Evidence-based design was used to achieve specific goals. To reduce the number of patient injuries, for example, Lakeland took a variety of steps, including installing cushioned flooring and building large patient toilet rooms with double doors to allow caregivers to be on both sides of the patient.
Patient satisfaction was another target. Satisfaction was measured on nine scales — from room temperature to how well things work — and design steps were taken to support each area. Individual room climate controls, thermally broken windows and window shades were among the steps taken to improve room temperature scores. To boost patients’ perceptions of how well things worked, lighting controls were strategically located where patients could readily find them, easy-to-use temperature controls were selected and a new nurse call system was installed.
Design strategies like those have done the trick: Lakeland has research to show measurable gains in everything from noise levels to patient, visitor and physician satisfaction.
Lakeland’s use of evidence-based design has drawn national notice. “Evidence-based design is talked about, but not a lot of people have really done it,” says Kastner. “We got a lot of attention from people around the United States.”
The new tower has attracted a lot of attention closer to home as well. The new tower has 140 beds. All but 24 are in private rooms. The planning assumption was that both beds in those rooms wouldn’t be needed except during high census periods. “It turned out that they were filled most of the time,” says Kastner. But private rooms became a sort of brand promise for Lakeland. To remedy the situation, Lakeland is using renovation of the 1986 patient tower to create more private rooms.
Evidence-based design is an important factor in Lakeland’s success, but it’s not the only one. Mergers – the most recent in 2011 – have made Lakeland the only health care system in Berrien County. After each merger, Lakeland has consolidated functions when possible, reducing overhead. “Each time we merge, we drive costs out,” Kastner says.
Mergers have also helped to increase the overall volume of business done by the system. A recent merger brought Community Hospital Watervliet into the system. Community Hospital Watervliet had been affiliated with a hospital outside Berrien County. Before the most recent merger, Community Hospital Watervliet would have referred patients it couldn’t handle to that affiliated hospital. Now, those patients are referred to a Lakeland facility.
Serendipity has also played at least a small role in Lakeland’s success. Consider the Lakeland Health Park. The first parcel of land on what is now a 106 acre site was purchased in 1992. Since then, there has been a long procession of construction, renovation and expansion projects. Today, the health park includes a two medical office buildings, a regional cancer center, and an outpatient center with spaces for surgery, radiology, and a women’s center, as well as other specialties. The system’s information technology center, finance center, and patient accounting are also located at the health park.
Although the immediate vicinity of the Health Park is not heavily populated, it is located in the population center of Berrien County, on a major interchange on I-94, making it easy for many area residents to reach. Today, says Kastner, most physicians in the northern half of Berrien County have offices in the Health Park or in a facility across the street, making the area a magnet for health care consumers. It couldn’t have worked out better if Kastner had planned it that way.
But if good fortune had a bit part in the story of Lakeland’s success, a far-sighted philosophy played a leading role. The organization’s leadership has been willing to invest in facilities. Kastner says that the organization just wrapped up one 10-year plan and is starting work on another. That plan takes into account depreciation of existing infrastructure, and generally has been supported by funds to turn the plan into reality.
“We believe in master planning,” he says, “If you don’t continue to invest in your facilities, you’re going to go backwards.”
At Lakeland HealthCare, Mike Kastner Uses Research to Shape Facilities
Evidence-Based Design Part of Lakeland’s Far-Sighted Approach