How Medical Offices are Adapting to the New Normal

Covid-19 is transforming nearly every aspect of life, from how we work to how we eat and play — and especially how we seek care. As the pandemic wears on, the ways in which medical offices will evolve to limit infection and set patients’ minds at ease are starting to become clear.

Access, flexibility, and transmission reduction are key concepts to bear in mind as we move into this new era. Here are trends Remedy Medical Properties and integrated design firm BSA LifeStructures are tracking as the healthcare community adapts working environments to reduce the spread of the coronavirus and future novel viruses:

1. Transforming the waiting room
2. Technology to facilitate patient flow
3. New office formats to accommodate operational changes
4. Use of virus-reducing surfaces/systems and updated
   janitorial standards

By implementing these changes, you’ll create a safer, more functional, and welcoming facility that fully supports the needs of both your patients and staff.

---

1. Transforming the Waiting Room

As the entry point for patients into the medical office environment, the waiting room will be the most immediate and prominent indication of how the office has changed in response to the pandemic.

“In Maslow’s hierarchy of needs, physical safety ranks above shelter in terms of personal importance. The built environment needs to support the safety of people, and the experience must outweigh the risk of uncertainty.”

Jennifer Worley
Director of Design Research, BSA LifeStructures

Healthcare providers are taking several approaches to ensuring the safety of both patients and staff.

Expanded & Zoned Waiting Room

For some offices, an expanded waiting room that allows for greater distancing between patients makes the most sense. Dividing the room into zones — indicated through visual cues such as different colors or material choices on floors and furnishings — or even installing enclosed pods or cubicles for patients to wait in can produce a sense of comfort, help staff manage traffic flow, and simplify sanitization between visitors.

Separate Waiting Rooms

Establishing separate waiting rooms for sick patients and those who are just in for routine checkups may be another option. Where weather permits, practices could also move the waiting room outside, in tents or covered patios that allow for better air flow and increased distancing.

Direct Access to Exam Rooms

Other providers, like Washington state’s MultiCare, are doing away with waiting rooms altogether in favor of direct access to exam rooms. This is facilitated by an app-based check-in or a kiosk in the lobby, which notifies staff that the patient has arrived and directs them to an available room.

2. Technology to Facilitate Patient Flow

Apps and other technology can help practices manage patient volume in the waiting room and coordinate traffic flow both inside the clinic and in common areas.

“One way to shrink or do away with the waiting room is to be more in sync with the patient and the plan for their visit, and then use technology to time and manage their arrival, whether that’s through an app-based check-in, a kiosk, or just tracking the patient with their phone as they arrive.”

Sam Sears
EVP of Percival Health Advisors,
Remedy’s In-house Strategic Innovation and Advisory Firm

Touchless Kiosks for Check-In

For example, Baton Rouge General implemented a self-rooming check-in system at its recently opened Ascension Neighborhood Hospital that results in less exposure risk for both patients and staff. Patients receive a QR code by email or a mobile app, which is then scanned at one of four self-service kiosks upon arrival and are assigned a room. Patients don’t have to touch the kiosk except to edit details. Similar check-in kiosks in use at UCFS Health in San Francisco are equipped with a sensor that detects when the patient has left and automatically disinfects the kiosk between uses.

Patient Navigator

“For patients who aren’t tech-savvy, there may be a navigator who meets the person at the front door and directs them to where they need to go,” says Worley. This approach reduces each patient’s contact with other patients and with practice staff, reducing opportunities for potential exposure.

Geofencing and Contact Tracing

These strategies all may be paired with geofencing technology such as an app or device that monitors visitors’ location in the facility or detects one’s proximity to others and signals when one has gotten too close to another patient, and can further aid in contact tracing.  

“These are all methods we’re seeing more of, and there’s probably a shift where that sort of tech is going to come into play even more often thanks to Covid,” Sears says.

3. Adaptable Formats to Accommodate Operational Changes

Beyond the waiting room, medical offices are becoming more flexible to meet the shifting demands of the pandemic era. In addition to pre-screening patients before they arrive and more efficient registration processes, either in person or online, many clinics are separating patient and staff work zones with physical barriers to reduce contamination.

