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Opinion - The customer as a stakeholder

Changing the conversation in facility design

Written by Senior Associate Cath Muhlebach, for the Joint 2017 ACHSM/ACHS Asia-Pacific congress.

The design of facilities for the delivery of healthcare services presents a particular challenge: to find a robust solution that more than satisfies the varying competing interests, particularly those focussing on the provision of care, patient experience, and the work environment.

Considering these across a variety of projects started us thinking:

‘How can we unite the competing interests and voices through a collaborative and integrated design and delivery process?’ and

‘How do we define who should be consulted and how we consult with them?’

It is this broad, stakeholder-focused thinking that led us to the development of our approach to healthcare facility planning, adapting a process used by our practice to deliver positive community outcomes on a diverse range of projects across a variety of sectors. This process comprises three key phases:

- visualise: establishing the project vision and methodology for engagement, consulting and setting project targets

- realise: making the vision a reality through design, consultation and building physical elements and implementing the initiatives to deliver the ‘soft’ or non-built vision

- activate: commissioning and commencing operations within the new facilities as well as undertaking post-occupancy evaluations to see how well the project has delivered on the vision and targets set in the visualise phase.

Identifying and engaging the appropriate stakeholders to participate through each of these phases, including to gather useful insights and information, is an important element in this process. Traditionally in health we’ve been very good at engaging the medical team, caregivers and support services, but not the consumers. This is interesting, given that considering their needs will improve their experiences of the facility in ways that have the potential to aid recovery and reduce the length of stay, and in a private setting having facilities that attract patients and clients can have definite financial advantages.

We understand though that inviting consumers, whether patients, clients or their families can be challenging. The perspectives they bring can sometimes be viewed as ‘non-critical’ to service delivery by busy healthcare staff and there may be a reluctance to talk openly when non-professionals are part of the conversation, particularly when discussing sensitive issues such as security and harm minimisation.

The key to successfully engaging all groups is to ensure that you have the right people present for each discussion, setting clear agendas for each meeting as well as some parameters for the discussions, and utilising a range of methods to communicate the information. Throughout the consultation and design process we utilise hand drawings, computer plans and models, mock-ups and prototypes and visit other facilities that can set benchmarks and promote discussions.

Acknowledging that everyone has limited time, and most are taking part on top of their normal activities, is crucial and best demonstrated by avoiding time wasting. In our experience not wasting people’s time makes for much more robust discussions and better decisions. And having the right people in the room promotes the conversation and assists in alleviating nervousness around raising sensitive issues, whether in an initial design meeting or a construction site walk through.

This process has assisted us to define who the right people are and how we are best to engage them for each project, and has highlighted that the who and the how vary significantly from project to project. Taking the time in the initial visualise phase to develop a bespoke engagement strategy has become an essential part of our process and one of the things we truly value as health and community architects.


March, 2019