Healthcare Design And The Medical Home, G Jones, 6.12.11
1. Healthcare Design and the
Medical Home
Paul Groenier
Gilbert Jones
Associates for Healthcare
Improvement
2. Goals of session
Consider definitions of Health/Wellness
Consider how design principles can improve
communication and healthcare service in
the Medical Home
Examine control structures in healthcare
design
Focus on prototyping strategies which
incorporate all principles of service design
3. Key Principles of the
Patient-Centered Medical Home
Patient-driven: The primary care team is focused
on the whole person. Patient preferences guide the
care provided to the patient.
Team-based: Primary care is delivered by an
interdisciplinary team led by a primary care
provider using facilitative leadership skills.
4. Key Principles of the
Patient-Centered Medical Home
Efficient: Patients receive the care they need at
the time they need it from an interdisciplinary
team functioning at the highest level of their
competency.
Comprehensive: Primary care serves as a point
of first contact for a broad range of
medical, behavioral and psychosocial needs that
are fully integrated with other health services and
community resources.
5. Key Principles of the
Patient-Centered Medical Home
Continuous: Every patient has an established and
continuous relationship with a personal primary
care provider.
Communication: The communication between
the patient and other team members is
honest, respectful, reliable, and culturally
sensitive.
6. Key Principles of the
Patient-Centered Medical Home
Coordinated: The primary care team coordinates
care for the patient across and between the health
care systems.
8. Definitions provided by Master of Arts students
exploring Health Geography.
Adapted from Herrick, Journal of Geography in Higher Education, 34;
345-362, 2010
9. Domains of Wellness
Physical Wellness
Emotional Wellness
Mental-Intellectual
wellness
Social Wellness
Environmental Wellness
Occupational Wellness
Spiritual Wellness
10. 1. Physical wellness/health
Reflects a healthy body maintained by
eating right, exercising regularly, avoiding
harmful habits, making informed and
responsible decisions about health,
seeking medical care when needed,
participating in activities that help prevent
illness.
11. 2. Emotional wellness/health
Requires understanding emotions and
coping with problems that arise in everyday
life.
can have and express a wide range of
emotions such as anger, sadness, or joy and
love.
12. 3. Mental -Intellectual
wellness/health
open to new ideas and concepts.
open to learning a variety of lessons (in life
and in the classroom).
will ask questions about health care needs
unhealthy person will remain closed to new
ideas or will blame others for their poor
performance.
Racial, religious, gender, and age prejudices
factor into this area
13. 4. Spiritual wellness/health
reflects a state of harmony between you and
others.
understanding of your place in the greater
universe.
this does not mean religion
specifically, although religion can factor into
a personal sense of harmony and
spirituality.
14. 5. Environmental wellness/health:
 Refers to an appreciation of the external
environment and the role individual’s play in
preserving, protecting, and improving
environmental conditions.
 This domain looks at the impact that environmental
pollutants have on all of us
physically, mentally, spiritually, emotionally, and
socially,
 also looks at our impact upon the environment and
the circle of involvement and effect this can create.
Therefore, recycling and pollution are part of this
domain, but understanding the human role as part
of the environment is also important.
15. 6. Social wellness/health
refers to the ability to perform social roles
effectively, comfortably, and without
harming others.
looks at relationships, social norms and an
individual’s reaction to those relationships
and norms.
18. Principles of Service Design
Orientation to the future
Collaborative teamworking
Prototyping to improve dialogue
Mutual enhancement of design capability
Integration between emotional and
functional benefits
Open-ended adaptability
19. Principles of Service Design
Orientation to the future
Collaborative teamworking
Prototyping within dialogue
Mutual enhancement of design capability
Integration between emotional and
functional benefits
Open-ended adaptability
20. Examining control structures in healthcare design
Taken from Lee, Design participation tactics: the challenges and new roles
for designers in the co-design process; CoDesign, Vol. 4, No. 1, March
2008, 31–50
21.
22. Control Structures and Task
Requirements
Task requirements and the resources available
within frames of activity them
23. Secondary Control Structures
• Professionals use secondary control structures
to make their primary techniques work.
• Some secondary control structures are
necessary to achieve health or wellness.
– Examples:
• Infection control to prevent hospital-acquired infections
• Holding a baby still to safely perform lumbar puncture
(spinal tap)
24. Examining control structures in
healthcare design
What are your experiences of feeling
controlled when receiving healthcare?
28. Orientation to the future
Agency: requires
– awareness of how one is influenced by the past
– orientation toward the future
– capacity to imagine alternative possibilities within
the contingencies of the moment),
– and ability to use these to critically evaluate and
choose a course of action
(Emirbayer and Mische 1998:963)
29. Agency
• This definition of agency is consistent with
interpretive habits-of-action, but is not
consistent with reactive habits of-action.
• It requires heedfulness, mindfulness, and the
development of frameworks of understanding
that place relevant features of the task
environment in relationship interpreted
through the lens of desirable outcomes.
