Are you effectively using the space you have?

What if your behavioral health organization could provide a more therapeutic, healing environment for patients and reduce medical errors by streamlining staff workflow? And, what if your organization could improve patient outcomes in a safer environment and reduce operating costs by standardizing the supply chain?

These are just two examples of how it’s possible for behavioral health organizations to enhance their financial and clinical operations. How? By implementing two emerging healthcare concepts, “lean” design and evidence-based design (EBD) and applying them in synergy to reach your specific organizational goals and objectives.

Integration of lean workflow strategies in tandem with EBD environmental concepts has the potential to decrease operating costs and improve the delivery of care. Eliminating process waste and improving the flow of data, supplies and equipment enables facilities to capture underutilized resources and avoid redundancies of space, personnel and supplies.

Understanding lean and EBD

In today’s economy, two trends are increasingly finding their way into the forefront of behavioral healthcare facility design: “lean” design and EBD. Thus far these two concepts have been implemented separately into healthcare settings as a means to significantly improve care delivery and positively impact the “bottom line” from a financial standpoint.

What do these two concepts have in common in the design of behavioral healthcare facilities? Plenty, it seems, as both trends share the same goal of achieving optimal results and efficiencies in the delivery of behavioral health services.

Table: Click on the chart to see how how lean performance improvements can directly impact space planning innovations.

Often associated with the Toyota Motor Company in the 1950s, lean processes are designed to improve production, quality and efficiency by reducing or eliminating several different forms of waste in the workflow process. To gain a competitive edge in automobile production, Toyota implemented lean by strategically placing standardized components and parts to reduce travel time and streamline inventory.

Evidence-based design, as defined in 2008 by the Center for Health Design, is “the process of basing decisions about the built environment on credible research to achieve the best possible outcomes.” In other words, by incorporating the best practices in facility planning, positive health outcomes in a healing, therapeutic environment can be achieved.

Research has even shown that simply providing access to daylight and views to the outside can significantly reduce patient depression, pain and anxiety, while also improving staff satisfaction.

Connectivity 

The impetus for both concepts is to achieve or improve positive outcomes, either for financial gain or the enhancement of patient care—ideally, it’s both. While lean is a process of doing more with less (saving money and resources by increasing efficiencies and eliminating waste), EBD is more focused on improving outcomes (by applying specific interventions to the built environment).

In facility design, the combination of these two concepts translates into fewer spaces, reduced staff costs, greater control of inventory and time-related activities, and most importantly, improved patient care. It is possible to enhance not only the financial return-on-investment but healthcare delivery as well.
Integrating these two strategies can provide many opportunities to create a better healing environment, use resources more efficiently and reduce waste.

Innovative design and space planning strategies used to achieve these synergies also include opportunities to reduce a building’s spatial footprint by designing flexible shared multi-purpose spaces, determining appropriate adjacencies and improving staff and patient circulation in a supportive environment.

By incorporating lean concepts into the facility planning and design process, excessive, underutilized and/or poorly designed spaces can be identified and eliminated or repurposed. The removal of design inefficiencies (EBD goals) which impede the quality of behavioral healthcare delivery, can and should, work in tandem with the removal of workflow inefficiencies (lean goals).

Conceptual synergies

Improvements in the workplace environment can be a challenging cultural realignment best achieved by changing the behaviors of staff and caregivers. It is only by prudent analysis of the current care delivery system that one can recognize the potential for improvement. Gaining staff support, acceptance and a collaborative approach establish a clear vision of the goals, objectives and understanding of each person’s role in that process.

This realignment transition is critical to process implementation, improved delivery and overall success. The physical environment, which has a tremendous impact on a patient’s clinical treatment and recovery, can also share and complement lean goals by employing innovative space planning and design strategies.

Numerous opportunities exist in the behavioral healthcare setting to achieve these goals. In fact, these opportunities can positively impact return-on-investment with very little capital expended on facility improvements. That’s because the bulk of these improvements are conceptual redesign of existing behaviors and workflow processes—not costly facility redesigns.

Some relatively low-cost design interventions have the potential to significantly impact the delivery and timeliness of quality care. Improving signage and wayfinding, for example, have been shown to reduce patient and family stress while reducing the time that staff spends on giving directions. Standardizing supply purchases and distribution is also relatively inexpensive to implement, yet can reap great benefits in the control and management of inventory.

The goals of lean implementation (improve operational efficiencies) and the goals of EBD interventions (improve outcomes) have the potential to increase both the fiscal health of a behavioral health organization (by lowering FTE-associated costs and providing greater inventory control) and the environmental health of that organization (by improving patient and staff health outcomes).

Conclusion

The synergies between EBD and lean design concepts are extremely pertinent to behavioral healthcare design as both provide the impetus to achieve improved positive outcomes as well as an increase in efficiency of the delivery of care.

This synergy of process redesign and performance improvement has the potential to create quality patient outcomes and healthier fiscal outcomes. Creating maximum value for patients and staff while also improving quality, efficiency and safety should be the ultimate goal for any behavioral health facility.