Addressing Healthcare Burnout Through Architecture and Design Concepts

The following is a guest article by Joshua Crews, AIA, ADAC, NELSON Worldwide.

Burnout among healthcare staff is a prevalent problem in the United States. It often leads to health and safety-related consequences for both patients and staff and oftentimes drives essential workers to leave their jobs. The issue was further exacerbated during the pandemic and is a challenge that continues to plague healthcare systems nationwide. And while there isn’t a one-size-fits-all solution to healthcare staff burnout, the physical environment plays a huge role in mitigating this growing problem.

A recent study by JAMA Internal Medicine found that “physicians with burnout are twice as likely to be involved in patient safety incidents, twice as likely to deliver suboptimal care to patients owing to low professionalism, and three times more likely to receive low satisfaction ratings from patients.”  In other words, the implications of burnout are felt not just amongst caregivers but also between patients and other staff. Through architecture and design, it is possible to address this growing issue and implement solutions and processes that create a more productive and safe environment for healthcare workers and those they care for.

The Provider-to-Patient Relationship

Healthcare designers must position the built environment to reduce stress, waste, and redundancy. For instance, when designing patient rooms, it is imperative that the design solution aids in minimizing the time it takes healthcare workers to grab supplies or medical equipment from storage. One approach is to implement a concierge approach—this reduces the time it takes to get a task done and allows nurses, doctors, and other staff to spend more time with the patient rather than searching for supplies. Often, nurses juggle between patient rooms and get interrupted frequently, ultimately increasing the time it takes to service one person. Our goal as designers is to enable the caregiver to spend the maximum amount of time at the bedside. Nurses, for instance, spend a majority of their days with patients and designing a patient room for success will not only improve the quality of care, but it will also make work a lot less stressful for caregivers.

Encouraging and establishing positive behaviors in the workplace is another way to prevent burnout.

Handwashing compliance is a given, but it can also be awkward for the patient when a physician or nurse walks in and immediately turns their back to wash their hands. We need to prevent this situation from happening as it sets the wrong tone for the patient-to-caregiver relationship. Instead, designers must “storyboard” the experience and identify those pain points for staff. Something as simple as a hand-washing station and its placement now becomes pivotal in the layout of a space. Increasing the number of touchless sanitizer stations found on the floor of a medical facility is also becoming increasingly important as it cuts down the time healthcare workers spend on handwashing and allows more immediate face-to-face communication with the patient.

Bringing the Outdoors In

Another challenge is one that third-shift workers face—the adjustment of their circadian rhythm. Access to nature and natural light will always be vital as it positively affects our health, mood, and wellness. Humans have a third photoreceptor that is not connected to their vision, but is connected to circadian rhythm, which transforms the light from the sun to help us autocorrect this rhythm. When we are not exposed to this type of light, there are a number of health issues that can fall off track leading to low energy and reduced productivity as well as depression. Now, the push to have an abundance of natural light in both patient rooms and other areas where third-shift workers gather is even greater. To address this issue in healthcare for third-shift workers, we incorporate artificial light that adjusts in color to minimally impact the absence of daylight during work hours.

Direct access to nature can be a challenge  depending on the location, context, and setting of the healthcare facility. Still, as designers, we find ways to provide and bring in those wellness features synonymous with the outdoors. By incorporating natural light, expansive views of the environment outside, and calming sounds, it is possible to bring the outdoors in to connect caregivers and patients with their surroundings. Marrying the color and material palettes with the design scheme also helps to make the space inspiring and welcoming with a connection to the local outdoor setting. Not only does this add personality and character to the facility, but it enables a comfortable, less sterile, and more pleasing environment for caregivers and those they treat.

Looking at the Layout

We also approach designing for burnout through a series of space syntax tools to create a heat map of the layout. This allows us to view the rooms and predict the use of space prior to being built while also sharing step depth (a wayfinding tool). When you understand the way people work throughout the day, you make better and more informed decisions about how a space should be designed. By utilizing this process, we capitalize on the opportunity to create a variety of active zones throughout an area, combined with the necessary means to make it a productive and relaxing space for all who use it.

To decrease employee burnout, healthcare designers can create areas for staff to take a moment of respite. As healthcare workers are constantly experiencing many highs and lows throughout their work day, it takes a tremendous emotional toll on them. Providing a space for them to take the time to decompress is essential to help them cope and digest their feelings. Respite rooms with recliners, dimmable lighting, and silence become one of the most important elements of healthcare design as it is the most appropriate environment for collecting oneself.

Combating healthcare worker burnout begins with identifying the nuances of their day-to-day responsibilities. As designers, we ask ourselves, “how can the built environment support a simplified or streamlined process?” When we address these issues through design, it is then that we can pull in wellness-driven concepts to make the job less stressful.

   

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