Exploring Alternatives for Critical Access Hospitals: Research-based Design for Rural Hospitals

This paper reports a series of research and design activities that explore an innovative model of healthcare delivery in rural areas. In spring 2016, a group of researchers in the School of Architecture, Design, and Urban Planning and School of Engineering at the University of Kansas organized a think tank titled “Innovations in Rural Healthcare Environments.” The symposium brought together more than 100 healthcare providers, policy makers, and designers to outline specific research issues about how innovative design solutions can improve the efficiency and effectiveness of rural healthcare systems.

Several major themes emerged from the panel discussions: 1. Rural healthcare facilities will need to adapt to changing practice models and constricted economic conditions by blending themselves into the fabric of the surrounding communities they serve and partner with local communities; 2. “Community Outpatient Hospitals” (COH), a new type of facilities that concentrate on primary and outpatient services, community-based health maintenance programs, and information technology rather than bricks and mortar will replace the obsolete “Critical Access Hospitals” (CAH) model; 3. Future rural healthcare designs can recognize the root causes of community health issues and also address individual uniqueness; 4. One size doesn’t fit all.

These key themes were used in a research-based design in the Health and Wellness graduate capstone studio. Students explored a range of design options that addressed the ways that traditional rural inpatient hospitals could be repurposed and refocused using Philips and Harper counties in Kansas as examples. In addition to in-depth analysis of socio-economic status, community health, and physical infrastructures of these two typical rural communities, students also conducted onsite observations, workflow mapping using spaghetti diagrams, and focus group interviews to inform innovative prototypical solutions for rural hospitals. The inter-disciplinary evidence-based design approach has been shown to be effective for student engagement and deeper understanding of rural conditions.

keywords: Rural Healthcare, Critical Access Hospital (CAH), Community Outpatient Hospitals (COH), Research-based design, Design Education