system is the same as another, the need to emphasize convenience, accessibility, and reputation is shared. Utilizing the outpatient environment to explore ways of offering a different type of experience can help set the stage for system-wide brand and care model evolution.
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