Modular Design with Wider Hallways

Buildings and office suites are being reconfigured with wider hallways to accommodate social distancing. Modular walls and floorplans that allow rooms to be converted or expanded quickly and easily can help facilities handle a patient surge.

“Modular construction accelerates speed to market and provides the opportunity to reconfigure the space as needs change over time, without the disruption of traditional construction.”

Jennifer Worley
Director of Design Research, BSA LifeStructures

At the height of the pandemic, modular building components maker Falkbuilt worked with Anna Laberge Hospital in suburban Montreal to rapidly design, manufacture, and assemble 18 new patient care rooms and two washrooms in one week. The components meet stringent infection protection and control guidelines as well as Covid-19 sterilization protocols, and each is equipped with electrical drops, lighting and switch boxes, and connectors for medical gases. The rooms may be reconfigured or dismantled and rebuilt elsewhere as needed, providing the hospital with flexibility to match its current needs.

Dedicated Telemedicine Space

While telemedicine has risen to meet the demand for contact-free examinations, the result is that more space must be devoted to telehealth and the technologies that support it. This means apportioning space for servers and broadband connections, and ensuring rooms used for telehealth appointments meet HIPAA guidelines for patient privacy.

Employee Work Bubbles

Some organizations are taking the step of grouping employees into “work bubbles” or “pods” that always work together in order to reduce opportunities for infections to spread and simplify contact tracing when they do. The strategy may extend to the spaces occupied by different pods when in the office, necessitating cleaning regimens or even separate workspaces.

4. Use of Virus-Reducing Surfaces and Systems

In the early days of the pandemic it was unclear how Covid-19 was transmitted, which led to significant research into how long the virus survives on various surfaces. Although aerosols and airborne droplets are the most likely vector for the disease, healthcare facilities are still switching to antiviral and antimicrobial materials for door handles, sink fixtures, and other surfaces wherever possible to help limit exposure.

Surfaces

This means stainless steel, plastic, and glass are out, while copper, aluminum, and cardboard are in. Using virus-resistant and -reducing surfaces can also help your practice prepare for future disease outbreaks, whether it’s similar to Covid-19 or something new.

Ventilation Systems

Effective HVAC design and air cleaning technologies are also key to reducing airborne transmission. Ventilation systems should be designed or reconfigured to increase fresh air intake and incorporate proper HEPA filtration or needlepoint bipolar ionization to help trap and destroy pathogens. Portable HEPA filters or UV air cleaners may also be used to help clean the air in exam rooms and other high-risk areas.

“Remedy is always looking out for the long-term health of its properties. We take a proactive approach to medical office improvements, and are willing to work with tenants to make necessary updates. We understand that these updates require expertise and capital to implement. Remedy is well capitalized and empathetic to the rapidly shifting needs of medical practices at this time, and are ready to help meet your needs as a tenant.”

Gary Denenberg
EVP of Asset Management, Remedy Medical Properties

Janitorial Services

In addition to air quality, healthcare facilities have instituted more frequent cleaning and waste disposal schedules, and the CDC has recommended guidance for cleaning and disinfecting offices and common areas after potential contamination.

Janitorial staff should use products that contain bleach solutions, alcohol at concentrations of 70% or higher, and other EPA approved disinfectants to ensure safe and thorough cleaning. Logging apps can help keep track of when a room or station was last cleaned.

PPE Stations & Vending Machines

Medical offices are also placing washing and PPE stations in prominent locations in waiting rooms, exam rooms, and visitor areas for patient and staff use. As the pandemic stretches on, PPE vending machines like those now seen in some airports may even become commonplace. These conveniences should be paired with trash receptacles to reduce litter and avoid cross-contamination.”We understand that these changes require expertise and capital to implement. Remedy is well capitalized and empathetic to the rapidly shifting needs of medical practices at this time, and are ready to help meet your needs as a tenant.”

^{© 2021 Remedy Medical Properties, Inc. and BSA LifeStructures. All rights reserved.}

---