At a recent conference, a colleague shared something that caught me off guard. When choosing between two hospitals for surgery, she made her decision based almost entirely on the building itself. Not the surgeon’s credentials. Not the safety ratings. The building.
At first, this seemed surprising. But research shows she’s far from alone—and her instincts are backed by science.
The Data Behind Design
In 2020, Gensler conducted the U.S. Outpatient Experience Index survey, which included over 3,500 patients, to understand better how healthcare settings and health technology impact patient outcomes. The findings were revealing: three specific factors emerged as having the most significant positive impact on patient experiences and outcomes.
What makes these findings particularly striking is what the researchers called a “power pair”—the building’s exterior and exam room experience working together to drive highly positive patient outcomes.
This research aligns with the broader evidence-based design movement in healthcare, which has gained significant momentum over the past two decades. Evidence-based design is defined as basing decisions about the built environment on credible research to achieve the best possible outcomes. The approach has evolved from theory to practice, with growing evidence that thoughtfully designed healthcare facilities can improve patient safety, reduce medical errors, increase patient and staff satisfaction, and even generate positive returns on investment.
Three Design Elements That Drive Outcomes
1. The Building's Exterior: Your First "Diagnosis"
For a building’s exterior to positively impact patient outcomes, it must appear modern, high-tech, inspiring, and welcoming. However, here’s the critical part: it needs to align with patients’ online impressions. When there’s a disconnect between what patients see online and what greets them in person, the entire visit is compromised before it even begins.
As the Gensler research notes, the outpatient experience includes not only direct interactions with care providers and staff, but also impressions and perceptions of facility elements. First impressions of design elements can trigger feelings of authenticity and brand consistency—essential for setting the stage for a positive visit and establishing trust.
In an era where patients are increasingly viewed as healthcare consumers with choice and agency, that exterior becomes a powerful statement about the quality of care they can expect inside.
2. Check-In and Registration: Where Privacy Meets Efficiency
The check-in and registration process plays a crucial role in the patient experience. Privacy during this phase leads to significantly higher outcome scores. When conversations can be overheard or forms must be completed within sightlines of other patients, the visit is negatively impacted from the start.
Interestingly, while forms can be completed in the privacy of an exam room, patients actually prefer the efficiency of handling paperwork in the waiting area—as long as privacy is maintained and staff are available to assist them. This highlights the importance of thoughtful spatial planning that strikes a balance between efficiency and dignity
3. The Exam Room: Empowering Patient Engagement
In the exam room, patients want control over their experience. Both physician interaction and the physical environment play critical roles. Key design considerations include:
- Computer monitor configuration that encourages shared decision-making about care
- Clear spatial delineation between exam and consultation areas, giving patients control over their interactions with physicians
- Adaptable spaces that accommodate different patient preferences and behaviors
The study also found that when physicians use tablets or other handheld devices to share information during consultations—such as showing test results, images, or treatment options—patients leave feeling more confident and better equipped to manage their health.
The Bottom Line
The Gensler study reveals a crucial insight for project managers and healthcare leaders: the perception of a building’s exterior and exam room design, combined with positive or negative experiences during the visit, has a direct impact on patient outcomes. With over 880 million outpatient visits occurring annually, getting these design elements right isn’t just about aesthetics—it’s about measurable health outcomes, patient loyalty, and competitive advantage.
The research found that when you pair positive feelings throughout the patient journey with high-quality physician interactions and strong design elements, such as the exam room and facility exterior, you can explain 70% of the variance in patient loyalty. That’s not just good design—that’s good business.
The Business Case for Design Excellence
Beyond patient loyalty, the financial implications of evidence-based design are compelling. Studies show that evidence-based design investments are often recouped within one to two years, with operating benefits continuing for several years afterward. This is particularly relevant as healthcare systems face increasing pressure on reimbursement.
The Centers for Medicare & Medicaid Services now factors patient satisfaction scores into reimbursement metrics. Hospitals that fail to meet satisfaction benchmarks face financial penalties, while those that excel can see improved revenue. This regulatory shift has elevated facility design from a “nice to have” to a strategic imperative.
Additionally, well-designed facilities can enhance staff efficiency and workflow, thereby reducing medical errors and improving safety outcomes. When staff can navigate spaces efficiently and have access to well-designed work areas, patient care improves measurably. (See my post Enhance Patient Flow for Better Hospital Efficiency.) This connection between design and operational efficiency creates a compounding effect on both quality metrics and financial performance.
What This Means for Your Project
As healthcare systems continue to invest in new construction and renovation projects—the U.S. spends over $65 billion annually on healthcare facility construction—the integration of evidence-based design principles from the project’s inception becomes critical. The most successful projects involve all stakeholders from the outset: clinicians who understand the workflow, patients who experience the space, facilities operators who maintain it, and project managers who can coordinate these diverse perspectives into a cohesive vision.
The Key Takeaways
- Design drives business results: Healthcare facility design directly impacts patient outcomes, loyalty, and financial performance—it’s a strategic investment, not just aesthetics.
- The power pair matters: Building exterior and exam room experience together explain 70% of patient loyalty variance.
- The stakes are high: With over 880 million outpatient visits annually and CMS tying reimbursement to patient satisfaction, design excellence is essential for competitive advantage.
- ROI is compelling: Evidence-based design investments typically pay for themselves within 1-2 years through improved operational efficiency, reduced medical errors, and increased patient satisfaction.
- Early integration is critical: The most successful projects bring together clinicians, patients, facility operators, and experienced project managers from day one to create spaces that support both healing and business success.
Your Experience Matters
What has been your experience with healthcare facility design? Have you seen these principles put into practice?
If you’re starting a healthcare design or construction project and want to ensure these evidence-based principles are incorporated from the beginning, let’s have a conversation. Message me through my website at kingpm.net or connect with me on LinkedIn to set up a call.
#healthcare #construction #projectmanagement #healthcaredesign #patientexperience
