Clinic Design for at-Risk Consumers: A Mixed Methods Pre- and Post-Occupancy Study

Nicholas Watkins (Gensler)

Mt. Sinai Peak Health Clinic provides ambulatory intensive care for high need, high risk, high cost, medically vulnerable, and historically underserved consumers in New York City. Peak Health and Gensler is performing a two-phased mixed methods study of the current Peak Health Clinic setting to measure how design and operations impact consumer engagement and satisfaction and efficiencies in care delivery. Phase 1 of the study included behavioral observations throughout the existing clinic setting to identify consumers’ and care providers’ use of technology, furnishings, and spaces. Upon leaving the clinic, consumers were asked to fill out a self-report questionnaire including items on demographics, health literacy, medication adherence, technology use, missed appointments, emergency department use, quality of interactions with care providers, and quality of examination room and waiting area design. Survey administration was facilitated by an interviewer over a two week period, resulting in a total of 27 completed surveys. Statistical analyses of the survey revealed that the consumers’ experiences with various features of an examination room were related to missed appointments and likelihood to visit the ED instead of the clinic. Results from the Phase 1 investigation informed conceptual designs for a prototypical examination room and waiting area/commons and a connected place strategy on how best to leverage the patients’ mobile technologies to better support care delivery and preventive medicine in and outside of the clinic. Phase 2 of the investigation focuses on consumers’ and care providers’ interactions in a functioning mock-up of the Phase 1 examination room prototype. Consumer – care provider interactions within the functioning mock-up are being filmed and analyzed. Results from Phase 2 will inform refinements to the examination room prototype and the connected places strategy. This session will share the results and implications from Phase 1 and provide an update on Phase 2 of the investigation.