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Optimizing Space Case Report: Gouverneur Health

Gouverneur Health, a part of the New York City Health and Hospitals Corporation (HHC), serves 250 patients per day in its two primary care practices. Within the clinic, patients struggled to find the way due to long corridors and minimal signage. Furthermore, the scattered practice teams had few places to interact, which inhibited the team from getting work done efficiently and contributed to long wait times for patients.

Gouverneur Health teamed up with a local design school to create better use of space, employing the following tools:

  • Mapping Patient Flow: What was the patient path from arrival to departure?

  • Literature Review: What had other peer-reviewed research uncovered?

  • Space Inventory: How was the space currently used and did it match the intent?

  • Interviewing Clinic Staff and Administrators.

  • Observing Patient Flow and Behavior (Ethnography).

  • Clinic Layout Analysis: How many spaces are there? Are the spaces visible and accessible?

The design team provided the following recommendations:

  • Install programmable LED lighting to enhance wayfinding in corridors.

  • Use art to alleviate patient anxiety and enhance the patient experience. Gouverneur has begun an art installation project to engage patients and staff in choosing appropriate artwork for practice spaces.

  • Use standardized furnishings and equipment positions, including computer screens that are moveable or swivel, to enable face-to-face interactions with patients.

  • Employ self-registration kiosks and patient-driven movement (e.g., self-rooming, where patients are assigned an examination or consultation space upon entering a clinic and proceed immediately to their assigned space, bypassing the waiting area) throughout the clinic from triage to the patient room and discharge area.

  • Incorporate visual cues to indicate if a room is occupied, such as lights or flags.

  • Expand outlet availability in areas where patients may be waiting to keep them connected and occupied.

  • Use a variety of seating configurations, such as private seating or pods for small groups.

  • Make better use of less visible or underutilized exam rooms, opening them up to act as team rooms or alternative work spaces for practice team members.

  • Create team spaces in close proximity to, and ideally visibly accessible from, exam rooms.

Kenneth J. Feldman, Ed.D., FACHE, Associate Executive Director, Gouverneur Health, observed, “Our recently updated facility provides a nurturing, safe environment to deliver cutting-edge care.”

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