Salus journal

Healthy Planet. Healthy People.

Healthcare / Quality improvement

European Healthcare Design 2019

Putting Cleveland Clinic in place: findings and implications from mixed-methods research for place-based health

By Nicholas Watkins, Travis Laird, Richard Tyson, Michelle Gandolf and Travis Tyson 16 Aug 2019 0

This session will describe and share the research methods and projects deployed to inform design and operational decision-making that helped Cleveland Clinic arrive at its current inpatient facility model.

Download the slides for this video presentation


​Cleveland Clinic London is the latest addition in the health system’s international business strategy and an example of the evolution of its inpatient facilities based on research of consumers, care providers and their communities.

Methodology: The mixed-methods, multi-layered approach allowed integrated design teams to target high-priority solutions while framing subsequent layers of investigation and hypotheses. A post-occupancy evaluation study of more than 2000 patients from 12 inpatient facilities was a first step towards a holistic understanding of design impact across the health system’s portfolio. Facilities were assessed in aggregate and compared on facility design and patient experience measures.

Results: Overall, facility design had a profound impact on patients’ loyalty and likelihood to recommend. Findings revealed opportunities to improve patient experience through facility design, including specific interventions. Additional opportunities to optimise patient experience and return on investment were identified and prioritised. Post-occupancy evaluation methods also underscored a need to give weight to the latest advances in computational design tools, as healthcare organisations shift from generic square-foot management to contextual place-based approaches instrumental to population health and preventive medicine.

Conclusions: Innovative approaches to portfolio management can integrate extensive and cumbersome data streams into accessible and intuitive tools that inform advances in population health, community planning, personalised medicine, telehealth, and outpatient services, among others. In turn, these tools equip healthcare administrators, providers, and facility designers to work as integrated teams through shared decision-making. We now have the ability to integrate and visualise data streams on facilities, patient experience, care quality, demographics, real estate, among others. Predictive analytics and machine learning can be applied to identify quantifiable indicators of performance, often undetectable to the naked eye and contemporary visualisation methods. The shift in portfolio management and development can transition facilities from risky liabilities to agile partners in care service innovation and population health.

Organisations involved