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” at the 2023 Healthcare Design Conference + Expo, held in early November in New Orleans.

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

“Health systems are generally built around driving throughput and efficiency,” Lyons said. “Additionally, many health organizations that serve communities of color are often federally funded and have specific requirements and associated limitations to how care can be delivered and by whom.”

Community-led design process

To help illustrate their point, the 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 move closer to displaced community members.

Key to delivering the project and creating a clinic that met the specific community’s needs was developing a trusting relationship among the provider, residents, and the project team.

“The mission of the OBCC is to provide quality care with dignity to those in need, regardless of ability to pay,” Lyons said. “OBCC has always been a part of the community and has always valued the partnership within the community and families. The clinic was specifically created to serve the Black community within Seattle’s Central District neighborhood and to 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 out of a connection to solving specific problems,” Lyons said. “They are the experts about what the challenges and barriers are and what needs are priorities for their community.”

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

Community clinic design features

Opened 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 light rail, it has ample and free parking,” Lyons said.

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

“[The] artwork is created by native indigenous artists to honor and reflect the history of the place and their role in the community,” Yates said. (For more on OBCC Othello artwork, read “Using Artwork To Alleviate Patient Anxiety.”)

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

An open work space for providers in the front of house portion of the clinic (called the Town Square) allows patients and families to connect and see their care provider in real time when they come in for an appointment. Additionally, the OBCC Othello clinic provides a recreation center and community kitchen that helps support groups and community-based learning to address key health challenges.

“There are different models of delivering care that make sense for different communities,” Yates said. “Take risks and challenge assumptions and be okay with some unknowns. A good trusting relationship between the client, 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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