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7-27-17: Location vs. Size - Medical Education and Simulation Centers

Of course, centralized space is preserved for patient care and essential clinical support functions. This leads the discussion to comparing two alternatives: (1) minimal to modest available on-campus space, usually in an older portion of the Hospital or; (2) an abundance of space, off-campus, just a few miles down the road. The debate then continues: a full program in a new building vs. a modest, or often reduced program on the Hospital campus? From my experience, location trumps size every time! A successful simulation and training center needs to be within walking distance of the learners. Simulation Centers are expensive to build and the ROI can be difficult to ascertain. Healthcare professionals are very busy with demanding schedules. Easy simulation center access is essential to promote high utilization, giving your organization the best opportunity for improved patient outcomes.

Simulation Centers can vary in size from small simulation suites of 500sf to 2,000sf, to simulated hospitals and education centers of over 50,000sf. In the northeast, the sweet spot for on-campus simulation centers can range between 5,000sf to 10,000sf.

So you now have a great location, but with limited space. How to do you maximize the square footage without sacrificing program? The planning of a success training center can be focused on two critically, but equally important factors: multi-functional spaces and a highly effective space plan organization.

The creation of multi-functional spaces starts at the very beginning of the project, during space program development. Most training centers are used by in-house clinical and nonclinical teams, medical and nursing schools, local emergency response teams, the National Guard, and more. Once you have identified your potential learners and end users, gathered programming information, and developed the curriculum and education goals, your team can then determine potential simulation and training scenarios. Information gathered during this first step will shape the space program and have a major impact on the success of your new Center.

Simulation training will vary from individual clinical skills to complex multi-disciplinary team training. Some labs require replicated, complex clinical environments where others, focused on “soft skills,” may only require a simple conference room. The key lies in developing a space program that views each space as multi-functional, all capable of supporting simulation. The following are a few examples:

  1. Clinical simulation labs can be planned to simulate multiple healthcare settings by superimposing space and equipment requirements within the same room, and utilizing each wall for multiple headwall scenarios. Labs should also be designed to accommodate in-room debriefing.
  2. Multi-bay fundamentals labs can be designed for skills training for inpatient and outpatient settings, traditional classroom instruction, demonstration stations, and clinical training stations.
  3. Skills / Task training labs can be designed with mobile tables and equipment and infrastructure to support: individual task trainers, skills training, and classroom instruction.
  4. Debrief rooms can also be used for Consultation, Behavioral Health, or even Outpatient Clinic space.
  5. Support spaces should be multi-purpose. Kitchenettes can double as Nutrition rooms. Storage rooms can be used as simulated Clean Supply, Soiled Utility, or Meds Rooms. Single occupancy toilet rooms can be designed to simulate a Patient Toilet / Shower in a Nursing Unit. Post encounter note stations can double as satellite nurse documentation stations. Even corridors can be used for training where teams can simulate patient transport and “hand-offs.”
  6. Reception / Waiting areas can also be used to simulate patient registration, check-in, and waiting rooms in a clinical setting.
  7. Lastly, highly flexible labs require sufficient storage to support a variety of clinical settings.

Once you have developed a multi-functional program, it now needs to be translated into a highly efficient and effective space plan layout that considers: operations and logistics, critical adjacencies, entrances, and occupant circulation. Simulation Centers generally break down into three programmatic zones: (1) Reception / Conference/ Research / Administration, (2) Simulated Healthcare Labs, and (3) Specialty Skills / Task Training Labs.

When planning these zones, it is critical to consider the circulation of visitors, learners, staff, supplies and standardized patients (actors). Simulation centers require controlled access, separated circulation patterns for visitors, learners, staff, supplies, and of course standardized patients, and an appropriately located “backstage” space to minimize downtime and promote high simulation lab utilization. In addition, carefully planned support spaces can allow for multi-room simulations to simulate patient transfers as well as simulate a hospital or nursing unit for complex team dynamic training.

The use of clinical simulation is on the rise. Initially simulation centers were focused on education, improved clinical skills, and patient care and safety. As technology advances our healthcare professionals are using virtual reality simulators, highly realistic human patient simulators, 3D printers (to practice patient-focused procedures), and of course standardized patients to improve communications and team dynamics. In addition, simulation centers are used as testing laboratories for new medical equipment, procedures, healthcare pilot systems (for operations and practices), research, and to respond to the growing trend to require simulation for accreditation and competencies.

About the Author
Richard Pizzi, AIA, CEO

Simulation Programming and Design Expert
Healthcare Studio Leader

Rich has led the programming and design of 14 Medical Education and Simulation projects including projects at: Boston Children's Hospital, Yale New Haven Health, Dartmouth-Hitchcock Medical Center, University of Vermont, Western CT Health Network, and Bryant University to name a few. He has focused his energy on the research and design of medical education and simulation centers, and is a member of the Society for Simulation in Healthcare and the New England Healthcare Engineers Society.

A Syracuse University graduate with a Bachelor of Architecture, Rich has over 23 years of healthcare planning and design experience. He has spoken nationally about: planning hospital-based simulation centers, multi-functional simulation spaces, and medical education and clinical simulations centers.

Recent Speaking Engagements

2015 “Planning Hospital-based Simulation Centers with Limited Available Space,” webinar, hosted by Education Management Solutions

2015 “Multi-functional Simulation Spaces at Boston Children’s Hospital,” MED ED Facilities Conference, Boston, MA

2015 “Planning Hospital-based Simulation Centers with Limited Available Space,” MED ED Facilities Conference, Boston, MA

2014 “Where Healthcare and Education Meet; Medical Education and Clinical Simulation Centers,” MED ED Facilities Conference, Boston, MA