Department-less 'hospital of the future' would cluster radiology near related services, cut patient travel 54%
Healthcare designers are envisioning a new hospital of the future, one without departments where radiology is clustered near other similar services to limit patient movement.
Experts detailed their novel “Patient Hub” concept Dec. 15 in the International Journal of Computer Assisted Radiology and Surgery. It would involve establishing defined hubs to locate related functionalities and processes near one another. This way, a patient diagnosed with cancer would not have to traverse a large campus to receive various exams and treatment.
Researchers utilized 3D software to simulate resulting workflows from this practice change, comparing them against a traditional hospital using a generic template from Kaiser Permanente. The Patient Hub was able to reduce overall traveling distances by 54%, elevator runs by 78%, and improve patients’ access to nature and quality views in exam rooms by 100%.
“The simulation results were highly promising, showing clear advantages of the Patient Hub layout throughout all benchmark parameters,” Carlos Amato, principal with Los Angeles-based Cannon Design, and co-authors representing departments of radiology and surgery at European academic institutions, concluded. “We see this as a proof-of-concept of our ideas and as an important validation before implementing the Patient Hub in the real world.”
Amato et al. gave the example of a patient diagnosed with rectal cancer after a pelvic MRI and CT, along with an endoscopy. Following that, providers would discuss the case in multidisciplinary consultations; the patient would schedule surgery; prep measures would include anesthesia and gaining informed consent, and then ICU observation afterward. Even in a complication-free scenario, the patient would follow a list of about 95 necessary steps, the authors estimated, many involving changing locations and sitting in waiting rooms.
The investigators model scenario would instead deliver all services on one floor, with the patient entering through a single entry point to minimize movement and simplify wayfinding. Radiologists, surgeons and other providers would be centralized, bringing together various specialties to encourage clinical collaboration. Rather than passing from the radiology department on level A to cardiology on level D prior to the operation, the patient would move from one door to the next.
“The new design concept aims at achieving a logical and self-explaining layout by bringing together what belongs together,” the authors noted. “However, the vision of the Patient Hub encompasses much more than a traditional hospital: This new environment (or ecosystem) co-locates outpatient, inpatient, rehabilitation, wellness and prevention, ancillary support spaces, and industry (research and development) all under one roof.”
The simulation showed improvements across all metrics. Exploring the hub model in a real-world scenario could serve as a next step. But Amato and colleagues also see room for further innovation.
“Intervention rooms could be suitable for surgery, interventional radiology or cardiologic manipulations. CT scanners and other assistance systems could be designed as self-navigating systems, to move independently to desired locations,” the authors advised. “While we plan to incorporate such considerations into future work, we advocate a very deliberate use of technology, governed by the paradigm of bringing care to the patient and not solely by economic interests.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.