Facility Design in the Nuka System of Care

Southcentral Foundation’s core principles of customer-ownership and relationship-based care are reflected in all elements of the organization, such as our integrated care teams and our approach to improvement, both of which have been discussed on this blog previously. However, SCF’s core principles drive other areas of our care delivery that might not be as immediately obvious. One such area is facility design.

SCF has recognized that each individual has more control over their own health than the health care system does, and one key determinant of health (as well as success in other areas of life) is self-confidence. Self-confidence draws from pride, honor, dignity and respect. SCF’s facilities are designed to be beautiful and to reflect Alaska Native culture, with spaces for the display of Alaska Native art. Our facility design is a key piece of improving Alaska Native pride, honor, dignity and self-confidence.

SCF’s facility design also promotes focus on relationships, not only with customer-owners, but also between employees. Prior to the construction of our current facilities, providers had private offices, and physicians sat with physicians, nurses sat with nurses, etc. Managers also had private offices, and these were often separated from the employees they were responsible for.

In the newer facilities, SCF radically changed office spaces to promote relationships between employees. Primary care providers now sit together in open workspaces with nurse case managers, certified medical assistants, case management support and other care workers. This open environment fosters collaboration among team members. SCF has also de-officed managers and supervisors, and they sit together in open areas with the people they supervise. Communication is made much easier in these types of environments.

SCF has also added talking rooms to clinic spaces as part of facility design. These are “de-medicalized” rooms where care workers can talk with customer-owners in a setting that feels less clinical than the rest of the primary care facility. SCF’s integrated behavioral health consultants make use of these spaces as well, as needed.

SCF’s facilities are an example of how the core principles of an organization can translate into physical space, and how facility design can help providers and customer-owners work together toward wellness. An example of another organization influenced by this philosophy is Cherokee Indian Hospital. For more information on how they accomplished this, read Healthcare Design’s article, “Natural Beauty: Cherokee Indian Hospital.”