Communications: the essential ingredient in successful design - importance of communication in designing long-term care facilities

Nursing Homes, Oct, 1999 by Rebecca Stahr

Do you have a facility that needs renovation? Or perhaps you plan to build one? Knowledge of what you need and want is your best ally - but, keep in mind, unless knowledge that is "second nature" to you is communicated well to those you wish to assist you, all the knowledge in the world will not deliver the best results.

The power of the written and spoken word is yet unrivaled, despite advances that technology has brought our way. Technology has only allowed us to share communication better. Yes, even with computers, connecting with individuals to exchange an understanding is the basis of all accomplishment and relationships. If we want something - service, product, person or an attractive facility - we must communicate it properly in order to achieve our goal. From the standpoint of a design professional, I would offer a few suggestions that could benefit everyone involved in a facility renovation or construction - specifically, points of communication that work.

Don't overlook details. Renovations involve many intangibles. What is an average day in your typical facility? What would be an ideal day? Take nothing for granted. If your dining service has two seatings with three different population groups having different food service needs, and seatings are divided among two staffers for one hour each, after which lingering residents are supervised by on-staff duty nurses, would you not consider these details imperative in planning for a new and improved dining environment?

Ask how far the envelope can be pushed in creating new and improved environments - how far change might be pushed without creating overload. Decades-old, double-barreled-corridor nursing homes are in urgent need of being brought into conformance with the needs of the twenty-first century - but you feel that nothing can be accomplished short of leveling the structure and starting from the ground up. Not so. Sound environments start with open books, open minds and open lines of communication.

Be open and honest. If you have renovation plans and a predetermined budget, the best way your money can be spent is to make the amount known and then allow a professional to distribute it judiciously. If there is not enough to achieve your stated goal, you will be told - if good communication is maintained - and this will allow you to prioritize for the most crucial of improvements. Perhaps even tabling the project would be better until the best use of funds can be realized. One thing is certain: Withholding financial figures from professionals who are trained in allocating funds for these specific purposes will likely only cost you more in revisions and reassessments.

Share information as early in the process as possible. As a facility administrator, developer or entrepreneur, the earlier you can share your vision with professionals trained to assist you in efficient improvement efforts, the sooner your investment can work for you. Even if you choose not to use these professionals in initial parts of the project, the earlier they are involved, the sooner you will have a finished product that can produce for you.

Engage in master planning. Think of an input/output scenario: You usually get from something what you put into it. That means having a master plan.

Master planning starts with a firm foundation; that is, you should expect design or planning professionals to interview you about your wants and goals in depth. They will want to know everything about your operation; remember, no details should be overlooked. Once this programming phase is over, you will be given a written confirmation of understanding, to ensure that the plan is on the right track. It is at this stage that communication is critical. Slip up in this area, and costly changes will surface as projects develop.

A schematic design follows. In this stage, the planning professional composes possibilities on paper in an effort to assess any and every way a solution for improvement can best be achieved. Think of this stage as a diamond in the rough. The core ideas are established and refined until a gem surfaces. Decision making can be enhanced with aids such as visual presentation boards (see inset). This should be the stage at which you and the designer will learn what will and will not work. Spending "too much time" in this phase is not possible; if major changes are required after this conceptual phase, it will cost you money. Taking care to see that major changes won't be required will only save you money.

After this, design development involves watching the vision unfold before your eyes. Each specific detail is addressed and costed. There is still time to make changes before the concrete is poured, but it is at this phase that the total project cost should become known.

You will then go on to establish contract documents and enter an administration phase. If your master plan has been well established, the contract administration plan will merely seem like deja vu. You are simply following through with what you have already planned. That's not to say that there won't be surprises; with a project of any complexity, these will always occur. Exercising proper due diligence, though, should guard against development of real problems.