Calibrating healthcare delivery and design for generational distinctiveness. The country’s demographics have changed dramatically in recent years, but little has been done to change the process of designing hospitals or the outcome to reflect a new generation. NBBJ healthcare experts present new technologies—including sensors, VR and analytics tools that save time and money—and a new patient room that caters to the needs of young patients.

1. MILLENNIALS AND
BABY BOOMERS
CALI B RAT I N G H EALT H CAR E D E LI V ERY F OR
G EN ERAT I O NAL D I STI N CTI V EN ES S
S A R A H M A R K O V I T Z ,
A I A
Pr incipal
K E R I A N N E G R A H A M ,
A I A , L E E D G R E E N A S S O C .
H ealthcar e Ar chitect / Planner

2. 1. INTRODUCTION: UNDERSTANDING GENERATIONAL DISTINCTIVENESS
2. GENERATIONAL CHANGES IN THE HEALTHCARE WORKPLACE
3. GENERATIONAL CHANGES IN PATIENT CARE SETTINGS
4. HOW WILL THESE CHANGES SHAPE YOUR ENVIRONMENT
AND BEHAVIOR?
5. CONCLUSION
C O N T E N T O U T L I N E

3. 1 INTRODUCTION: UNDERSTANDING
GENERATIONAL DISTINCTIVENESS

4. BABY
BOOMERS
MILLENNIAL
S
S I D E - B Y- S I D E

5. BO R N
1946 –1964
BO R N
1980 –2000
AG ES
52–70
AG ES
16–36
BABY
BOOMERS
MILLENNIAL
S
S I D E - B Y- S I D E

6. BO R N
1946 –1964
BO R N
1980 –2000
C A R EER PH A S E
Transitioning out of the workforce
C A R EER PH A S E
Transitioning into the workforce
AG ES
52–70
AG ES
16–36
BABY
BOOMERS
MILLENNIAL
S
S I D E - B Y- S I D E

7. BO R N
1946 –1964
BO R N
1980 –2000
C A R EER PH A S E
Transitioning out of the workforce
C A R EER PH A S E
Transitioning into the workforce
S O C IAL ACT I VI S M VE N U E
Protest marches
S O C IAL ACT I VI S M VE N U E
Social media
CAU S E S
Peace / Rights of women and minorities
CAU S E S
LGBT rights / Global democracy
AG ES
52–70
AG ES
16–36
BABY
BOOMERS
MILLENNIAL
S
S I D E - B Y- S I D E

8. BO R N
1946 –1964
BO R N
1980 –2000
C A R EER PH A S E
Transitioning out of the workforce
C A R EER PH A S E
Transitioning into the workforce
S O C IAL ACT I VI S M VE N U E
Protest marches
S O C IAL ACT I VI S M VE N U E
Social media
T EC H US AG E
Stationary and mobile devices
T EC H US AG E
Mobile devices and experiences
CAU S E S
Peace / Rights of women and minorities
CAU S E S
LGBT rights / Global democracy
AG ES
52–70
AG ES
16–36
BABY
BOOMERS
MILLENNIAL
S
S I D E - B Y- S I D E

9. BO R N
1946 –1964
BO R N
1980 –2000
C A R EER PH A S E
Transitioning out of the workforce
C A R EER PH A S E
Transitioning into the workforce
S O C IAL ACT I VI S M VE N U E
Protest marches
S O C IAL ACT I VI S M VE N U E
Social media
T EC H US AG E
Stationary and mobile devices
T EC H US AG E
Mobile devices and experiences
H EALT H C AR E PR I O R IT Y
Prioritize life-long provider relationship
H EALT H C AR E PR I O R IT Y
Prioritize healthcare provider convenience
CAU S E S
Peace / Rights of women and minorities
CAU S E S
LGBT rights / Global democracy
AG ES
52–70
AG ES
16–36
BABY
BOOMERS
MILLENNIAL
S
S I D E - B Y- S I D E
Becker’s Hospital Review, In A Virtual Age, Connection Still Matters, Jan 17, 2015

10. Both are at critical points in their lifetimes
Both generations are cost conscious and socially minded
And both value family relationships.
T H E T I E S T H A T B I N D

11. MILLENNIALS MAY BE
THE BIGGEST AND
MOST INFLUENTIAL GENERATION YET

12. Millennials are now the largest single
generation, accounting for a quarter of the
entire population and $200 billion in annual
buying power.
Retailer Leader, Millennials Spending Power, Jan 2017

13. Millennials are the biggest instigators and influencers
of market trends.
They are 2.5x more likely to be early adopters of digital, social and
mobile trends.
Other generations shift their own habits due
to the influence of millennials.
I N F L U E N C E
Adrenaline, The Generation of Innovation, Jan 6, 2015
Futurecast, Millennial Mindset, April 2016

