Promising Practices in Safety-Net Clinic Design: An Overview

Safety-net clinics will need to invest in an estimated 10.5 billion in facility construction, renovation, and expansion between now and 2015, according to the National Association of Community Health Centers, in order to provide care to the 17 million patients the facilities serve, including a growing uninsured population. With an allocation of $1.5 billion from the 2009 American Recovery and Reinvestment Act (ARRA) specifically designated for health center infrastructure, clinics now have the unique opportunity to rethink how they can provide greater access to care, better patient experiences, and improved staff satisfaction and organizational outcomes. However, the gap between the available funding and the anticipated need will necessitate carefully planned use of limited funds in clinic design projects.

A review of the literature on ambulatory care clinics, conducted by The Center for Health Design in 2008, demonstrated that little information is available on the effect of safety-net clinic design on patients, staff, and organizational outcomes. Research carried out in other ambulatory care settings is somewhat useful in making design decisions for safety-net clinics, but gaps in applicable data exist. Issues affecting the patient, provider, and community need more detailed study to support quality improvement within safety-net clinics. A more substantial knowledge base for health care leaders, architects, designers, and construction professionals is equally important for future design and operation of these clinics.

To help fill this gap, a series of white papers has been developed to inform and educate all participants in the clinic design process. These papers, “Designing Safety-Net Clinics for Innovative Care Delivery Models,” “Designing Safety-Net Clinics for Flexibility,” and “Designing Safety-Net Clinics for Cultural Sensitivity,” are based on literature reviews, interviews, and visits to exemplary health centers and clinics. They suggest a range of design strategies for building and renovating safety-net clinics. Collectively, the papers reveal a variety of issues that impact health care experiences and inform the planning and design of the physical environment. The most critical of these issues are health care interactions, patient flow, use of new technology, and the changing needs of the community. The papers explore these topics from the perspectives of patients, providers, and communities.