HCD Conference 2023: The Importance Of Trust In Clinic Design

Trust plays an important role in developing design solutions that meet the needs of a community and specifically underrepresented and underserved communities of color, according to presenters of the session “Relationship-Based Design: The Role of Trust in healing” in 2023. Health Design Conference + Exhibitionheld in early November in New Orleans.

Across the country, many underserved communities of color face the challenge of accessing quality, comprehensive health care, which can lead to numerous health disparities within these communities, according to speakers Christina Yates, designer and senior associate at NBBJ (Seattle) and Antwanette Lyons, community health program and development manager, at Seattle Children’s Hospital, Odessa Brown Children’s Clinic (OBCC; Seattle).

“Healthcare systems are typically built around driving performance and efficiency,” Lyons said. “In addition, many health organizations that serve communities of color often receive federal funding and have specific requirements and associated limitations on how care can be provided and who can provide it.”

Community-led design process

To help illustrate their point, speakers shared how gentrification and rising costs of living in Seattle’s Central District displaced many residents near OBCC’s Yesler Way clinic. In response, OBCC sought to develop a new pediatric clinic in Southeast Seattle’s Othello neighborhood to reach out to displaced members of the community.

The key to executing the project and creating a clinic that met the specific needs of the community was developing a trusting relationship between the provider, residents, and the project team.

“OBCC’s mission is to provide quality care and dignity to those in need, regardless of their ability to pay,” Lyons said. “OBCC has always been a part of the community and has always valued partnership within the community and families. The clinic was created specifically to serve the Black community within the Seattle Central District neighborhood and provide quality care with dignity.”

During the project, OBCC and NBBJ intentionally invited families and community members to be an active part of the design process. “A truly trusting relationship allows for vulnerability and sharing of true needs, and innovative design solutions are born from a connection to solve specific problems,” Lyons said. “They are the experts on what the challenges and barriers are and what needs are priorities for their community.”

The design process began by listening to what programs families want and need. OBCC also developed a governance council made up of community members, staff and patients’ families to “act as a system of checks and balances for OBCC to make sure we are engaged,” Lyons said.

Community clinic design features.

Opening in 2022, the Othello clinic is located in an urban space that includes a charter elementary school and mixed-income housing, helping to address health disparities and build a relationship of trust in the care the clinic provides to pediatric patients and their families.

“The new clinic is easy to access as it is located next to the light rail and has ample free parking,” Lyons said.

Within the clinic, several design features were chosen to also help foster community relationships, including local artwork. Specifically, speakers said OBCC Othello’s new location includes more than 20 commissioned art installations and more than 20 wearable art pieces by local artists of color, including for exam rooms and public spaces.

“[The] The artworks are created by native indigenous artists to honor and reflect the history of the place and its role in the community,” Yates said. (To learn more about OBCC Othello artwork, read “Using Artwork to Relieve Patient Anxiety.”)

Another clinic design feature intended to build trust with locals is the use of larger exam rooms for families and multiple care providers and waiting spaces outside the exam rooms for siblings and parents to wait when need privacy during a clinical visit.

An open provider workspace at the front of the clinic (called Town Square) allows patients and their families to connect and see their care provider in real time when they come in for an appointment. Additionally, the OBCC Othello clinic offers a recreation center and community kitchen that supports community learning and support groups to address key health challenges.

“There are different care delivery models that make sense for different communities,” Yates said. “Take risks, challenge assumptions and accept some unknowns. A good relationship of trust between the client, the community and the design team can facilitate a process that leads to a successful outcome.”

For more session reviews from the 2023 HCD Conference + Expo in New Orleans, visit hcdmagazine.com/news/awards-events.

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