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Case Studies provide real stories of current efforts, including programs being initiated, practices being implemented, and outcomes being targeted and/or achieved. Case studies are presented as both an opportunity for learning from others as well as a spark for further ideas on how we work to improve the patient experience. If you have a case study to share please contact us
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Designing a New Model of Care Around Patients
What was the challenge, opportunity or issue faced?
When Genesis Healthcare, located in Zanesville, Ohio, decided in 2010 to consolidate its two community hospitals into one location, it set out to establish a new cultural brand for itself on a reimagined 1960's campus, where all their patients and staff could feel at home.
The project presented an opportunity to transform the Genesis environment and culture of care through facility and process design. It was estimated that the consolidation of location and services would generate nearly $1 million in monthly operational savings. The system chose to re-invest those resources into advancing specialized Centers of Excellence, including Cancer Care, Heart & Vascular, Women’s and Children’s Health, Emergency & Trauma, Neurosciences and Orthopedics, to address population health in its southeastern Ohio community.
The $150 million modernization and expansion project involved a 100,000-square-foot outpatient services addition; a 34,000-square-foot outpatient cancer center; a 200,000-square-foot addition including an emergency department, interventional platform and new patient care beds; and a 250,000-square-foot hospital renovation including the renovation of 260 patient rooms and expansion or relocation of over a dozen departments. To preserve the quality of care environment during the transformation, resources were dedicated to a phased implementation strategy that leveraged both sites. Once new shell construction was complete, departments decanted to the sister site so service line renovation and expansion into the new facility could occur simultaneously.
What did you do to address it?
Tours of nationally recognized institutions helped the team to codify national best practices. A new vision for patient care transformation was informed by staff and patient interviews, applicable models from service industries outside of healthcare, embedded observation by the design team and physical and virtual mock-ups. One example of this outside-the-industry thinking are the cancer center infusion pods, which were inspired by first-class sleeper cabins on overseas flights. The individual treatment pods offer privacy, comfort and high level of service from attending staff. SmithGroupJJR worked with the Cancer Center staff and the hospital’s Six Sigma team to design a custom infusion pod that would provide the opportunity for privacy or socialization. Before the final build-out, prototypes of the concept were constructed in the existing medical oncology practice and tested with staff and patients before the final build-out. The completed pods are staggered so that there is a direct view to the community park from each station. Touch-down nurse stations at a ratio of 1:4 to allow for a direct line of sight into the pods.
Throughout the project, the team tested concepts and collected data to identify the required steps to improve the patient experience and to address specific gaps between the institution’s existing state and desired future vision. The facility design introduced new support and care spaces that integrated over 400 process changes improving operational and staff efficiency, as well as off-stage circulation, and increased natural daylighting in all public and patient spaces. The team also and investigated methods for increased patient independence, and evaluated patient perception of empowerment and measured the increased time staff focuses attention on care delivery.
What outcomes were achieved?
The best aspects of both hospitals’ care delivery models are now integrated into a comprehensive environment of care model, integrating data-driven solutions to align with national healthcare benchmarks. By pairing comprehensive market and operational analysis with community stakeholder engagement in its strategic organizational development, the transformation achieved an 18% increase in patient satisfaction amid a spike in patient volumes.
Improvements in the patient experience occurred at multiple scales. Site access, clarity of wayfinding and circulation were redesigned to enhance the patient experience. The hospital also made the transition to single-patient rooms and invested heavily in medical equipment to improve the standard of care. Increased patient satisfaction resulted from the expansion of outpatient services and physician groups on campus as well as increased utilization of new services by extended network partners. The patient’s ability to schedule multiple services within a single visit has reduced cancellation rates for outpatient services. There has been a 33% improvement in access to care and a 12% improvement in pain management access.
Staff are more efficiently allocated and more attentive to patients. An 8% improvement in patient communication with nurses has resulted from lean process improvements and technological integration of care spaces. The reduction of administrative and circulation space allowed additional area to be allocated to support physician and staff engagement with patients, resulting in a 19% improvement in staff responsiveness according to patient experience survey data.
"The new hospital is working… and it is working extraordinarily well. Most of the improvement is in the new building… It’s just a remarkable change."
Matt Perry, CEO Genesis Hospital
“Thank you for all you do. You have all made my treatments and appointments go well. Even when I have come in so sick I was ready to pass out, you all worked together to make me comfortable until I was better. You all seem to work well as a team. “
“Not only is everyone compassionate but they are also knowledgeable and fun. Thank you so much for making this experience a positive experience.”
About Genesis HealthCare System
Genesis is an integrated healthcare delivery system based in Southeastern Ohio. The system includes Genesis Hospital, a not-for-profit hospital in Zanesville; Centers of Excellence for Cancer Care, Heart & Vascular, Women’s, Emergency & Trauma, Neurosciences & Orthopedics; an extensive network of more than 300 physicians; and multiple outpatient care centers throughout the region. For more information, visit www.genesishcs.org.
SmithGroupJJR is one of the largest architecture, engineering and planning firms in the U.S. With a staff of 1,000, we specialize in the healthcare, workplace, higher education, and science & technology sectors. Our integrated practice offers depth in all disciplines, providing the full range of strategic planning and design services required by today’s healthcare organizations. For nearly a century, we have worked with clients around the world to reinvent and reshape the healthcare environment. In thinking about the future of healthcare design and delivery, we believe that it is necessary to consider not just the facility of the future, but the patient of the future.