Channeling Patient & Staff Experience: Stanford Neuroscience Health Center

 

Just as workplace design continues to evolve and envelope outside influences, so too does healthcare design. Design firms are grappling with new challenges in healthcare environments – how best to shape the patient experience, how to better support evolving forms of care, and how to ease increasingly complex medical staff roles through design.

The Stanford Neuroscience Health Center is Palo Alto, CA
The Stanford Neuroscience Health Center is Palo Alto, CA

Situated in Palo Alto, CA, the new Stanford Neuroscience Health Center is a project that aims to resolve many of the most pressing design challenges in healthcare today. The project, designed by TEF Architecture & Interior Design, is a key component of Stanford Health Care’s landmark renewal program to rebuild and modernize the facilities that are the foundation of its healthcare services.

This new addition to Stanford Health Care facilities is an excellent illustration of how Stanford is thinking radically about the healthcare experience, and about how patients and medical staff can interact and use healthcare spaces more successfully.

The most notable innovations of the new building are:

>As one of the first outpatient settings in the nation to house neurosurgery, neurology, and interventional neuroradiology under one roof, the center combines world-class care, comfort and convenience to transform the patient experience.”

Elevator bank
Elevator bank

>The facility features “state-of-the-art technology including the only comprehensive autonomic laboratory on the West Coast with a thermoregulatory sweat lab and one of the first PET/MRI machines in North America designated for clinical use.”

>”Through engagement with a 12 member Patient and Family Advisory Council, feedback from those living with neurological diseases, as well as physicians, and care team members, was integrated into virtually every detail of design – from flooring to lighting resulting in a bespoke, streamlined place of healing that will lead to more accurate diagnoses, organized care, better quality of life and improved outcomes for patients.

2016-1107-tefstanfordneuroscience6-supportiveservicesgroundfloorspace“The Patient and Family Advisory Council was instrumental in guiding critical features of the building integrity to enhance the patients journey and accommodate the sensitivities of people with neurological disorders. The council’s influence impacted both operational and design elements of the building down to the details, like carpet patterns and lighting, which is important since many of the members will actually be treated in the building.”

“It was really interesting to have users so involved in the design process,’ said Ms. Fisch. “In healthcare design, this isn’t that common. We got comments that I’ve never heard before, and were able to use a lot of their input to make the space better.”

2016-1107-tefstanfordneuroscience7-physicalandoccupationaltherapyMs. Fisch noted that neurological patients almost always have limited mobility, and one of the primary care goals is to regain that mobility.

Outdoors, patients and their doctors and therapists can use a mobility garden with multiple surfaces and textures underfoot, ramps and handrails, to practice walking again. The mobility garden is a great example of how designers can do more with outdoor spaces, moving beyond the “peaceful,” “reflective” goals that outdoor healthcare spaces often fall back on.

One major area the Patient and Family Advisory Council was weary of was flooring material. In light of their challenges with mobility and depth perception, neurological patients need absolutely flat surface flooring and no differential in textures.

2016-1107-tefstanfordneuroscience9-equipment“The challenge was, ‘How do we provide a completely flat surface that is also maintainable?’” said Ms. Fisch.

Everything from tile footprint to grout joints played into the decision-making.

“Where we would usually be looking for more contrast in flooring materials to add visual stimulation, neurological patients need the opposite. All of the flooring became very monochromatic and tonal, and we ended up going with a larger footprint tile than we normally would.”

2016-1107-tefstanfordneuroscience10-patientservicesandwaitingarea>”Centralized check-in for all appointments is consolidated into one stop on the ground floor and is one of the most significant aspects of the new building. Patients with several appointments receive a same-day itinerary and are able to move from floor to floor without additional check-ins.”

Patients who come there might see three or four doctors in one day, sometimes spending an entire day there. They have the option to check in and receive their itinerary before they get there or on the ground floor, and can share their itinerary with family who might be stopping in or picking them up.

