In November 1999, the U.S. Institute of Medicine (IOM) published the landmark report “To Err is Human: Building a Safer Healthcare System.” The title hearkens back to the notion that to make a mistake is part of the human condition. Yet what the book actually shines a light on is the fact that the systems we have in place, or at times the lack thereof, were often the precipitating factors that led to the error, not the people. It did a lot to give insight into medical errors and created a movement toward patient safety that we continue to build on to this day.
The work of The Center for Health Design, which started over 30 years ago, is based on the premise that the built environment has an impact on the outcomes, culture, and financial bottom line of our healthcare systems. Though this idea is decades old, it has renewed relevance today in light of the global coronavirus pandemic and our planning for a changed, post-COVID-19 world and healthcare system.
The stressors COVID-19 placed on our healthcare system exposed its frailties but highlighted its strengths, as well. For example, some hospitals reported that the thoughtful upfront planning and designs they invested in to allow for flexibility and surge potential in the case of a disaster worked exactly as they had been designed—validating once again the role that design plays, especially at critical times in healthcare delivery.
At The Center, we’ve been working the last few months to fine-tune our business model so we can continue to meet our mission in a post-COVID-19 world. We’ve launched a new “Voices of the Industry” webinar series as a way to present both innovative solutions that have worked as well as the problems we have yet to solve. The first three webinars showcased thought-leaders from both within our industry and outside of it, all of whom are making a difference through their work and leading the next generation of design. If you missed this new series, the webinars are available on The Center’s website, under “Open Access” in the Insights and Solutions section.
Another highly attended webinar program that’s available on our site looks at safety through the lens of materials selection and cleaning protocols, especially focusing on new durable coated fabrics and emerging materials like copper and silver that may have innate properties to reduce the spread of healthcare-associated infections.
One last resource from The Center to explore is the Safety Risk Assessment Tool, which is designed to encourage a proactive process to mitigate risk by prompting a multidisciplinary discussion and using an evidence-based design approach in six areas of safety: infections, falls, medical errors, security, injuries in behavioral health environments, and patient handling. Like all the resources mentioned in this column, the tool kit is free to all.
As an industry, we’ve come a long way in both our knowledge and designs since the IOM report came out decades ago. Many design features that improve safety in healthcare environments, such as single-patient rooms and incorporating hand-washing sinks into the patient room, have been standardized.
And yet COVID-19 has shown us our weaknesses and how far we still have to go to ensure all healthcare facilities can provide safe and efficient care. The added pressure put on our buildings, staff, and communities exposed the inefficiencies and inequities in our healthcare system. The just-in-time supply chain and minimized workforce that helped bring efficiencies to healthcare couldn’t scale up quickly enough during a pandemic. Moving forward, how can we design more respite areas for overworked staff?How will we ensure spaces can quickly scale in acuity when needed?
As a community, we don’t hold all of the pieces to this puzzle, but we do hold the skill sets needed to be a part of the solution. Sadly, all too often change comes out of adversity. I hope that our collective experiences with COVID-19 will motivate us to find and share new insights and innovations.
Debra Levin is president and CEO of The Center for Health Design. She can be reached at dlevin@healthcaredesign.org.
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