As UNC REX Healthcare’s cancer treatment services outgrew their current facilities, the System decided not to simply expand current spaces, but to create a new comprehensive outpatient cancer facility. Existing spaces were landlocked, and a new site was founded for the cancer center in an attempt to allow full functional capacity. One question was always considered: How will the building adapt to future changes in cancer treatment and future expansion? To ensure users could be fully engaged in the process of developing the design for the UNC REX Healthcare Outpatient Cancer Center, our design team used technology to let users see how their input might take concrete form.
The team engaged in a “mapping with empathy” approach by virtually walking different user personas through the proposed design for the new Cancer Center. The team initially diagrammed the flows for each patient type identifying the key steps in the patient’s experience as 21 different patient flow experiences were initially identified. Many of these flows would be experienced by the same patient during different types of visits to the same facility. The goal of maintaining personalized care, yet simplifying and somewhat standardizing the patient experience became a driver in the design of the new facility. This goal aimed to optimize ease of use for the patient.
The team then used a computer-simulated model and choreographed the patient experience including wait times and staff handoffs (such as from registration to a patient navigator to care team). Leveraging technology and data allowed the team to align the goals of the project from a variety of stakeholder perspectives, both practical and abstract. The simulation maps out all of the flows for the entire facility and provides metrics for staffing as well as utilization of waiting spaces, parking, and other high-congestion zones. The team simulated combining several stand-alone specialty cancer clinics (with separate registration) into a centralized registration process in the new facility. The team also used simulation modeling to map vehicular traffic flow in order to right-size parking, valet queuing, and the entire patient and family arrival sequence.
What was the outcome of the model? The simulation showed that using a basic centralized registration approach for all patients and patient types in such a large facility could potentially cause bottlenecks upfront that would negatively impact the patient experience. In order to limit the risk of backups, yet still maintain consistency with the centralized registration experience, the team implemented several solutions:
1) Right-size the number of registration bays in order to minimize wait times during peak registration times of day,
2) Identify opportunities for online (pre-registration) or assisted kiosk registration for returning patients, and;
3) Determine that specific patient populations can bypass daily registration and go directly to their treatment areas (such as radiation oncology patients who visit daily during intense treatment periods).
The team also analyzed patient volumes for near-term and long-term growth as well as made future predictions by modeling various scenarios to predict when the planned building might reach maximum utilization. This modeling caused additional refinements to the initial design necessary to plan for growth. Key refinements included adding departmental expansion throughout the facility and incorporating a new additional 4th floor to the building in the first phase for “to be determined” flexible space.
The result? The project team viewed empathy as important as data-driven metrics and the need for a viable proforma, leading to project success from both a quantitative and qualitative approach. View the simulation model, here.