14. Millennials are marrying later than every other generation before them.1
Millennials are buying fewer houses than the previous generations.2
The number of Millennials living at home has steadily increased since 2005.3
Millennials are less likely to be religious than previous generations.4
M I L L E N I A L H A B I T S
Source: Pew Research Center, “Millennials in Adulthood,” March 7, 2014
http://www.huffingtonpost.com/2014/03/11/millennials-marriage-age_n_4944558.html
Source: White House.gov, 2016
https://www.theatlantic.com/business/archive/2016/08/millennials-the-mobile-and-the-stuck/497255/
Source: U.S. Census Bureau, 2015
http://jedkolko.com/2015/11/23/why-millennials-still-live-with-their-parents/
Source: Pew Research Center, May 12, 2015
http://www.pewresearch.org/fact-tank/2015/05/12/millennials-increasingly-are-driving-growth-of-nones/
1
2
3
4

16. 2 GENERATIONAL CHANGES IN THE
HEALTHCARE WORKPLACE
2

17. Randstad Healthcare, Healthcare Workplace Trends, 2016
Research shows the
cost of replacing an
employee often
represents 20% of their
salary
66% of healthcare
executives cite
increased competition as
the biggest
external threat to
their business.
54% of healthcare
executives cite
finding the right
talent as their biggest
internal threat.
44% citeretention as
their biggest
internal threat.

18. THE SAME MILLENNIALS THAT ARE
CHANGING CULTURE AND SPENDING
HABITS
NOW MAKE UP THE MAJORITY
OF THE US WORKFORCE

19. BOOMER
PRIORITIES
Acoustic privacy
Formal meeting spaces /
conference rooms
High function work environment
Seeking outward recognition of
achievement
MILLENNIAL
PRIORITIES
Integrated technology
Informal meeting spaces /
amenities
High connection work environment
Seeking “meaningful work”
A D I F F E R E N C E I N W O R K P L A C E P R I O R I T I E S

20. BOOMER
PRIORITIES
MILLENNIAL
PRIORITIES
A D I F F E R E N C E I N W O R K P L A C E P R I O R I T I E S

21. NATURE

22. C H O I C E

23. SOCIALIZATION

24. COLLABORATION

25. Amazon Headquarters,
Bioshperes

28. 3 GENERATIONAL CHANGES IN PATIENT
CARE SETTINGS

29. CONVENIENCE
The New Imperative
Photo: Pexels

30. The Advisory Board says convenience is the overriding factor
for Millennials in healthcare.
6 of Millennials top 10 priorities involve convenience,
from extended hours to online scheduling to retail settings.
34% of Millennials prefer retail clinics due to convenience and
24% prefer acute care clinics.
T H E C O N V E N I E N C E I M P E R A T I V E
USA Today, How Millennials Could Change Healthcare, Feb 7, 2016
The Advisory Board, Millennials Are Changing Healthcare, Feb 8, 2016

31. MOVING BEYOND THE HOSPITAL
Expanding the Care Delivery Envelope

32. BOOMERS CARE DELIVERY
SETTINGS
MILLENNIAL CARE DELIVERY
SETTINGS
Hospital
Ambulatory care facility
Hospital
Ambulatory care facility
M O V I N G F R O M H O S P I T A L - B A S E D C A R E
T O M U L T I - S E T T I N G C A R E

33. BOOMERS CARE DELIVERY
SETTINGS
MILLENNIAL CARE DELIVERY
SETTINGS
Hospital
Ambulatory care facility
Hospital
Ambulatory care facility
Home
Workplace Retail
Mobile & virtual platforms
Vacation
Public transport
M O V I N G F R O M H O S P I T A L - B A S E D C A R E
T O M U L T I - S E T T I N G C A R E

34. Because services are
administered locally,
employees confront health
matters before they became
larger and more costly issues.
Microsoft Building 21,
Living Well Health Center
W O R K P L A C E C A R E D E L I V E R Y

35. “ZOOM+ is the iPhone of Healthcare”
Forbes
R E T A I L C A R E D E L I V E R Y

36. THE EMPOWERED PATIENT
A millennial Shift From Physician-Directed Care to a
Patient-Physician Alliance

37. Millennials generally do not trust physicians to the same extent as older generations, and prefer to
make their own informed decisions regarding care.
Only 58% say they trust their physicians, vs. 73% of other generations.
They’re 12% more likely than other generations to switch providers if dissatisfied.
T H E E M P O W E R E D P A T I E N T
NUeMED, What Millennials Expect, Jan 12, 2017
Fortune, What Healthcare Gets Wrong About Millennials, Dec 16, 2016

38. BIG DATA IS MY DOCTOR
Millennial Shift Toward Expanded
Diagnostic Resources

39. Millennials are far more likely than other generations to use and
trust online experts and reviews (only 41% view doctors as the
single best source of information).
54% of Millennials search online for health information compared
to 38% for all generations of patients.
B I G D A T A I S M Y D O C T O R
Mobi Health News, Millennials Look Online Before Choosing Doctor, Aug 31, 2015
Chicago Tribune, Survey says more than half of shoppers check online reviews, June 2 2015

