In a virtual age, physical connection still matters — especially during a hospital stay

Kerianne Graham, Associate, NBBJ, and Ryan Hullinger, Principal, NBBJ -

The inpatient room of the future must appeal to baby boomers and millennials alike. Here's how it can.

Demographic changes are pulling healthcare in contradictory directions. Millennial patients, born into a mobile world, are driving investments in telemedicine, on-demand services and dispersed ambulatory care. Yet an aging population of baby boomers will soon require more acute and inpatient settings. Given these conflicting demands, what can institutions do to meet the needs of both demographics? And how do these needs specifically inform the design of the inpatient room?

In proposing a solution, we first need to understand who these patients are, what they value and how they lead their lives. First, the differences: the two generations are at unique stages in life, have different health needs, have different relationships with technology, and while one group is exiting the workforce, the other is entering it for the first time. But interestingly, the two generations have more in common than might be expected. Both are at critical points in their lifetimes, and both generations are cost conscious, socially minded and value family relationships.

Baby boomers

Millennials

1946-1964

Ages 52-70

1980-2000

Ages 16-36

Transitioning out of the workforce

Transitioning into the workforce

Social activism venue: protest marches

Causes: Peace, rights of women and minorities

Social activism venue: social media

Causes: LGBT rights, global democracy

Stationary technology

Mobile technology

Prioritize healthcare provider relationship

Prioritize healthcare provider convenience

When members of these generations require a hospital stay, they want to remain connected — to their families, to their work, to their care providers, to anything and everything outside the walls of their hospital room. These days, in-room connectivity is more than an amenity. It is a care imperative. It ties patients and families to their broader support network at a time when they need it most. Additionally, both generations want to understand the value of their care and be able to tie their choices to that value. They want technology to work for them, to improve how they are cared for and the outcomes of that care. And perhaps most importantly, they want to be able to involve their family members in their care.

At the same time, many providers operate within extremely tight cost and space constraints and need to do more with less. In order to resolve this tension, we took a page from the "micro apartment" movement when considering how to design a hospital room that will meet the expectations of both boomer and millennial patients. Like a micro apartment, our patient room design economizes space and maximizes flexibility. It can be reconfigured by the family or staff throughout the day to support consultations, plug-in time for working, dinners with family, sleep and, of course, use of technology.

Consultations: This setup resembles the most typical use of a patient room, and is meant to provide a space where the patient, family and providers — consultboth present and remote — can connect as an integrated care team.

work relaxationPlug-in: We all have different activities that are important to us or help us relax, and we need time and a place in which to do them. Providing a space for patients or family members to stay connected to their work, social networks and entertainment helps them return more quickly to their routines.

Dining: Meals together have always been celebrated as a unique dinneropportunity for providing comfort and encouragement to loved ones. Creating a way for visiting family members to share meals in the room rather than leaving for the cafeteria allows their time to be less fragmented and more normalized and supportive. Plus it reduces the abandonment concerns that trouble many family members (especially parents) who feel like they can't afford to leave the patient's side.

bedtimeSleep: While it is not new to provide family members with a pull-out chair or couch, their ability to stay overnight and get real rest is often limited by space. Using a full size Murphy bed gives family members a more comfortable space in which to spend the night, rest well and wake up better prepared to support their loved ones the next day.

Technology: Present throughout the patient's stay, technologies that are both visual and non-visual enhance experience and support better outcomes. Visual technologies — such as a video screen and camera — allow for telemedicine consults with an outside or remote provider; they can also display the patient's stats, care plan, food and nutrition and can help them better engage in their own care. Invisible technologies — such as sensors embedded in the room — can track any number of vital statistics, deliver medications or supplies and take unnecessary burdens off of staff so they can work at top of license. All of the panels in the wall system are rail-based and demountable to easily support repair and upgrades as technology evolves.

For addressing infection control, UV disinfection technology could be built into the system to clean thesurfaces between uses. And while this proposal entails a moderate cost increase, we believe that the increased family engagement that that the system promotes can accelerate healing, reduce average length of stay and decrease costs in the long run.

Whether we're designing for millennials, baby boomers or the generations that surround them, increasing the value of care through increased involvement of patients and their families is a concept that everyone can benefit from. It's clear that the future of healthcare is about choice and value, and healthcare design needs to rise to that challenge.

Kerianne Graham and Ryan Hullinger are leaders in NBBJ's healthcare practice, an architecture firm that designs hospitals and clinics for 11 of the 15 U.S. News & World Report Honor Roll Hospitals, including Massachusetts General Hospital, NYU Langone Medical Center, and Brigham and Women's Hospital.

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