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Optimizing Space Case Report: Kaiser Permanente

In preparing to build a series of new medical office buildings, Kaiser Permanente realized it had an opportunity to transform care delivery by thinking differently about the human connections in physical spaces. For this to be successful, Kaiser Permanente knew the design of the new space would have to be a collaborative process that leveraged its integration as a health care delivery system. In setting out to design something different, Kaiser Permanente asked its facilities and information technology executives to shadow patients, physicians and staff to better understand the challenges being faced. Through this process, staff members who do not directly deliver care in the traditional sense—such as receptionists, architects, information technology leads and administrative partners—were able to realize the integral role they play in the care that patients receive.

Space embodies the idea of “Thrive” by promoting active lifestyles, health, and wellness

Upon arriving at the new medical office buildings, it is clear right away that this is not your standard physician office. The design of the space begins to live Kaiser Permanente's “Thrive” brand and extends its presence not only to its members, but to the community as well. The buildings and surrounding space are not just places for people to visit when they are feeling ill; patients will want to come when they are well, too. Kaiser Permanente was intentional in its use of outdoor spaces to expand care delivery, for example, using green spaces for a community game of kickball and outdoor kitchen areas for healthy cooking demonstrations

Service offerings in the Public Square expand the care team's influence

Kaiser Permanente found that, on average, patients do not spend more than a few hours in its system each year. Given this, it needed to leverage every opportunity to expand its care team's influence and spread messages of preventive health. With this in mind, Kaiser Permanente transformed its traditional waiting spaces into “public squares” that allow members options for connecting with their care in new ways. Digital signage shares up-to-date information and local happenings. The placement of “community” furniture encourages members to interact with one another. And, the “Thrive Bar” lets members informally connect with Kaiser Permanente to ask simple questions and learn more about its services.

In considering its care delivery model, Kaiser Permanente found that perhaps its greatest untapped resource is its patients. With the use of electronic tablets, patients are encouraged to share—with Kaiser Permanente as well as with others—their goals, values and what matters to them. Questionnaires that patients complete either in the Public Square or even on kp.org at home, are uploaded automatically into their electronic medical record to give providers more meaningful information.

Technology shifts unnecessary transactional tasks away from providers

Displays in the exam room allow Kaiser Permanente to share health education materials that augment a patient's visit and enhance the provider's ability to visually show patients the details about their specific diagnosis. This makes the patient-provider interaction more productive and meaningful.

Space, processes, and technology enable collaboration

Kaiser Permanente recognized the need to make collaboration easier. Today, technology and the built environment can get in the way of collaboration among providers. Being able to problem-solve with colleagues, partner on tough cases or even just socialize with them—these are all strategies that are known to improve work lives and help with recruitment. For this reason, Kaiser Permanente is using technology to create opportunities for collaboration, for example, through exam rooms that have telehealth capability and mobile devices that provide information at your fingertips.

Keep the entire care team in close proximity to the provider to deliver true team-based care

To deliver true team-based care, Kaiser Permanente created team spaces that break down physical barriers and lead to natural “collision points” throughout the day. These team spaces facilitate co-location of physicians and staff and allow Kaiser Permanente to leverage the collective knowledge of the health care team and improve collaboration on behalf of patients. This also reduces isolation and leads to greater staff satisfaction, and for patients, improved satisfaction and clinical outcomes. Where possible, Kaiser Permanente located supporting specialties adjacent to one another. For example, a Neurosurgery and Interventional Anesthesia team now share a space. Their proximity allows for non-surgical candidates to seamlessly be referred to Anesthesia for pain management and vice versa. The team space also allows more effective care for patients with chronic diseases such as diabetes, obesity or depression. Treatment of chronic disease is not an individual effort, but rather requires a team-based approach that centers on the patient.

At Kaiser Permanente, the newly designed spaces are augmenting relationships that are fundamental to good health. Fostering relationships between care teams, patients and communities is bringing back the joy in medicine.

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