Case Study: The Community's Clinic

LENS worked with The University of Houston (UH) to design a new care delivery model that breaks down barriers to reach the city’s most underserved populations.

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At University of Houston we shattered traditional healthcare orthodoxies to train a diverse group of future providers for a deep understanding of the social determinants of health and a commitment to providing compassionate, high value care to underserved populations—specifically Houston’s Third Ward. The clinic consolidated previously scattered clinics and teaching programs into a welcoming multispecialty clinic and coordinate patient care across primary care, behavioral health, and the treatment of chronic conditions.

The following are 5 innovative strategies that challenge industry orthodoxies:

1) A Clinic as Community Center

Historically, the Third Ward has had little access to health services, and thus the population is accustomed to utilizing emergency services over the preventative services that UH will offer. To encourage preventive health behaviors, the design team developed a clinical program that reflected that of a community center, connecting to the deeply-rooted traditions of community held by the local population. Health and wellness services—including a learning kitchen, group rooms, a teen recreation room, and a yoga studio—help bridge the gap between clinical treatment programs and lifestyle choices.

2) Multidisciplinary Care Teams

The clinic facilitates flexible use and operational efficiency while still providing distinct identities for specialty services and discrete flows for patients. The floor plan is layered, offering a transition from public spaces, to patient spaces, to collaborative staff workspace in the back. A centralized front-end integrates scheduling, electronic health records, and billing. Collaborative workrooms are placed at department junctions to reinforce multidisciplinary teamwork, where medical professionals will learn how to break down the silos between departments as they collaborate and find new ways to address patient needs.

3) Caring for Families

To cast a wider net, the clinical team shifted their approach from caring for the individual to caring for the family. The design team planned larger exam rooms so that care teams can access and even treat the entire family during a single session. Much like group sessions, these family sessions would become a creative way of building support networks and delivering care efficiency. This model will help the University of Houston scale their practice rapidly, increasing the number of patients and billing codes per visit. This is very relevant to the Health Hub, as the model increases utilization and emphasizes family health.

4) Respond to Shift in Patient Demands

Benchmarking tells us that the average outpatient clinic space utilization is 60 percent— largely due to swings in patient demand or staff schedules. At Health 2, we addressed these historically poor utilization rates by eliminating departmental boundaries. The program was built to meet peaks in patient demand across all departments rather than on a departmental basis. A Demand Dashboard was developed to help the clinics flex to their space needs on a shift-by-shift basis. This strategy is projected to increase space utilization to 85 percent. This strategy is also meant to help the clinic nimbly respond to emerging patient needs.

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5) Deliver Rewarding Patient Experiences

Patient personas were created to better understand what would motivate patients to visit and return to the clinic. We found that in traditional care settings, these patients were only 30 percent likely to show up for their follow-up visit. By developing patient personas, we found that by providing teenagers a safe place to study or socialize or giving diabetics a place to learn to cook healthy meals, we created a community within the clinic, increasing patient compliance. Journey maps were then used to identify facility design criteria and staff workflow at each step in the patient experience. We subtly designed discrete patient flows while centralizing support functions such as registration.