Redesigning the Hospital as a Community Health Network

Sep 10, 2015, 3:35 PM, Posted by

Cleveland's MetroHealth Medical Center has reimagined itself to embrace community and build in thoughtful improvements to its programs and design that focus on everyday wellness and well-being.

Graphic of the MetroHealth Medical Center Image via HKS Architects

In a room filled with architects, acting Surgeon General Rear Admiral Boris D. Lushniak shook up the common definition of our profession by saying that “if you are an architect, you are a public health worker.

And many architects were already with him. We have been expanding our thinking beyond typical individual buildings to create healthy blocks, corridors and neighborhoods by shaping what they do within the property line so it’s responsive to what’s happening outside the property line. This in itself is not new, but doing so to improve health and wellness, while leveraging the resources of large civic-minded institutions, is a new approach to a traditional problem.

MetroHealth Medical Center in Cleveland, Ohio has taken on this mindful, responsive approach while morphing from an isolated hospital into an inclusive community health center. This process flips the paradigm of health delivery; instead of focusing on the hospital as the first line of defense in the care and wellbeing of a population, it is now the last stop.

The 175-year-old institution, founded at the same time as the City of Cleveland itself, was created as a public hospital and exists today as the backbone of the neighborhood in the very same spot it was founded. Its new mission is to lead the way to healthier individuals, and a healthier community. This shift in thinking requires a fresh look at what it means to be a healthcare provider, community partner and civic resource. It requires a master plan that envisions a county-wide approach to health care: from clinics, seminars and music festivals, to traditional inpatient care. While hospital buildings alone don’t necessarily cover this scope, health systems like MetroHealth deliver value beyond the physical space to improve the lives of the people they serve.

Right now, the master MetroHealth plan is in the approval process, and the goal is to fund and adopt the plan by the end of 2015. The plan, by working with the health system and community groups, considers both building and non-building features. Elements for Cleveland residents range from gardens and vegetable patches, to new bike paths and bus routes that enhance access different parts of town, and to nearby outdoor venues. Programming such as performing art programs, cultural celebrations and community social events help reinvest in Cleveland and the communities with a mind towards hope. To this end, the plan is about place-making, celebrating health in all of its forms.

To transform the new MetroHealth system, hospital leaders, staff and over 31 community members came together in a series of health design workshops. This work reinforced the idea of taking an “extroverted” approach, which includes work that extends beyond the MetroHealth property lines. This includes reinforcing social activities such as the 11 school-based health clinics in the area; approaching local urban farms to purchase food for the city’s healthy food initiatives; and revamping the parks, bike paths and fitness centers to impact lifestyle choices in the Cleveland area.

By taking this more decentralized approach, and by moving more resources into health wellness and prevention, these changes will allow the hospital to become smaller and more focused inpatient facility—one that should save money by treating health issues before they become critical or chronic. The transformation process should set an example for hospitals nationwide by taking MetroHealth from an oasis walled off from the surrounding Cleveland community, to embracing that community and building in thoughtful improvements that focus on everyday wellness and well-being.

As Senior Vice President and Healthcare Practice Leader HKS, Shannon Kraus, FAIA, FACHA, MBA, has been an integral part of the design and planning of over 20 million square feet of healthcare projects around the globe during his 20 years of experience in healthcare planning.