Better by Design: Engaging Patients In the Design of UW Health at The American Center

Kristine Wiese, UW Health Patient and Family AdvisorKristine Wiese and her family know very well the challenges of finding their way through UW Hospital and Clinics and of negotiating tight spaces in inpatient rooms and doorways, especially for those with disabilities.


Now Wiese is among a group of patients and family members who are playing a key role in helping to design UW Health at The American Center, the new health care facility slated to open on the eastside of Madison in 2015.


''As we began to plan the new site, we wanted to challenge ourselves to think differently,'' says Mark Hamilton, Vice President of Ambulatory Services for University of Wisconsin Hospital and Clinics. ''Engaging our patients in the design was one of the guiding principles of the project and very much in line with our commitment to patient- and family-centered care.''


During the last three years, the committee of 12 Patient Family Advisors (PFAs) has been engaged in all levels of design planning for the new facility, from participating in 3P (Production, Preparation, Process) sessions, to meeting with architects, and attending design and image workshops and open house events. Patients will continue to be engaged in operational planning, development of a care model, and shaping the overall patient experience at the new facility.


''With a better understanding of our patients' perspectives and ideas, we're able to create a more welcoming, easy-to-navigate facility that not only meets their needs, but makes them true partners in their care experience,'' says John Sheehan, FACHE, President, UW Health at The American Center and Senior Vice President, UW Hospital and Clinics.


Planning for The American Center has involved countless hours and more than 225 individuals, including architects, medical and administrative staff, and patients. In particular, patients played a key role in shaping decisions related to parking ramps, valet service, way-finding, patient rooms and green space.


The project's level of patient engagement is capturing national attention. In March 2014, a group from UW Health will present at the American College of Healthcare Executives (ACHE) conference in Chicago. Presenters Hamilton, PFA Partnership Program Co-Chair Alan Sweet, and Laura Stillman and Tom Grove of Flad Architects, will detail how patients contributed to design planning, highlighting the Lean process. The group was selected from more than 500 submissions to present to the 5,000 health care professionals that the ACHE conference attracts.


''This project would not have been the same without the input of the patients. Their level of commitment was extraordinary, ''says Laura Stillman, Principal, Flad Architects. ''They were willing to take risks in what they suggested and challenge others at times. All this was done with care and consideration, but also with conviction.''


The patients stressed the importance of way-finding, the need for clear circulation routes on campus, signage, and ease of access to the front door and the parking facilities, says Stillman. They also expressed a desire for covered parking or a parking ramp, which was to be clear in its layout, easy to navigate, and directly accessible to the hospital. ''Their feedback was important in validating current design trends and the need to focus on the patient first and foremost,'' says Stillman.


Her experiences with her parents as patients shaped Wiese's design input. ''We've had great difficulty getting in and out of rooms with my parents, who are elderly, disabled and have a language barrier. So I was insistent on ease of navigating hallways being a priority. I also advocated for enough seating for the patients' family members as well as room for their coats and bags.''


Longtime PFA Peggy Zimdars felt strongly about having a desk long enough so a family member or friend could take notes for the patient and the provider could face the patient rather than the computer screen, which would be visible to the patient and family members as well. She also suggested separate child-friendly areas for those who need to bring children with them, as well as quiet waiting areas with cluster seating and separate areas for TVs.


Staff response to the patients' involvement in the planning process was totally positive says Hamilton. ''We're truly beginning to change as an organization and move more toward having Patient and Family Advisors be a part of our everyday life at UW Health,'' he says. ''This is one of the most positive projects I've ever been involved with. We got to know our patients better, they taught us to look at our organization in a new light and they had a positive impact on the outcome. ''


Stillman agrees: ''It was inspiring and immensely valuable to hear the patients' perspectives. We learned from them and became friends and colleagues in the process.''


The patients, too, found the experience gratifying. ''It was a great learning experience of what goes on with planning a project such as this,'' says Weise. ''I feel very honored to have had this opportunity.''


''We were welcomed and embraced as true partners,'' says PFA Partnership Program Co-Chair Alan Sweet. ''My experience has been satisfying and enriching beyond my wildest expectations.''


Video: Patient and Family Advisors at UW Health at The American Center