Transformative Healthcare Design for an Ever-Changing World

August 28, 2023

How institutions and designers can work together to address critical workforce shortages and support the ongoing delivery of high-quality care.

Though the term “The Great Resignation” is relatively new in our collective vernacular, the effect of this phenomenon has made a significant mark. Across regions and industries, the U.S. labor market has been impacted by this extraordinary upheaval, driving quit rates to reach a near 20-year high in November 2021. With an estimated 500,000 healthcare workers quitting their jobs every month in 2022, few industries have been more impacted by The Great Resignation than healthcare. While there’s been great emphasis placed on recruiting new talent, we’re also facing the stark reality that the pool of available talent from which to fill these gaps is increasingly limited. Enrollments in nursing schools are not growing fast enough to meet projected demand, raising concerns about the capacity of nursing schools to meet the need for nursing services.

As designers of both educational and healthcare environments, we at RDG are aware of the impact this turbulence is having on health systems and universities. We can’t solve all the problems facing recruitment and retention, but by working closely with clients and listening to their concerns, we can better understand current and future needs. Here, we explore ways designers can work to develop intentional, responsive design solutions that address current and future healthcare needs and support the ongoing delivery of high-quality care.

Design spaces that care for caregivers.

Many family members and loved ones are heavily involved in a patient’s post-operative care. As such, architects and designers should look for ways to design spaces that support these caregivers. For example, family areas on patient floors and in patient rooms where caregivers can work remotely from the patient's bedside and stay virtually connected to other family members via integrated technology (e.g., video conferencing capabilities) are one way to support caregivers. Another example is the design of education spaces that allow family members and caregivers to learn from providers and nursing staff on how to care for patients after the patient is discharged. We already use simulation technologies to train medical staff, so why not look at creating spaces that incorporate practice holograms that mimic home life and allow caregivers to practice patient care before individuals are discharged.

Providing post-op training to family members and caregivers decreases the probability of rehospitalization or the need to contact nursing staff from home for further instruction. By providing spaces that support caregivers’ ability to stay with and care for their loved ones we can enable family members to learn care techniques from providers and nursing staff as they stay close to their loved one as well as free up time for nursing staff to be available for and focus on patients who are within arm’s reach.

Look for opportunities to incorporate technology and automation.

There’s growing interest in finding ways to leverage technology and automation to enhance patient outcomes and support healthcare workers. By incorporating innovative tools and processes, healthcare providers can streamline their workflows, reduce administrative burdens and focus on delivering high-quality care. As a result, there’s a significant opportunity to transform the healthcare industry through strategic solutions that incorporate technology and automation.

Employees across industries have moved into fully remote or hybrid work models, and while on its face it may seem like a virtual (pun intended) impossibility for healthcare workers to practice in this way, increased usage of telehealth services has made a hybrid approach to work more accessible to nurses and doctors. To support this modality, designers can create healthcare spaces that accommodate virtual nursing staff. This change in approach to providing care has caused clinicians to reevaluate the number of exam rooms they have or need in a clinic and consider different types of spaces to support more telehealth opportunities, both synchronous and asynchronous. These telehealth spaces are typically smaller and more cost-effective than typical exam room spaces. Our team is seeing an increased request for the incorporation of telehealth technology for consulting with specialists in operating rooms during surgeries as well. In other words, specialists don’t have to be physically present during surgery if they have access to technology that allows them to support the surgeon during the procedure via virtual/video conferencing technology.

Designers are seeing an increased demand for the ability to incorporate technology to support artificial intelligence, augmented reality and virtual reality to aid providers in patient care services. The incorporation of this technology further supports the need to support more technology-rich spaces and fewer exam rooms. The Davis Global Center for Advanced Interprofessional Learning, for example, is a cutting-edge training facility that houses a variety of spaces in which learners are immersed in simulated and virtual, life-like scenarios. This project is a springboard for future healthcare professionals to apply learned technologies in their daily practice.