40. BOOMERS
Patient is typically reliant on
opinion of a single Physician
Physician x1
Or in some situations, requests
a second opinion
Physician x2
MILLENNIALS
Patient considers opinion
of a local Physician
Physician x1
And often incorporates online
health information
Physician10
Or even (emerging) big
data diagnostics
Physician1000
B I G D A T A I S M Y D O C T O R

41. Why millennials are excited about Watson…
It’s based on all available medical knowledge
It’s accurate
It's consistent
It has very low marginal cost
It can be offered anywhere in the world
B I G D A T A I S M Y D O C T O R

42. ONLINE REVIEWS
A Uniquely Millennial Form of Economic Agency
(HCAHPS Were Just the Beginning…)

43. Millennials are far more likely than other generations to
make online reviews.
7 in 10 millennials think it’s their responsibility to write
online reviews and share feedback.
O N L I N E R E V I E W S
Edelman, The Evolving Role of Brands for the Millennial Generation, Dec 4, 2012

44. Millennials use online reviews to find health providers almost
2x as much as boomers
O N L I N E R E V I E W S
PR Newswire, Five Ways Tech-Savvy Millennials Alter Health Care Landscape, May 23, 2015

45. Yelp reviews cover the 11 categories used by HCAHPS, as well
as another 12 which are not covered, including cost,
insurance/billing, ancillary testing, facilities and amenities.
4 of the 5 categories most closely associated with positive
reviews, like compassion of staff and doctors, aren’t covered by
HCAHPS.
O N L I N E R E V I E W S

46. The Challenges…
HCAHPS
Suffer from low response rate and a significant time lag before public
of results.
O NLINE REVIEWS
While detailed and continuously updated, are not randomized, curated,
and are subject to gaming.
O N L I N E R E V I E W S

47. 4
HOW WILL THESE CHANGES
SHAPE YOUR ENVIRONMENT
AND BEHAVIOR?

48. CONSIDERATIONS
FOR A MILLENNIAL WORKPLACE
Microsoft Envisioning Center

49. The best collaborative
spaces also support
solitude

51. Shared Extended
Documentation
Shared Rounding
WOWs
9+
Up to In Room
Charting Stations
Bedside
Stations
CIC
1
N Y U K I M M E L P A V I L L I O N :
C L I N I C A L I N T E G R A T I O N S T A T I O N

52. N Y U K I M M E L P A V I L L I O N :
C L I N I C A L I N T E G R A T I O N S T A T I O N

53. B O R R O W I N G I N N O V A T I O N F R O M O T H E R S E C T O R S

54. C O N N E C T I O N T O
L A N D S C A P E A N D V I E W S
S A M S U N G ’ S W O R K P L A C E C O M M I T M E N T T O
E M P L O Y E E H E A L T H A N D W E L L B E I N G

55. CONSIDERATIONS
FOR A MILLENNIAL CARE
ENVIRONMENT

56. Importance of Family
Connectivity
Technology
K E Y D E S I G N D R I V E R S

57. TA P P I N G I N T O T H E M I C R O
A PA R T M E N T M O V E M E N T
Our approach learns from Millennials
(and also downsizing Baby Boomers)
who are focused on efficiency through
convertibility.

58. F G I B E D
C L E A R A N CE
M E D /S U R G
4'
3'
3'
3'
5'
5'
In a universal room, 20-30% of the
overall floor area is set by ICU bed
clearances that are often not utilized.
A high-performance utilization strategy
converts often-wasted floor area into an
amenity zone that could directly
improve satisfaction.
IN T E N S IVE
C A R E
F G I B E D
C L E A R A N CE

60. C O M PA C T
M O D E
Maintains required clear
floor area
around patient bed
For ICU level care.

61. O V E R N I G H T
Enabling a good night’s
sleep for the patient, and
their loved ones.

62. W O R K P L A C E
M O D E
Allowing patient
and family to stay
connected.

63. FA M I LY D I N I N G
Room for everyone
at the table.

64. F A M I LY D I N I N G
Makes room for everyone at the table.
Now that hospitals are actually growing and serving nutritious food,
let’s enjoy it together.
FA M I LY D I N I N G
Allows family time to
be less fragmented,
more normalized, and more
supportive.

65. 9AM CO NSULT

66. 1PM WO RK + RELAXATIO N

67. 5PM FAMILY DINNER

68. 9PM READY FO R BED

69. Physical Support Components
Emotional
Support
Components
H O L I S T I C P A T I E N T S U P P O R T
Providing for a patient’s physical and emotional needs
INTEG RATED
HEADWALL / FO O TWALL
CO MPO NENTRY

70. S A R A H M A R K O V I T Z ,
A I A
Principal
1 B e a c o n S t
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Healthcare Architect / Planner
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THANK YOU FOR YOUR INSIGHTS
Let’s Continue the Dialog!
C O N T A C T I N F O R M A T I O N :