E74 – Designing for Resilience: Reimagining the Emergency Department for Patients and Caregivers
Emergency departments are the front door of healthcare and often the first point of contact for patients navigating crisis, vulnerability, and uncertainty. Providence Portland Medical Center undertook a nine-phase renovation and vertical expansion of its two-story emergency department (ED) to address growing patient volumes, behavioral health needs, and staffing burnout and retention challenges—while remaining fully operational 24/7.
The project was grounded in a deep understanding of the ED’s most complex “super users,” including non-English speaking patients; individuals experiencing housing or food insecurity; transgender and immigrant communities; refugees; people with disabilities; the uninsured; elderly patients; and clinical professionals. Prioritizing safety, dignity, and trust shaped every design decision. A hardened second-floor expansion enables extended stays for behavioral health patients, while reconfigured workflows keep patients moving continuously through care, supporting caregiver resilience. Design strategies intentionally respond to the cultural and demographic context of East Portland, advancing equity and accessibility for the community it serves.
Delivered within an existing facility, the project required close collaboration among hospital leadership, designers, contractors, and procurement constraints, and system integration. The expansion demonstrates how a super-user–driven, phased approach can improve patient experience, support staff retention, and create resilient emergency departments that perform better for all users.
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