 

2016-1107-tefstanfordneuroscience12-patientspaces“It gives the patient more control over their day, and more knowledge about what their day will look like,” said Ms. Fisch. “They’re tapping into that idea of first touch – being very professional and super concierge-like.”

Patient waiting rooms are located on the perimeter, allowing guests to enjoy the outdoors as well as stay in touch with the time of day. Patient rooms fall next to the perimeter, and medical staff and team work areas line the building core.

circulation was built in a very particular way,” said Ms. Fisch. “The windows in patient rooms also serve as built-in wayfinding, making it easy for patients to feel like they know where they’re going based on what’s outside.”

2016-1107-tefstanfordneuroscience13-patientspaces2The facility’s infusion treatment spaces, often required for neurological patients, were designed for flexibility.

“Patients getting their treatment can push the sliding walls of these spaces out to get more privacy, or can keep them pushed in to visit with their neighbors who are also receiving treatment,” said Ms. Fisch. “This can be very therapeutic, especially for regular patients who often see the same people in regular treatment.”

On the ground floor directly to the left of the main entrance, a “Supportive Services” room is an innovative multi-purpose space for virtually everyone to use, including the public, who can reserve it for free.

2016-1107-tefstanfordneuroscience14-infusiontreatmentspacesLined on one side with windows and mirrors and a bar on the opposite side, the space can be used as a classroom, a meeting place, or exercise/therapy space for physical therapists and exercise therapists.

>Ms. Fisch also noted a shift in Stanford’s focus from a heavy-handed emphasis on the patient experience to include a balanced focus with more attention paid to the staff experience as well as patient experience.

Much of the patient/medical space layout design incorporates the “lean method,” a health care design model codified by the Virginia Mason Institute.

2016-1107-tefstanfordneuroscience15-staffspaces“It’s a way to look at delivering healthcare in the most efficient way from a staff perspective,” said Ms. Fisch.

In this model, the physician and medical staff are in a large workroom directly adjacent to the patient rooms, about 12 staff members to each of these large workrooms. Each exam room has two doors – one where patients enter from, and one where physicians and other medical staff enter from.

2016-1107-tefstanfordneuroscience16-adminandsupportstaffspaces“This allows the medical staff to be more in tune to each other and allows for better communication between physicians,” said Ms. Fisch. “It’s a big change to go through, but Stanford is an amazing institution that is thinking very progressively and very radically about how to change their processes for the better.”

Designers must also pay careful attention to circulation paths in healthcare environments. They have some of the same concerns as corporate companies have with their visiting clients, but for slightly different reasons.

2016-1107-tefstanfordneuroscience17-staffterrace“There has to be a circulation path for patients and a circulation path for medical staff that allows the medical staff to circulate behind the scenes, without crossing paths with patients.”

This is referred to as “onstage and offstage circulation.”

In addition to locker rooms and lounges at the buildings perimeter that allow for natural daylighting exposure for medical staff, there are two outdoor terraces on the top floor designated solely for staff.

 

“It’s a balancing act to find ways to make sure each occupant’s needs are taken care of.

2016-1107-tefstanfordneuroscience18-staffterrace2The trend away from a hospital as a machine or factory has been out there for the last decade, with both residential and hospitality influences gaining more sway. Residential trends made an entrance into healthcare first in labor and delivery recovery and postpartum care, with more home-like, softer colors and more wood.

“But the trend toward hospitality is more analogous in scale to healthcare environments.”

Stanford has pursued a synonymous aesthetic for all of its facilities in the past decade – white and other neutrals as a base, often complemented with wood as an accent, and always accompanied by a collection of art thoughtfully curated for each specific building. This focus on curated art is a long-standing practice at Stanford; the institution employs an in-house curator who selects each spaces art works to channel each particular space.

At the Neurosciences Health Center, selected works embody the circle shapes that often represent cells in the body, and much of the work is in resin.