Innovative Design inspires layout at Mediclinic Stellenbosch Day Clinic

Posted on 30 April 2019

It can be said that the new design at Mediclinic Stellenbosch Day Hospital is not original – in the truest sense it is not. The whole design borrows from three facilities in the United States that prompted a brand new look at how we manage the flow of patients and care within our facilities. The result of these design learnings is a brand new blueprint for day clinics within the Mediclinic group.

The new design, dubbed the “Pod Design” by the Mediclinic executives that originally debated the concept, consists of individual “Patient Private Cubicles” instead of traditional 6-bedded units. The theory has now become tangible with the opening of the new Mediclinic Stellenbosch Day Clinic.

After visiting the Rush University Medical Center, Virginia Mason Hospital and Seattle Children’s Hospital in the United States during 2015, a flood of innovative concepts came to light. Kobus Jonck, General Manager of Infrastructure for Mediclinic Southern Africa, came back with one thought, “We have not always got it right in our hospitals – there are points of delay that waste time for our patients as well as causing delays in the patient journey.”

“When we saw how the Rush University Medical Center manage their surgical day cases, the ideas started to flow within the team, we knew that when we adjusted our designs to meet the current needs within the day clinic environment, we would definitely have an improved offering for our patients,” Kobus explains.

“There are four basic stages during a day clinic experience,” explains Kobus, “Admission, which includes the paperwork around the patient until the patient is waiting in bed; the surgery in theatre, then recovery and then finally discharge. Traditionally we may have staggered these stages with patients waiting pre-theatre, then moving back to recovery before going back to the ward. All these pause areas in the process delayed or disrupted the patient experience, providing what we refer to as ‘waste’; referring either to time, space or resources. When looking at the whole journey it is important that we focus on what our patients prioritise: privacy, short waiting times and the ability to deliver quality care on a continuous basis.”

The principle of a day clinic within the Mediclinic environment is a streamlined offering for minor, planned surgeries (this would include procedures such as tonsillectomies, scopes and other less invasive procedures for which the recovery time is expected to be short). The benefits are that the waiting-times are shorter as admission times are based on expected time in theatre, streamlined processes resulting in a leaner cost for the patients, but all these benefits are combined with the assurance that the patient will receive the same quality of care experienced in the acute hospital.

Based on the principle of on-stage and off-stage areas (on-stage being areas accessed by patients/public and off-stage being sterile areas occupied by clinical staff), a new approach was taken to the design of the day clinic rooms. The new design allows elements such as patient privacy to be optimised while at the same time improving clinical oversight by the nurses and doctors involved in the care. As a hybrid of the on-stage/off-stage design, the layout of the cubicles offers nurses a full view of patients before and after surgery.

The four stages during a hospital experience motivated the design – four cubicles per theatre. A smooth transition can be achieved between patients being admitted and those being safely discharged, but having sufficient cubicles to accommodate a patient at each stage of the surgical journey. The new design has been incorporated into the layout of the Mediclinic Stellenbosch Day Clinic – and to ensure that patients are only discharged when they are well-recovered, two additional 6-bedded units have also been incorporated.

The design is, in theory, a hybrid between a private room and a waiting/recovery cubicle that ensures that once the patient is in bed, he/she is part of a sterile, clinical environment and can be wheeled directly into theatre from the cubicle. Additional design elements include the option for laundry and other items to be collected from outside (through the use of double sided cupboards), never breaking the sterile environment.

The new day clinic design also allows the central nursing station to have a full view of and easy access to each patient, while allowing each patient the benefit of a private space. This concept seemed like a win to the full team. Doctors have quick access to patients between theatre cases, as they never depart the sterile environment and beds can easily be moved from theatre to the cubicle for recovery purposes.

Each private patient cubicle contains the bed, storage area for the patient’s personal items as well as access to all necessary services above the bed. Access from the public corridors is one side, with access towards theatre on the opposite side of the bed.

The new unit opens on the same day as the newly built Mediclinic Stellenbosch on 1 June 2019. The new design will be ‘real world’ tested and, according to Kobus, the team are keen to learn how the design can be reworked and adjusted over time and across new facilities to ensure that the leaner design really provides improved value for the patient. Less waiting time in hospital and quality care within a structure that allows for privacy before and after surgery.

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