The Davis Global Center features a five-sided laser-CAVE immersive environment with augmented/virtual reality (AR/VR) technology to enhance education by providing unique experiential learning opportunities. Photo by Kent Sievers.

Many clients are looking at the automation of certain processes and procedures, including things like medication distribution. If we can design spaces that allow for the integration of automation technologies, which in turn don't require the direct involvement of healthcare workers, we can free up staff time to focus on patient care. We’ve seen this at work in our recently completed design of a new pharmacy hub for Nebraska Medicine. The hub distributes medications to the various Nebraska Medicine campuses with the use of robotic technology and creates a more efficient process for medication and prescription distribution.

We can also look for ways to support improvements in technology that help address the staffing shortage. Designers can collaborate with institutions to incorporate spaces that support communications via apps for family members to communicate with staff to share patient preferences, such as a patient’s preferred sleeping positions, without the need for a face-to-face interview. This saves valuable staff time and helps ensure patients receive personalized care. One example of this effort is the work of Dr. Breanna Hetland, Ph.D., RN, CCRN-K, an assistant professor at the University of Nebraska Medical Center College of Nursing and Nurse Scientist at Nebraska Medicine, who is in the developmental stage of creating an app called Family Room to support this type of need.

Support recruiting efforts through responsive planning and design.

By creating environments that are conducive to staff well-being and productivity and designing spaces that are flexible, comfortable and efficient, architects can help healthcare organizations create work environments that attract and retain skilled professionals. In addition to designing spaces that support the people already in a program or institution, we can work with clients to support ongoing efforts to recruit future healthcare workers. To increase the pool of candidates graduating from their programs, for example, the University of Nebraska at Kearney and the University of Nebraska Medical Center College of Nursing partnered on a new initiative, allowing admissions to the Bachelor of Science in Nursing program twice per year instead of once per year as had been the institutions’ approach; the institutions also created scholarships to attract out-of-state students to rural campuses, an area and population particularly impacted by The Great Resignation. These efforts are all part of UNMC’s Office of Rural Health Initiatives, a program focused on developing rural outreach education activities and providing direction and support for a variety of rural health programs, services and initiatives that aim to enhance access to quality healthcare for Nebraskans. Not only is the initiative growing UNMC’s programs, but it’s also enabling the institution to have a presence in places where it previously could not, leveraging technology to provide remote access, support and training. Thanks to these efforts, the number of students enrolling in the college each year has nearly doubled. This increase in enrollment is a positive for the university and the nursing profession – and it also means there’s a need for more space to accommodate a growing student body.

When the Rural Health Education Building opens, not only will medical, public health and pharmacy students be able to attend class on the Kearney campus for the first time, but existing allied health and nursing students will enjoy expanded class and program offerings. Rendering by RDG.

We previously worked with the University of Nebraska at Kearney to design the first phase of their expanded campus, which built on the momentum of the collaborative rural health initiative to develop a new home for the College of Nursing. Completed in 2015, the Health Science Education Complex on UNK’s west campus houses collaborative learning classrooms, gross anatomy, clinical learning, simulation, musculoskeletal, rehabilitation and health assessment laboratories, with clinical research woven into the program. The project was the first in a series of master-planned buildings that will link the core of campus with the emerging south campus development in response to the robust results of UNK and UNMC’s recruiting initiatives. We worked with both schools to continually evaluate the established master plan to see where new or renovated spaces were needed to accommodate the influx, and we’re now designing a new 113,000-SF Rural Health Education Building on UNK’s campus to expand opportunities for students to study, train and eventually practice in central and western Nebraska.

UNK/UNMC’s approach is a model for how institutions and designers can work together to address critical workforce shortages and turn the tide on the gap between supply and demand in healthcare staffing. And as healthcare continues to evolve, designers of these environments should serve as trusted partners and allies in transforming the industry for the better. We don’t have all the solutions, but we do have the power to create spaces that encourage care for caregivers, incorporate robust and innovative technology and automation and empower educational institutions to increase the pool of future healthcare workers.

Written by Katie Ramsbottom, Architect