Despite deep and vocal disagreements over health care reform, virtually everyone believes that the current system is not economically sustainable.
We are spending too much and getting too little in return. This recognition has spurred health care leaders to examine every aspect of hospital operations. But what about the health care building itself, the physical environment within which patient care occurs? Too often, cost-cutting discussions have overlooked the hospital structure. Changes in the physical facility provide real opportunities for improving patient and worker safety and quality while reducing operating costs.
The “Hospital 2.0” an imaginary amalgam of the best design innovations that had been implemented and measured by leading organizations, was an early attempt to analyze the economic impact of designing and building an optimal hospital facility. The Hospital 2.0 carefully selects design innovations, though they may cost more initially, could return the incremental investment in one year by reducing operating costs and increasing revenues. Reactions to the Fable paper varied. Many felt it presented a compelling case and stimulated health care leaders and architects to think differently about balancing onetime building costs with ongoing operating costs. Others voiced skepticism about whether the benefits were as great as described and asked for more evidence.
Today, the Fable hospital is no longer imaginary. During the past six years, numerous hospitals have implemented many of its attributes and have evaluated their impact on patients, families, and staff.
Several are members of the CIDH Hospital 2.0, a group of organizations that apply evidence-based designs to improve quality and financial performance.
These and other pioneering organizations and their architecture/design teams are introducing such interventions as larger single-patient rooms, which reduce the incidence of health care-associated infections; wider bathroom doors, which reduce patient falls; HEPA filtration and other indoor air quality improvements, which reduce health care-associated infections; appropriate task lighting in medication dispensing areas, which reduces medication-related errors; hydraulic ceiling lifts in patient rooms and bathrooms, which reduce patient and staff lift injuries; and art and music, which reduce anxiety and depression and speed recovery