-By Courtney Johnston and Joy Bartolotta

"Designing for Health" is a monthly, Web-exclusive series from healthcare interior design leaders at Perkins+Will that focuses on the issues, trends, challenges, and research involved in crafting today's healing environments. This month's article focuses on medical teaming centers.

Collaboration and flexibility are key elements in most workspaces, and the healthcare industry is no exception. In designing a new bed tower addition to Midland Memorial Hospital, in Midland, Texas, Perkins+Will was challenged by the client to create caregiver-staff workspaces to be both collaborative and flexible, and quite different from their current conditions. Bob Dent, chief nursing officer at Midland Memorial, was supportive of “teaming center” concepts and decentralized nurse alcoves; “patient safety” and “assisting clinicians in efficiencies and reducing the wear and tear on their bodies” are his top priorities. Upon touring other facilities and researching the decentralized nurse station model, during the design phase of Midland, he challenged the design team to reevaluate at the design for the patient floors and apply the model to the facility.

The majority of the time patients do not see one physician for their condition or treatment, but rather a whole team working together to meet the challenges of each patient’s needs, thus requiring medical staff to collaborate. According to the Midland CNO, “it is very important for collaboration between all disciplines in meeting patient safety and excellent care.” Medical teams can include physicians, specialist, nurses, technicians, cardiologists, anesthesiologists, pharmacists, case managers, and social workers. Occasionally even family members are encouraged to participate in brainstorming for best treatment options. Healthcare designers and planners are looking to the work environment at caregiver areas to help in this teaming concept. Caregivers are decentralizing and moving to work locations in closer proximity to patients, as it puts the staff in better positions to monitor and respond to patients quickly. With staff decentralized, collaborative moments need to be encouraged through well-thought-out planning of open spaces to allow for “chance encounters.”

The design team at Perkins+Will revised the core of the patient floors to house equally spaced staff teaming centers, were placed strategically to support equal numbers of patient room nurse alcoves, as well as serve as the pass-through point from one side of the patient floor to the other. (Click here to see a typical floor plan at Midland Memorial Hospital.) This traffic flow placed adjacent to the teaming centers support the concept of chance encounters of staff, as well as a convenient meeting point for various disciplines. At least one teaming center per department houses the unit clerk, which was carefully placed to be able to monitor visitor traffic to the department when volunteers are off duty.

More recently, the healthcare industry has begun to look to models in corporate work environments for their own environment structures. Many large corporate office furniture manufacturers are developing product lines for use in healthcare settings; modular furniture is now being used in the treatment and patient areas of medical centers, rather than solely in the administration departments. To build these healthcare teaming centers, Perkins+Will has utilized the Sync products and Montage modular panels and worksurfaces, both from Nurture by Steelcase. Demountable partitions in an L-shape at one corner of the teaming center serve dual purposes. On the outside wall, graphic accent material is attached in patterns unique to departments for wayfinding, while also this accent material shields the internal function of staff members jotting notes on a writable surface and hides the ceiling-mounted patient monitor. The modular panels with a standing-height transaction counter surround the nurse station on one side and allow staff to meet informally while standing. Inside the teaming centers are touchdown areas; unassigned computers for quick research, access to files, and access to printing. Ergonomically shaped freestanding workstations are in the center of the teaming areas, with one side taller to promote for “perching” on stools or standing and the other side at standard desk height. These various workstation heights and configurations allow for flexibility to accommodate different work styles. Some larger teaming areas offer a small, enclosed room for up to four staff for private conferences or traditional dictation. The physician will update records and patient information through computer data entry or via telephone system.

The unit clerk workstation is C-shaped to support work habits and limit constant movements. (Click here to see a floor plan or teaming center with unit clerk at Midland Memorial Hospital.) The surrounding work area minimizes the amount of time this person is doing non-ergonomically friendly tasks. A computer monitor on an arm and a keyboard tray free up counter workspace, thus facilitating paper sorting. Storage of forms was set at desk height to sight and to minimize bending. And a central printer tower is located near the unit clerk desk and in the center of the teaming hub to allow for other staff members to access paper documents without crossing into each other’s work zones.

Increasing patient care and satisfaction, team involvement, and collaboration along with staff safety have been harmoniously achieved through a mind shift to collaborative teaming stations with advanced technology and greater mobility. Most importantly all parties will function as one central resource and with one goal, healing patients.

Courtney Johnston is the director of design for the Interiors Studio of the Perkins+Will Dallas practice. She is responsible for managing the design process for projects and collaborating with other design disciplines for the best possible project solutions. Her experience includes healthcare, corporate, and education projects.

Joy Bartolotta, an associate with Perkins+Will, is an interior design project manager. Currently project manager for the Midland Memorial Hospital, she has been instrumental in the success of the project. Her expertise is in the healthcare industry, in projects ranging from hospitals, ambulatory care facilities and medical office buildings.

Past installments of "Designing for Health" include (click on title to access the full article):
• Integrating Security in Hospital Emergency Departments
• We Eat What We Build
• Evidence-Based Healthcare Design Forum
• Designing the Ideal Space
• The Importance of Family in Patient Rehabilitation
• Maximizing the Impact of Art in Architecture
• The Benefits of Healthcare Learning Environments