The goals were to improve operational efficiency via flow and collaboration between the two existing levels; facilitate team-based care; improve patient safety and satisfaction; and improve wayfinding.
Access Community Health Centers System is a federally-qualified health center (FQHC) serving people who face financial, cultural, or language obstacles to accessing health and dental care. ERDMAN was engaged to remodel the existing William T. Evjue Clinic in Madison into a 20,000-square-foot clinic that provides primary care, dental, behavioral health, and pharmacy services.
Meeting community needs and quantifying capacity is about more than physical facility space. Access receives an estimated 50,000 visits per year at the William T. Evjue Clinic, however the estimated demand is over double that number. Additionally, the clinic serves a multicultural patient base speaking over 39 different languages. The organization received a federal grant to remodel their aging facility; as an FQHC, it was necessary to maximize value. Designs were chosen with the greatest impact in the existing space, so the organization could continue their focus on serving as many patients as possible. The existing space lacked daylight, was confusing to navigate, needed to better support the children and caregivers visiting with patients, and had to reflect the multicultural make-up of the neighborhood.
Despite the challenge of using an existing space, the client and the design team combined their knowledge about how to best serve the community and recent research. Initial meetings with the client, their patients, the community and members of ERDMAN’s integrated services team informed the design process. Visioning sessions were held to discuss their goals. Once the goals were identified, the design team reviewed research about wayfinding, adjacencies and layout impacts on collaboration and efficiency, and effective waiting areas to create an initial design. The Access team brought their knowledge about best practices and experiences in serving a multicultural patient base; they knew that their patient base would come in for integrative care and social services, often with family members.
It was important to the organization that the patients feel respected and that they have an experience on par with leading providers in the area. Patients are greeted upon entry, see fresh flowers, bottled water is offered and there is an unobtrusive security presence. Patients now enter the clinic into a bright area with natural daylight, with navigation to the lower floor and registration clearly visible. On both sides of registration, waiting areas provide options for seating – quieter spaces further from the entrance and a new dedicated children’s waiting area with reading nooks, play options, and bright colors. Patients now have an easier, clearer navigation pathway with more daylight, clear signage, and a variety of wall colors and flooring to indicate location. A large art piece completed by all 383 students at the neighborhood elementary school and several pieces by local Hmong and Guatemalan artists provide positive distraction and reflect the unique community served.
The integrated services layout is centered around two pods with teambased workspaces for providers and touchdown points for charting at the far ends. Social support offices and space for small groups are provided, along with rooms for consultation and respite. Moving dental services to the lower level allowed the clinic to serve their patients separately. Behavioral Health has integrated with family medicine on the upper floor in the two pod-based layouts.
The clinic provides a positive patient and staff experience with improved waiting areas, team-based integrative care layouts, improved wayfinding, natural daylighting, and spaces and art that reflect the diverse community served. Access has reported, since opening, that the improvements to the patient experience will lead to better patient engagement in preventive care, follow-up, and management of chronic conditions. The staff estimates the volume of patients will increase this year and preliminary reports indicate staff and patients are very satisfied with the space. The team hopes to gather data one year after being open to compare results to years prior to the project and to other locations.