Critical Access Hospitals – Efficiency, Flexibility, and Connection are Keys to Success


dsgw_RyanTurner2 By Ryan Turner, DSGW Architects, Healthcare Design

Every year, rural emergency and trauma facilities save thousands of American lives. Design for these Critical Access Hospitals is, for me—one of the most rewarding parts of working in DSGW’s Healthcare Architecture group.

In the late 1990s, the Centers for Medicare and Medicaid Services created the Critical Access Hospital (CAH) designation to sustain small and remote hospitals. Yet, even with relatively small supplemental funding, CAHs face enormous financial pressures and ongoing changes in government mandates and funding policies.

As architects, we can’t shape the enormous complexity of the Affordable Care Act or Medicare and Medicaid. But we can design CAH facilities that maximize efficiency, help control costs, and provide quality care when time matters most. We can help to keep these lifesaving rural centers effective and viable.

I am particularly proud of three areas of Critical Access Hospital design that we continue to explore at DSGW. They are:

  • Design for Staffing Efficiency
  • Flexible Emergency Departments
  • Integrated Helipads and Access

1. Design for Staffing Efficiency

dsgw nurse station diagram

In CAHs around the country, the staff often plays multiple roles—and facilities must be designed for minimal staffing—especially in off-hours. Often times, one person needs to be stationed at a unified care team area that is close to and visually connected with several operational areas including: a single entry point, hospital in-patient rooms, and the treatment rooms in ER.

2. Flexible Emergency Departments

dsgw cooks hospital er
Cook Hospital, Cook Minnesota – Emergency Department. Designed for staff-efficiency and flexible response, a single team member can observe the single entry and the entire ER to triage patients to the appropriate position.

Many CAHs lack the volume to sustain separate Emergency Rooms and Urgent Care Centers that serve less threatening conditions. We design CAHs with flexible ERs that can also treat a range of conditions including minor injuries and illnesses.

The “friendly face” at the center or the unified care team area greets, triages and directs patients to the appropriate position, based on their condition. We design flexible modern emergency departments incorporating fast track chairs in settings that are more like an exam room than a trauma bay.

3. The Power of Connection: Access, Information and Integrated Helipads

dsgw vrmc roof helipad
Helipad at Virginia Regional Medical Center, now Essestia Health in Virginia, Minnesota

As rural healthcare’s first point of contact, Critical Access Hospitals focus on stabilization and then discharge or transfer. For us, it’s all about connection. We design CAH facilities for quick access and, if needed, links to larger systems of expertise and care.

Working with our clients, we site new facilities at strategic locations on key roads and intersections easily reached from all directions.

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