Since the Affordable Care Act (ACA) was signed into law in 2010, there have been continuing transformations in hospital financial, technological, and clinical practices. These transformations have in some cases led to the establishment of competing priorities for hospital decision makers.

Two of the biggest issues facing hospitals that cross financial, technological, and clinical lines are hospital acquired conditions (HAC) and hospital readmissions. Due to the mandates of the ACA, the Centers for Medicare & Medicaid Services (CMS) has reduced payments to hospitals that rank in the top quartile of hospitals with the highest HAC scores, which are the lowest performers. Likewise, the CMS has also reduced payments to hospitals with excess readmissions. These two issues are driving decisions in healthcare systems not only in clinical practices, but also in terms of architectural design and engineered systems.

So how do we plan and design healthcare facilities to support clinical practices to improve infection control and reduce readmission rates? The first step is to design clinical workflows and facilities from the bedside nurse and patient perspective out. This requires collaboration between clinical service providers and facility design teams. Therefore it will be critical to provide the clinical voice a seat at the design table to translate clinical processes so that they can be captured in architectural drawings and ensure the finished facility enhances the environment of care.

A new resource is now available for clinical practioners that are or may become involved in facility designs. Nurses as Leaders in Healthcare Design: A Resource for Nurses and Interprofessional Partners, published by Herman Miller and the Nursing Institute for Healthcare Design, was launched at the Healthcare Design Conference. This comprehensive guide provides practical ideas for creating optimal healing spaces that connect healthcare design and function.

Many organizations have already put considerable effort into managing the interface between clinical practices and facility designs with good outcomes, but continuous improvements are required to maintain favored status and full reimbursement.

Contact the author, Debbie Gregory, DNP(c), RN, BSN.