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Behavioral and mental health (BMH) conditions affect one of five adults in the U.S. each year, and are even more common among patients receiving care for medical conditions. Up to 45% of patients admitted to the hospital for a medical condition or presenting to the emergency department with a minor injury also have a concurrent BMH condition. These BMH comorbidities increase the risk of psychological harm associated with care. Providing these patients with a healing, therapeutic environment should be an important goal for health design. Design interventions aimed at improving the psychological well-being of patients with BMH comorbidities may be more cost-effective than they initially appear, because they can be leveraged to support improved well-being for other populations as well, including other patients, staff, and visitors. 

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People treated in facilities where the setting is conducive to strong communication tend to give higher scores in patient satisfaction surveys. By focusing on the communication that occurs between providers and patients in a healthcare space, design can be used to facilitate and enhance meaningful interaction.
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As hospitals and staff are overwhelmed with an influx of patients, overcrowding and long wait times continue to be problematic as hospitals struggle to get patients in and out of the ED. Using creative strategies to design flexibility into the built environment, hospital EDs can optimize operations and improve throughput while continuing to put the patient first. To View a Complete List of Toolbox Contents and Resources, Click Here.

Healthcare reform is in full swing with the 2010 Patient Protection and Affordable Care Act (ACA), providing many opportunities for the built environment to be a driving force in better outcomes. Organizations are incentivized to improve the quality of the built environment, which can be accomplished by taking a comprehensive look at facility design, operational decisions, staff training, and care delivery, and how they relate to outcomes.
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As people live longer and longer, managing the needs of the aging population is more important than ever. Medical and technological advancements are changing healthcare for the better, giving facility designers and medical professionals new ways to provide flexible models of care and help individuals age in place. 

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Healthcare-associated infections (HAI) and other easily transmittable diseases are a serious concern in most facilities today. Implementing some of the latest best practices in your physical environment can help to minimize their impact—and help you get the best outcomes from your efforts.
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Noise affects patient safety and health, and is an important part of the patient experience. Patients often complain about noise levels during their hospital stay, but there are many interventions available to support a healthier and more comfortable environment.
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A healthcare setting that facilitates partnerships between individual patients, clinicians, and family, a patient-centered medical home is a place where individualized care is designed around patient needs to increase care coordination and communication between providers and patients, and enhance overall quality, while simultaneously reducing costs. Individualized care within a patient-centered medical home is provided in a culturally and linguistically appropriate manner. 
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Environmental cleanliness affects the patient experience, patient satisfaction, perceived service quality, and actual quality in terms of infection prevention. Successfully achieving certain levels of cleanliness requires an interdisciplinary approach that involves the building design, operational and policy changes, education of personnel, and cultural changes to the organization.  
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Population health refers to not only the overall health of a population, but also the distribution of health. Healthcare built environments and community environments can be used to support effective population health management strategies such as establishing patient registries, monitoring cost and clinical metrics, engaging in risk management outreach, communicating with patients, educating patients, and coordinating effectively between care teams and patients.
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In industry, process-driven design might be considered in the context of manufacturing and process optimization. In the context of healthcare, process-driven design can be considered through several approaches, including Lean, Human Factors/Ergonomics, and Experience Design. Each of these is similar but different in subtle (and not so subtle) ways. An evidence-based design (EBD) process would support any or all of these approaches. While any individual approach may move us ahead of a traditional design process of user meetings, we can aspire to an EBD process where these three approaches meet, leveraging the benefits of each. 
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Safety has often been addressed differently between the design industry and healthcare owners. Designers often think of safety in the context of fire and life safety, while healthcare owners and caregivers may think of safety in the context of serious reportable events and hospital-acquired conditions. But poorly designed and operated healthcare environments can also contribute to harm associated with adverse events such as healthcare-associated infections (HAIs), medication errors, injury from patient handling, self-harm (or violence against others), security breaches, and falls. Safety in healthcare is complex and requires a systems approach – understanding the organizational factors, the people, and the often overlooked environment. This toolbox details six risk components in healthcare settings (going beyond fire and life safety), with design considerations for the built environment that may contribute to improved safety for all who use a facility – staff, patients, visitors, and others. 
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When healthcare facilities do not have adequate staff to maintain operations, consequences can include lost revenue, high turnover of existing staff, and compromised patient outcomes. It is incumbent on healthcare futurists and leaders to rethink healthcare work environments. Creating spaces that not only support patient outcomes, but that support staff fulfillment, resilience and organizational commitment will be required for success as the healthcare industry seeks to sustain itself in the midst of high patient volumes and high operating expenses. Understanding the multifaceted impact of the built environment includes recognizing how acoustics, interruptions, break spaces, social support, and access to nature can be leveraged to support staff.
 

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With state-of-the-art capabilities such as electronic health record systems, robotic surgeries, remote video connections, and medication safety systems, organizations can increase diagnostic and treatment efforts and enhance patient outcomes in exciting ways. These advancements can support cost-effective and efficient patient-centered care, all of which should be thoughtfully integrated into layout and design details. 
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