I've heard of engaging patients in the design of the health care delivery system before, but until last week, I'd never heard of patient-centered design of an actual hospital, to say nothing of giving patients the final say on the architect.


But during last week's Patient Safety Congress in Washington, D.C., I had the chance to hear from hospital leaders and patient advocates at Dana Farber Cancer Institute, who discussed the elaborate, patient-driven process leading to the 2011 opening of the Yawkey Center for Cancer Care, which informed not just the hospital's interior design, but led to improvements in patient throughput and overall safety.

For instance, the patient-selected architect learned early on that patients would rather move around the facility and navigate between appointments with different specialists than wait in a single exam room for clinicians to visit them, Janet Porter, chief operating officer for Dana Farber, noted.

"Patients said, 'Don't you dare do that,' " Porter said. "Two hours [in the exam room] would feel like six."

The hospital also hosted a "chair fair" where patients tested different chairs for different parts of the building. Martie Carnie, a Dana Farber patient who co-chaired the Institute's Patient and Family Advisory Council, related that patients advocated for leather chairs in some areas and cloth chairs in others, while the chairs used during infusions are heated and include massage capabilities, a nod to the amount of time cancer patients spend in them.

Giving patients a voice in design decisions wasn't without its challenges — when patients requested that space on the ninth floor of the building with panoramic views be reserved for patients and families instead of for a staff room, "the doctors were not happy," Carnie recalled.

But the benefits to patients weren't simply aesthetic. Improvements in patient flow — including the addition of a GPS system that enables patients to more easily find their way around the building — helped the hospital reduce wait times for exams from 39 to 21 minutes. Patient safety also got a boost — in the exam room, the council helped design the location of a table so visitors could safely mount and dismount. Even the chair fair helped the hospital select furniture that could be cleaned more easily, reducing overall infection risks.

And patients and hospital officials aren't the only folks who are happy with the new facility. It's also won rave reviews from the Boston Globe's architecture critic.

"Patients and families are aware of details you never dreamed of," Carnie said.