Patient Voices Shape New UHealth at Doral Facility: Inside the Patient-Centered Design Process

As construction workers hammered away at the University of Miami Health System’s new 160,000-square foot facility in Downtown Doral, Fla., Stuart Rosenberg put on his hard hat and safety vest and rode the construction elevator up to the fifth floor to inspect the work. 

Unfinished slabs of drywall framed what would become the room where cancer patients receive their treatments. Designers had built temporary desks and cabinets to visualize where everything would go. Rosenberg carefully analyzed the setup, trying to balance the needs of medical professionals with the comfort of patients.

But Rosenberg doesn’t work for UHealth. He’s not a builder or a facility designer. He’s not a doctor or a nurse. Rosenberg is a retired accountant and tech entrepreneur whose only previous experience with UHealth was as a patient.

But now he’s part of a growing group of volunteer patient advisors UHealth is turning to in order to make impactful choices at its facilities that will have a lasting impression on patients and families.

At first, Rosenberg was hesitant about giving his two cents to doctors, architects, facilities managers, and other experts.

“I was thinking, ‘Who am I to walk in and say all this? These people are health care professionals,’" said Stuart Rosenberg. "But the people were very welcoming and open, saying, ‘How can we do this better? What do you guys think?’”

That kind of feedback is exactly what leaders at UHealth envisioned when they launched the Patient and Family Advisory Councils, or PFACs. They’re part of a movement known as Patient- and Family-Centered Care (PFCC) that originated in pediatric hospitals and grew to include adult and elderly health care facilities.

“Families got together and said, ‘We need to do things differently because we’re part of the team,’” said Catherine Hanson, Director of Patient Engagement for UHealth. 

How PFACs Make a Difference

The goal of the movement is to involve patients at every step of the design process of a UHealth medical facility from the layout of an X-ray room to the bathrooms.

PFAC members help site administrators tweak things to make life a little easier for their patients and caregivers by taking the approach from the patient point of view.

At UHealth’s recently-opened Palmetto Bay facility, suggestions from PFAC members led designers to lower the height of counters at the front desk so the check-in process isn’t so intimidating, especially for children since this facility offers pediatric services. At UHealth at Doral, which is scheduled to open in the fall of 2024, PFAC members recommended that wastepaper bins and electrical outlets be placed closer to patients’ infusion chairs and that family members be provided enough space to sit by their loved ones undergoing treatment. And at UHealth at Sole Mia, which is scheduled to open in 2025, designers changed the flooring after PFAC members pointed out that the proposed material could be too slippery for elderly patients and those using crutches. 

PFAC members have asked UHealth designers to add benches in long hallways to give struggling patients a place to catch their breath and to add more counter space in bathrooms for patients to place their urine samples.

PFAC members have even tested dozens of chairs to find just the right ones for people undergoing different procedures and relatives sitting by their side.

Once a change is accepted, the project team incorporates it into all new projects and tries to expand it to existing facilities as well. “It becomes the UHealth standard,” said Grace Litano, a Senior Manager in UHealth’s Project Management Office. 

How Does the PFCC Program Work?

 UHealth’s PFCC program, which is a division of the Office of Patient Experience, has two components. The core of the program are the PFACs – a group of 50 current and former patients or family members who participate in person or virtually. The members must go through an onboarding process that includes a criminal background check, health screening, and training regarding HIPAA and patient confidentially. The program also includes an e-advisor program made up of over 3,600 current patients who participate by responding to questionnaires or surveys regarding operations or new initiatives.

Members of the Facilities PFAC tour sites under construction while other groups focus on other aspects of UHealth such as communications, oncology, and caregivers.

At first, Anthony Diaz was skeptical of PFACs. The Director of Business Operations for UHealth logged into a virtual meeting in 2022 to discuss the construction of UHealth’s new clinic on Miami Beach and was shocked when someone introduced several members of the PFAC.

“I was caught off guard. I wondered why patients were there,” he said. “I thought, ‘Is this really the appropriate setting?’”

But Diaz said he came around quickly after realizing they weren’t there to second-guess any decisions, but simply to provide the consumer’s perspective. Diaz’s role was to ensure that each facility had all the medical equipment it needed, adhered to building codes, and met all federal, state, local, and medical regulations. So he appreciated it when PFAC members suggested the need for baby-changing tables in the bathrooms.

“Those are the things we sometimes miss because we’re looking at the big picture,” Diaz said.

“They bring a perspective we don’t see. They’ve made recommendations about the positioning of furniture and amenities in waiting areas and where our administrative offices should be located within the facility. Having them in these meetings and as part of the decisions we make, for me, it’s critical,” said Anthony Diaz, Director of Business Operations at UHealth.

Litano has also embraced the PFACs and sees that they represent far more than a feel-good marketing effort. At its core, the University of Miami Health System is a research institution, but UHealth is also a health care system that needs to compete in a crowded region of hospital networks. By improving the patient experience and making it uniform across all UHealth facilities, Litano said they can convince those patients to keep coming back – and refer their family and friends.

The Power of Patient Voices

Jackie Gonzalez, a former Chief Nursing Officer for the Nicklaus Children's Health System, understands the importance of combining patient satisfaction and revenue generation. And as a survivor of pancreatic cancer, Gonzalez also understands the unique and essential perspective of a patient.

After retiring, Gonzalez was recruited to join the UHealth PFCC program, including the Facilities PFAC, because she had been treated in UHealth facilities. She had driven and believed in the need for patient- and family-centric health care during her time at Nicklaus and has long felt that every health care facility should adopt the same practices.

“Anything that touches a patient, it should be a core (business) principle that there’s some review by those who are most affected,” Jackie Gonzalez said.

Some health care networks boast about their commitment to patients, but Gonzalez says she hopes more hospital leaders understand the true value of PFACs and support them as the national standard.

“In our community, sometimes people say it, but they don’t really know what that means,” she said. “You can say you have it, but you have to walk it – and you know it when you feel its essence in the healing process.”

Are you a patient interested in participating in PFCC? Send an email to PFCCAdvisors@med.miami.edu.

Alan Gomez is a contributor for the University of Miami Health System.

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