New Operational Models Transform Traditional Emergency Department Design

To serve more patients, hospitals are rethinking their emergency department design. Instead of relying heavily on a large waiting room to house guests, they are exploring new operational models that require spaces that are non-traditional.

Although the new process varies from facility to facility, it often looks like this:

  • Patients are seen upon entry by a provider, who can perform an immediate triage. At this point, a quick registration process occurs, generally in the same space as triage is performed.

  • Then, patients move to a treatment room, rather than the waiting room.

The bulk of these activities happen in one or two places. In the past, guests would have moved back and forth between four spaces. The new method is efficient and can improve a person’s experience with the hospital, but the existing layout of many facilities does not easily support this model.

While this approach offers a number of benefits, it does come with challenges. Patients are triaged as they enter, so the admitting staff needs to be an RN or mid-level provider. Also, large waiting areas are no longer needed, but more treatment rooms are required.

Hospitals are also moving towards a more universal and flexible design in treatment rooms. They don’t want specialized spaces that can see only one kind of case. Instead, they are hoping to maximize utilization rates for every room, so they can operate efficiently and effectively.

For a design to be successful, all of these operational details have to be established upfront. We typically begin by creating a process flow diagram with the department. We determine the steps required and where they will occur. Then, we create mock-ups of rooms, renderings, and/or use V/R, so staff members can see where changes should be made. Throughout our design and programming phases, we use data, like room utilization rates, door to doctor times and average stays for the hospital, comparing it to national benchmarks. This helps us determine if issues are related to design or operations. Then, we use that information to improve the ED, making it function well for all guests.

When designing an emergency department, there are two primary “guests” we consider. The first are visiting, like patients and their caregivers and support people. The other is staff or “working guests.”

Each group comes with a different set of needs and values. Visiting guests want amenities that make the space feel less sterile. These include items, like comfortable seating, such as recliners and accessible USB power. To provide an escape from heightened stress, some ED’s will provide the ability for guests to cast what they’re streaming on personal devices to a T.V.

When it comes to working guests, efficiency is the most important. They want to maximize their throughput, seeing as many patients as possible, while also minimizing the number of extra steps. Providing visibility, so they can oversee the department is another critical component, as is keeping noise and other distractions to a minimum.

Find out how to improve operations at your ED with pretty and smart design. Email us at to learn more.

Recent Posts