It was a classic childhood scene, a mom pulled her young daughter in a cherry-red wagon. Both had smiles as broad as a their faces would allow. When they made the a turn to the left, a young lady stooped down to the daughter's eye level and said something that put them both in a fit of laughter. There was something really special about how much fun they were having. It's a simple thing really, but aren't wagon rides kind of a childhood rite of passage? That wagon can be anything - a pony, a space ship, a semi truck or just a plane red wagon. The young lady stood up, adjusted her scrubs and went back to the nursing station. Mom and daughter turned the corner for another lap down the hospital floor hallway.
Have you ever stayed in a hip, boutique hotel? You know that cool thing they do with glass walls and bright lights? Well, that's pretty much exactly what I was not expecting when I stepped off the elevator at the University of Minnesota's Amplatz Children's hospital. My friend, J, was giving us a tour. He explained each floor has a story teller character, some animal who's image is repeated as a design theme throughout the floor. The wall was bright orange and yellow glass. If there had been club music I would have assumed we were, in fact, in a W hotel.
"The whole place was designed with onstage and offstage spaces," J explained. An onstage space is patient facing, it is their space where staff are expected to play the role of compassionate caregivers. Fred Lee, author of If Disney Ran Your Hospital, would be proud. Offstage spaces are where staff congregate, or push noisy carts - the kinds of things which wake patients up at night or remind you that you are in a hospital. The idea of onstage and offstage goes deeper than having a separate hallway for food service delivery. Being onstage reminds staff they are, in many ways, a guest in the space. Families, particularly in a children's hospital, settle into their rooms and the surrounding environs. Being onstage means always playing the part of someone who loves children, and serves families, and provides care, and doesn't mind getting a cup of shaved ice for the third time that hour. Need to huff and puff about it? Take it offstage.
"You know, it's funny, everyone thinks I've gotten into IT… I haven't, I've gotten into connecting people and making the experience for these kids a little less scary." J played a considerable role in the design of the hospital. One of his many contributions is the design and implementation of a state of the art video conferencing system. The system, available in about half of the rooms, consists of a wall of video monitors, including a 42" screen, and a motion tracking video camera. From a bedside touch panel, kids can dial up family members who may be hours or many miles away. Some kids have even been able to attend school using the video linkups. "It's a way to maintain some sense of normalcy and connection, " J told us. Amplatz is a regional draw, servicing a wide swath of the midwest. Video conferencing can enable the dad who can't take off work to talk to his child several times a day. Doctors can plug in a computer on wheels and do a split screen between the patient, the parent and the medical record, effectively hosting a virtual care conference. How cool is that?
I'm with J, the people aspect is by far cooler than the enabling technology. And the technology is impressive to be sure. The design aesthetic is also - and I say this with no hyperbole - the best design I've ever seen in a care space of any kind. But what really stands out at Amplatz is the atmosphere, the total package. It's not the iPod docks, rainbow walls, x-box enabled video conferencing onstage touch screen dohickies…. it's the utter selflessness that working around sick kids demands. You simply cannot bring your own baggage onto a floor where a family is fighting for what could be their last hours or months together. Kids level the playing field. Check your ego at the door.
Why does it work so well at Amplatz? I'm not entirely sure. There is undoubtedly some combination of culture, training, design and technology which enables the care environment. There is attention to design, particularly around experience. Hospital committees met and drew the initial brush strokes. A parent's council then came in and refined the ideas. The ultimate decisions, however, were made by a council of children patients. It's pretty hard to get the typical non-patient-centric committee compromises when patients get the final review. Clearly, you also have to give staff room too. I don't mean physical room, but rather latitude to be empathetic, personable and compassionate. I didn't get to observe the culture long enough to understand how Amplatz enables culture, although it is clear they do something right for their staff.
Every healthcare provider has a responsibility to be as good as Ampltaz. Here are some of my key takeaways from our short visit:
- Patient centered design with patient input and review
- Onstage and offstage spaces
- Give staff permission to be empathetic (here's an example, at Ampltaz, any patient care conference supersedes staff conferences. If staff are in the conference room for a meeting and a provider wants to discuss care with a family, the staff all leave and reschedule their meeting…wow!)
- Enable connections, relationships and remove fear - that will drive your IT choices rather than letting them drive you
- Don't be afraid to have fun - the space was fun. There were games everywhere. Each room had an Xbox! Why do we paint hospitals in muted tones and use dim lighting? No one wants to convalesce in a depressing cave.
The University of Minnesota Amplatz Children's Hospital is a joint venture between UMN and Fairview Health System.
You can follow Amplatz on twitter here.