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Weekly Overview: Week 1 1 HCS/529 Version 1 Weekly Overview

Week 1

Overview

Health care facilities have changed significantly over time. It started with the open space design and shifted to the primarily single room for inpatient hospital care. Primary care facilities began with home visits from the doctor to the now multispecialty providers residing in single medical office buildings. Nursing homes, once seen as impersonal and inadequate, are being replaced with long-term care facilities that strive to offer home-like environments with various levels of care. The list of evolving health care facilities continues to grow and you need to understand where healthcare started so that you can continue to develop facilities that work in the 21st century.

Evolving strategic health care facilities also consider evidence-based design to ensure that patient safety along with patient satisfaction is operationalized. Evidence gathered over time has showed that design can have a significant effect on both patients and staff. You must pay attention to the data as you move forward in designing health care environments.

What You Will Cover

.1 Health care facilities overview .a Discuss the historical overview of health care facility design. )1 Historical overview of healthcare facilities )a Hospitals developed out of religious organizations during the Middle Ages. )b Several changes occurring during the 19th century contributed to a wider acceptance of h ospital care and led to the admission of paying patients. )c Innovations by the end of the 19th century allowed the construction of more functional an d efficient hospitals. )d New floor plans developed with smaller patient rooms located off double-loaded central c orridors, a plan still highly prevalent today )2 Historical timeline of health care facilities )a By the late 1880s, many hospitals had become training facilities for doctors and nurses. )b By 1890s, hotel-like amenities were added for affluent patients. )c Economic conditions during the 1930s decreased the use of hospitals. )d New government programs after World War II increased utilization of health care. )e Government grants in the 1940s led to construction of newer and larger hospitals. )f In 1965, the passage of Medicare (Title XVIII) included capital funding reimbursement for hospitals, skilled nursing facilities, and other health care organizations. )g Beginning in the 1980s, Medicare began reducing reimbursement to health care organiza tions. )h Prospective payment systems paid a fixed amount for services rather than reimbursing c osts of care. )i Reimbursement for capital expenditures was eliminated. Resulting in reduced availability of funds for new equipment, building construction, or renovation. )3 By early 1980s, dissatisfaction with the skilled nursing model of care led to development of as sisted living facilities designed with features from hospitality (hotels). )4 Construction of retirement communities proliferated.

)5 By 1990s, the cottage design was introduced as a new model of care for the elderly, mental health patients, Alzheimer’s patients, and others. )6 Newer hospital designs began to focus on the healing environment. .b Describe various types of health care facilities. )1 Hospitals )a Academic medical centers )b Community hospitals )c Psychiatric hospitals )2 Ambulatory services )a Medical office building (MOB) )b Physicians’ clinics )c Urgent care centers )d Freestanding diagnostic services )e Day surgery centers )f Sports medicine treatment centers )3 Long term care (LTC) services )a Skilled nursing facilities )b Assisted living facilities )c Alzheimer’s and memory care facilities )d Continuing care retirement communities )e Adult day care facilities )f LTC facilities for children or for treating obesity )g Hospice )h Home health agencies )4 Wellness facilities )a Spas )b Medical spas )c Weight loss clinics )5 Rehabilitation )a Acute rehabilitation facilities )b Substance abuse facilities )6 Psychiatric facilities )a Inpatient )b Outpatient or day treatment services )7 Dental facilities )8 VA medical center .c Describe the use of evidence-based design in health care facility planning. )1 The effect of the environment on the patient and staff )a Patient and staff safety )b Staff effectiveness )c Quality of care )2 Containing costs )a Increased cost effectiveness and efficiency )b Decreased turnover