The Role of the C-Suite in the Incorporation of Evidence-Based Design in Healthcare Construction

Abstract

In this issue of Health Environments Research & Design Journal, we focus on the role of the Csuite to ensure the appropriate use of evidencebased principles in the conception, design, and construction of a healthcare facility. Corporate officers, such as the chief executive officer (CEO), the chief operating officer (COO), and the chief financial officer (CFO), are integrally involved in the business end of hospital and clinic construction. Traditionally, they have relied heavily on other members of the C-suite team, including the chief nurse executive (CNE) or the chief medical officer, to help incorporate evidencebased design elements to improve patient health outcomes.However, as operating margins shrink and necessary financial capital becomes scarce, it is more important than ever for the entire C-suite to work together in the design and building of healthcare facilities that incorporate innovative evidence-based features.Furthermore, the landscape of healthcare reform in the United States is causing members of the Csuite to renew their interest in design elements that have been proven not only to improve care, but also to better align the strategic goals of health systems with those of physicians and other practitioners. At a time when healthcare organizations must watch the bottom line and cannot provide every bell and whistle for physicians, the role of evidence-based design features stemming from studies that utilize disciplined research protocols is becoming more critical when allocating precious dollars.The C-suite plays a key role in just about every aspect of healthcare facility design and construction. However, no function is more critical than creating and fostering a vision for the new facility. And no one individual is more important in effecting this than the CEO. As the head of an organization, the CEO must take the lead in developing, communicating, and executing a vision for the kind of facilities the organization will commit to designing and building. The CEO must understand the role of evidence-based research in improving health outcomes through facility design and be able to garner support for and commitment to the use of such research throughout the organization-from other members of the C-suite to members of the design teams and even the construction crews. The CEO must develop, communicate, and nurture this vision.Once the CEO has articulated the vision, other members of the C-suite must implement the strategic planning necessary for the design and construction of the new facility. Members of the C-suite must engage with the CEO's vision. This means that they must be able to understand and accept the evidence-based approach to the various design elements articulated. The CFO, for example, has to understand and accept the premise that same-handed room design may decrease medical errors and improve operational efficiency despite the fact that it will cost more to build than traditional designs. The CNE could face staffing and clinical process change issues related to designing acuity-adaptable rooms or individual nursing stations. The COO must plan for the changes that come with stocking individual room supply cabinets, or the implications of cleaning floors designed and constructed with new materials that reduce off-gassing. The list goes on. The C-suite must make both strategic and operational planning a priority when implementing the vision of building using evidence-based design.Involving stakeholders in the development and implementation of evidence-based design is also important for executing such processes. Hospital operations are highly complex, and changes based on innovations in design and construction must be introduced carefully and deliberately. It is usually impossible to have a stand-down of staffwhile changing infrastructure Changes are often introduced in phases, making it extremely challenging for staffas they attempt to adjust to two concurrent processes-a potentially risky situation for patients and staffalike. …