Creating the Environment for Relational Healthcare - Possibilities in Collaborative Inter-Professional Designing  November 12, 2016 The Global Center for Health Innovation. Cleveland, Ohio Ron Smith, LS3P & Bernard Mohr, IPI

What we believe... Patterns of conversation (the heart of relational healthcare practice) are heavily influenced by physical and organizational environments “Co-Designing” is the human act of participatively creating “environments” that support our highest hopes and intentions - in spite of the constraints we face. All care system “environments” are perfectly designed to deliver the “patterns of conversations” they are currently producing. Most current designing, done in siloes, w/o meaningful participation,….does not support relational healthcare practices The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”: Improving the patient experience of care (including quality and satisfaction); Improving the health of populations; and Reducing the per capita cost of health care. Bruce Mau’s ‘manifesto’ - advice to designers for continual growth… “Collaborate. The space between people working together is filled with conflict, friction, strife, exhilaration, delight, and vast creative potential.

Inter-professional Design of Care Environments Organizational “Environments” are created by DESIGN of: Service groupings (eg by patient need or by provider specialty) Assignment of Roles & Responsibilities within those groups Technology and other tools used to deliver service Measurement & Monitoring Systems Planning and Continuous Innovation Systems People Systems (Selection, Development, Promotion, Perf Mngt. Justice, Compensation And Incentive Systems) Physical “Environments” are created by DESIGN of: The form and groupings of public space, private space, gathering space, connector space The technical details that support the function and use of the space Assignment of adjacency and proximity of people within spaces The flow of people (patients, family, staff), information, materials Materiality and Light, Color, Sound Sight Lines and Views Infrastructure systems that control air quality, energy use, communication, security

Activity: Visualizing Our Understanding of Care Connections pick an “outcome” in health care that really matters to you -eg- safety, pt experience, reduced costs, staff experience, access, etc. draw a picture/model showing what you see as the connections between the outcome that matters to you and patterns of conversation and the design of environments (both physical and organizational) post your drawings on the wall

Two propositions for moving forward Meaningful design collaboration of patients and staff (both clinical and nonclinical) AND inter-professional design specialists creates conflict/friction but also vast creative potential (B. Mau) Meaningful design collaborations that include a focus on “staff experience” (vs just patient experience) and “adaptability to changing situations” have much more potential. The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”: Improving the patient experience of care (including quality and satisfaction); Improving the health of populations; and Reducing the per capita cost of health care. Bruce Mau’s ‘manifesto’ - advice to designers for continual growth… “Collaborate. The space between people working together is filled with conflict, friction, strife, exhilaration, delight, and vast creative potential.

Activity: Bridge Building ...from here to back-home - in pairs “what new conversations (and with whom) might you have back home … what new opportunities might emerge?” ... consider… what sense do you make of today’s conversations? what resonates? with what experiences ? what new possibilities are emerging for you? why?

Design Design of the Organizational of the Physical Environment “Glue” ... For Participative, Inter-professional Design of Care Environments Design of the Organizational Environment Design Principles as GLUE Design of the Physical Environment

Thank You Ron Smith HealthCare Facilities Designer, RonSmith@LS3P.com or (713) 252-2032 Bernard Mohr HealthCare Organization Designer, bjmohr@innovationpartners.com or (207) 807-4974