1. 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

2. 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.

3. 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

4. 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

5. 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.

6. 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?

7. 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

8. Thank You
Ron Smith HealthCare Facilities Designer, or (713)
Bernard Mohr HealthCare Organization Designer, or (207)