NEW YORK, March 4, 2013 /PRNewswire/ -- Questions linger about how major changes to Medicare, such as the passage of the Patient Protection and Affordable Healthcare Act (PPACA), will impact the U.S. healthcare system and, in turn, hospital design. A core tenet of PPACA is accountable care, a topic whose goals will be greatly impacted and ultimately defined by healthcare design. The McGraw-Hill Research Foundation ( http://mcgraw-hillresearchfoundation.org) and HOK, a global design, architecture, engineering, and planning firm, unveiled a new policy paper examining the impact of healthcare design on accountable care goals. "Accountable Design for Accountable Care" examines healthcare in the United States and the context for PPACA, illustrates how healthcare design impacts accountable care aims, and investigates immediate actions that can be taken to integrate design research into improving healthcare facility design and patient care. "Under PPACA, the Centers for Medicare & Medicaid Services will shift emphasis from quantity of services to quality of services," said the policy paper's lead author, Nicholas Watkins Ph.D., HOK's director of research and a firm-wide knowledge specialist. "'Accountable Design for Accountable Care' focuses on the potential to improve quality by focusing on the intersection between process and place." The paper illustrates healthcare design's impact on the goals of accountable care through case studies from design research of hospital inpatient units. Unit configurations and layouts are examined, taking into account such variables as staff travel distances, visibility/communication, and proximities/room distance. The report also discusses innovations including decentralized nursing stations and family-centered care, which works alliances among patients, clinicians, and family members. The paper recommends two immediate actions that can be taken. First, occupancy evaluations can be performed before and after users move into a new or renovated facility, so that results from the pre-occupancy evaluation can be compared to results from the post-occupancy evaluation, thereby determining improvements or decrements, their ranges and causes. Second, the paper determines that the industry needs incentives and requirements for credible design research during building project delivery, such as the program currently in development by the Environmental Design Research Association.