Design hospitals that promote staff well-being – Healthcare Management and Economics
Joan Saba, Ryan Hullinger, Thomas H. McCoy
Harvard Business Review, June 2022
Even before Covid-19, behavioral health rates were rising. In the third year of the pandemic, mental health has become a crisis, with healthcare workers in particular facing high levels of stress and burnout. Although mask mandates have been lifted and restrictions eased in many areas, caregivers and medical staff continue to treat infected patients while coping with the effects of the past two years. This confluence of factors has led to an increase in mental health problems among healthcare workers, many of whom are reporting record levels of anxiety and depression compared to the general population.
In the past, the design of clinical wellness spaces was primarily patient-centered. Well, patient care is the right choice and place for families; but also a fundamental concern for the people who care for them is critical to creating and maintaining a high-performing hospital system with person-centered care.
Designing buildings for the well-being of healthcare staff is not only necessary to stop the mental health crisis in the profession. It is also important to reinforce the financial consequences resulting from high staff turnover, avoid additional pressure on a system already burdened with financial losses due to treatment disparities during the pandemic.
During Covid, hospital staff turnover has increased, with a costly impact on morale and profits. In accordance with Becker Hospital Reviewin 2020, The registered nurse turnover rate increased 2.8 percentage points to 18.7% industrywide. Each percentage point change corresponds to approximately $270,000 lost or saved per hospital.
These numbers have prompted hospitals to rethink their approach to the physical environment and implement research-based design strategies that improve the well-being of both patients and the staff guiding their recovery. Below we summarize three lessons on hospital and clinic design based on current projects NBBJ is working on with Massachusetts General Hospital, Atrium Health, Loma Linda University Medical Center and Montage Health.
Lesson 1: Employee mental health can be part of a building’s identity.
Massachusetts General Hospital (MGH) in Boston is currently building a 482-bed expansion called Cambridge Street, focused on staff and patient satisfaction.operational efficiency and environmental management.
Several years ago, NBBJ also oversaw the construction of the 150-bed MGH Lunder Building.
Both installations provide key insight into how seemingly simple design decisions can have a significant impact on the mental well-being of employees.
It is important to keep in mind that we are not recommending services, although some people call them that. Rather than focusing on the “nice to have” perks found at tech company headquarters, many of the spaces at MGH facilities are “essential” given the fact that lives are at stake: For example, light-filled staircases, intentionally quiet floors for patients, and safer working conditions.
The Lunder building offers abundant access to daylight through a glass staircase used only by staff, which has effectively transformed the hallway into a meeting space (dubbed the “staircase conference room”). Employees also use the staircase as a place to “sit alone” and report that they find it convenient to watch employees walk up the stairs while also using the space for reflection and relaxation.
The building further increases staff’s exposure to daylight, which impacts work-related stress and job satisfaction and has also been found to impact physician burnout, by incorporating hallways that allow staff to access areas through an exterior wall. Because less noise can reduce stress among caregivers and also help patients recover from illness, Lunder’s building uses a variety of sound-absorbing materials and technologies to make patient floors 35% quieter than conventional medical buildings.. Other features designed to minimize noise include sliding doors, distributing work areas for medical staff throughout the floor rather than in one location, and elevators and visitor waiting areas located away from patient rooms.
Finally, staff safety is perhaps the most important “service” of all. For example, Overexertion in the form of repetitive routine physical tasks such as bending, reaching, and standing accounts for 45.6% of all injuries sustained by nurses.According to an article published by the US Bureau of Labor Statistics in 2018. These injuries can cause musculoskeletal disorders such as sprains and sprains, which kept nurses in the private sector out of work for 8,730 days in 2016. Features such as motorized patient lifts with suspended ceilings or full-height glass doors that provide greater situational awareness can help reduce injuries.
Designing buildings this way makes a difference. For example, data from the occupancy of the new inpatient units and staff work areas that NBBJ designed for Atrium Health shows that the vast majority of employees feel safer and more comfortable in the workplace. In the same post-employment evaluation, employees noted “the collaborative nature of the research area,” “improved interactions with colleagues,” and “improved team collaboration.” as positive aspects of the new building, further demonstrating that opportunities for collaboration and interaction increase employee satisfaction.
Lesson 2: Design features can reduce stress on essential jobs.
Many hospitals are creating satellite rooms that allow people to choose how to spend their precious downtime. These spaces Both “backstage” (where staff can gather or remain alone) and “onstage” (where caregivers receive patients) allow staff to spend less time moving around the building and more time recharging.
The Loma Linda University Medical Center expansion in Southern California features an open design. It has wide hallways, access to daylight, and the placement of patient rooms and supplies along the wings, allowing staff to better communicate with each other and with patients. In open hospitals, key support functions such as staff changing rooms, break rooms and conference rooms are located in a centralized hub that connects to patient areas outside..
This arrangement reduces the need for staff to move between patient rooms and supply rooms, as well as the need to perform ineffective and repetitive physical tasks that can lead to burnout.
In addition to open core designs, there are shared clinical rooms such as The new examination rooms at MGH’s Cambridge Street project, large enough to accommodate interdisciplinary consultations, reflect the changing nature of medicine. Collaborative clinical spaces reduce the burden on caregivers and their teams while providing patients with a new, more efficient way to navigate their healthcare journey.
In future, These charging spots can come in different shapes, making it clear that everyone charges differently.. For example, since private spaces have been shown to reduce caregiver stress: Some hospitals are exploring food service areas with sleeping areas for their staff, located adjacent to the patient unit for ease of use.
Lesson 3: Good design is ultimately good for business.
Health systems like Montage Health on the Monterey Peninsula are taking advantage of their less densely populated locations to incorporate nature into the design of their buildings.. For example, the garden setting and private patios for staff at the Ohana Center are designed to reduce the level of arousal fatigue, the psychological exhaustion that results from prolonged, continuous stimulation. Agitation fatigue is one of the key factors contributing to burnout among behavioral health professionals, who have an annual turnover rate of 40%.
Other organizations are exploring solutions such as satellite meal lockers, mobile ordering apps and meal plans that offer discounts on nutritious food options. These types of design interventions represent investments in staff longevity; They help reduce stress and encourage positive lifestyle choices, ultimately supporting the mental and physical well-being of those tasked with helping others recover.
Behavioral health problems existed before the pandemic and will continue after it ends.
Therefore, as healthcare systems face the lingering effects of the pandemic, it is more important than ever that they shift to a more caregiver-centric mindset.
Only by creating spaces and implementing solutions that simultaneously promote staff well-being and patient recovery can you effectively retain and recruit staff, and reduce the financial impact of burnout and turnover.
Designing buildings to improve employee well-being will help keep employees happy and productive.