Notes from the Joint Commission Conference
I just returned from the Joint Commission “Hospital of the Future” conference in Orlando. CHD board members Ian Morrison, Ann Hendrich, Roger Ulrich, and Craig Zimring all spoke.
Roger Ulrich and Craig Zimring did a good job presenting the benefits of using evidence-based design to this audience of mostly healthcare managers and administrators. They spoke about CHD’s Pebble Project research and drew from the literature survey they conducted for CHD almost three years ago (the RWJF funded report), which they are currently updating.
Among other things, Ian described a typical hospital experience as “islands of excellence surrounded by the department of motor vehicles.” He also said that the “average baby boomer has $50,000 in assets. We’re all going to be limo drivers in Boca Raton someday.”
And, some of you have heard him talk about how hospitals are like MTV’s “Pimp My Ride” (PMR) show where they take beater cars and “trick” them out with cool interiors, blow-your-ears-off sound systems, super cool paint jobs, and huge chrome tire rims that go backwards while you’re going forwards (how do they do that?). The trouble is, they PMR homeboys never do anything to the chassis, so you have beautiful cars that will eventually break down again. He used this as a metaphor to describe how we’re designing many hospitals these days.
I also heard a fascinating talk on “medical tourism,” or “medical outsourcing,” as the industry prefers to call it. While it doesn’t seem like this will make much of a dent in the huge U.S. healthcare industry, it is becoming a viable option for the underinsured who can’t afford to pay for costly medical procedures in the U.S. Imagine paying just $5,000 for a hip replacement. It is happening in Thailand. Oversees hospitals that cater to that industry seem to be paying attention to the design of the built environment to attract patients and retain staff.
And, Uwe Rinehardt, the Princeton healthcare economist who is truly an industry guru, said this about investing in better building design: “I’m always astounded by how cheap it is to make a hospital attractive. People should have good experiences in your hospital. These things do seem to matter to attract revenue.” He also said that future labor shortages will mean create a need for “wireless long-term care,” in which hospitals become hubs of wireless, home-based, long-term care management.
Finally, in a review of a recent research project she did with Marilyn Chow of Kaiser, Ann Hendrich told us that “poor work processes will trump good design any day.” But she did acknowledge that physical design, work processes, and technology all need to be integrated for things to change.