About This Site



This website is intended for community health centers and other safety-net clinics planning upgrades to their facilities. The site was developed by The Center for Health Design (CHD), with financial support from The California HealthCare Foundation (CHCF).




Resources Available Through this Site


The literature review has been published in the Health Environments Research and Design (HERD) Journal. Read the abstract, or subscribe to the HERD Journal to read the full report. Additionally, The California HealthCare Foundation has published a related Issue Brief.


A growing body of research shows that the physical environment of healthcare facilities affects patients, staff, and families by impacting patient safety and quality of care. The intent of this review was to examine how healthcare facility design and various physical aspects of ambulatory care environments can positively or negatively impact patient experiences. While significant effort was devoted to identifying empirically derived references, additional resources such as unpublished research reports by respected researchers and other non-peer reviewed articles, reports and studies were included if found relevant. The main findings relate physical environment features to increased or decreased positive outcomes in three main categories: patient outcomes (e.g. anxiety), staff outcomes (e.g. productivity), and operational outcomes (e.g. workflow). Physical environment features identified in the literature include spatial relationships, visual and acoustic privacy, physical attractiveness, ambient experience, and information in the environment.


This list highlights best-practice facilities that serve as examples to those involved in designing new or renovated facilities. Thee facilities were selected by The Center for Health Design in conjunction with an independent advisory group, as part of the initial grant from the California HealthCare Foundation to understand community clinic design. The physical environment features and community attributes of safety-net facilities throughout the United States were examined through on-site visits and/or telephone-interviews with the primary care clinics’ CEOs, clinic managers, facility managers, and board members. The facilities vary in size, services offered, and the type of setting in which they occur (rural, suburban, or urban).


You can now add your clinic the list! In order to submit your clinic, you must first create a free account with The Center for Health Design. After you create your account, you can submit your clinic information online. The content will be reviewed before being posted live to the website.


The design strategies found within this website are supported by evidence identified within the literature review and in best-practice clinic examples. This website contains recommendations for those undertaking complete clinic redesign, renovation, or moderate changes to the existing environment. When considering a clinic redesign, renovation, or improvement to the physical space, the patient experience—what a patient goes through from the moment they access a community clinic to the time they exit the building or clinic parking lot—should always be taken into consideration during the design process. When looking at ways to improve the patient experience, there are certain design changes that are more appropriate than others, depending on which aspects of the patient experience are being examined.



Community clinics across the United States share their lessons learned and which design strategies they recommend.



About the California HealthCare Foundation


The California HealthCare Foundation works as a catalyst to fulfill the promise of better health care for all Californians. We support ideas and innovations that improve quality, increase efficiency, and lower the costs of care.


To help accomplish its goals, the Foundation focuses its effort in three program areas:


  • Improving clinical outcomes and quality of life for Californians with chronic disease. Nearly half of all Americans live with a chronic medical condition and this number is expected to rise by 25% during the next two decades. In California, individuals with multiple chronic conditions — 20% of the population — account for 60% of the state's health care expenditures.
  • Reducing barriers to efficient, affordable health care for the underserved. The cost of health care has put insurance coverage beyond the reach of many working Californians while the safety-net institutions that care for much of the state's underserved populations are under financial and organizational strain as they try to care for an increasing number of individuals. 
  • Promoting greater transparency and accountability in California's health care system. Public information about cost and quality is essential to improving health care for Californians. Objective data can help providers, policymakers, employers, insurers, patients, and consumers make better-informed decisions about the issues that matter to them. 
  • Supporting the implementation of health reform and advancing the effectiveness of California's public coverage programs. The passage of the federal Affordable Care Act creates an extraordinary opportunity to provide health coverage to millions of Californians. Its success will depend on how the law is implemented by the states. This initiative focuses on elements of health reform that have the greatest potential to affect California.

For more information, visit: www.CHCF.org



About The Center for Health Design


Founded in 1993, the Center for Health Design (CHD) is a nonprofit organization that engages and supports professionals and organizations in the healthcare, construction, and design industry to improve the quality of healthcare facilities and create new environments for healthy aging. CHD’s mission is to transform healthcare environments for a healthier, safer world through design research, education, and advocacy.


For more information, visit http://healthdesign.org



About the Community Clinic Voice

The Clinic Design website has partnered with the Community Clinic Voice to connect the primary care clinic and health center community with the facilities focus of the Clinic Design website.


The Community Clinic Voice is a free, online gathering place for clinic professionals and safety net partners to network, share information and exchange ideas to build stronger and healthier communities. The Voice connects a wide range of safety net professionals with daily news updates, a library of peer-review tools and resources, discussion forums, designated areas for private group projects, and more. There is no cost to join or use the Voice.



Project Advisory Group

The California HealthCare Foundation and The Center for Health Design would like to thank the following individuals who donated their time and talents to provide invaluable oversight and direction during this project.


  • Anita Addison, MCP, MPH, Planning Director at La Clinica de La Raza
  • Cindy Barr, Project Consultant at Capital Link
  • Franklin Becker, PhD, Professor and Chair, Dept. of Design & Environmental Analysis, College of Human Ecology at Cornell University
  • Gowri Betrabet Gulwadi, PhD, Assistant Professor of Interior Design at the University of Iowa
  • Peter Coughlan, Partner at IDEO
  • Sara Frankfurth, Program Officer at Kaiser Permanente
  • Ronda Kotelchuck, Executive Director for Primary Care Development Corporation
  • Nancy Lager, Director, Project Planning at Primary Care Development Corporation
  • Andra Lichtenstein, Principal at Capital Incubator
  • Nicola Majchrazak, Project Manager at Massachusetts General Hospital
  • Larry Mallak, Professor and Co-Director, EMRL at Western Michigan University
  • Zara Marselian, CEO and founder of La Maestra Family Clinic
  • Maria Montanaro, CEO at Thundermist Health Center
  • Doug Moore, Facilities Manager at Clinica Sierra Vista
  • Regina Neal, Director of Performance Improvement Programs at the Primary Care Development Corporation
  • David O’Neill, J.D., MPH Senior Program Officer at the California HealthCare Foundation
  • Melissa Schoen, MBA,, MPH, Senior Program Officer at the California HealthCare Foundation
  • Stuart Stoller, LEED AP, Architect at SPGA Architecture and Planning
  • Richard Veloz, CEO of South Central Family Health Center
  • Craig Zimring, PhD, Professor of Architecture at Georgia Institute of Technology