Perhaps no other industry has undergone as many recent fundamental changes as health care. Matched with advances in medical science and technology, are changes in the design, composition, and location of buildings. Historically, medical services were delivered either in hospitals or doctor’s offices.
Now there is an array of building types – specialty group practices, community-based ambulatory care clinics, large research centers, small specialty hospitals, and even shopping mall locations and mobile units. And increasingly, large health systems own and operate these networks that reach across counties and states.
What has triggered this geographic dispersion of facilities?
David Zuza, a former hospital administrator who now is on SSOE’s strategic master facility planning team, explains, “Cost is a major factor. More services are being delivered in outpatient facilities because they are less expensive than a hospital.” Also, health care has become more and more competitive which creates a premium on patient convenience and comfort. Zuza continues, “The point of care needs to be closer to the marketplace. Given the choice, people are more likely to seek services in attractive, comfortable environments that are close by. And that often equates to ‘new buildings.’”
Large health care institutions that want to grow and prosper have to make careful, intelligent decisions about which services they should offer and where they should be located. This is the goal of a strategic master facility plan.
The document is based on information from planners, architects and engineers as well as administrators, nurses, ancillary services, and facilities staff at the hospital. The plan should consider trends in medicine and patient care, the demographics of current and potential patient populations, the condition of current buildings, and cost projections for new construction and renovations.
These are some issues that a typical plan addresses:
How many beds and surgery rooms will be needed in five years and ten years?
Should older hospitals be demolished or renovated?
Where will the areas of population growth be in five years and ten years?
What kind of services is a given population likely to need? For example, younger households will need more birthing centers and pediatric care.
Which service lines offer the best opportunities for reimbursement?
How will technology and government mandates impact future reimbursements?
Who will be competing for a given set of patients?
Are there new services that need to be considered?
How should new facilities be built for expansion and flexibility?
What new technologies are on the horizon and how will they affect facility needs?
Smaller health care systems also have much to gain from strategic master facility planning even though the scope may be smaller.
Regardless of size, hospitals have distinct requirements for patient care. There is increasing interest in patient-centered concepts which have important implications for how facilities are designed because more space is needed to accommodate family members and private rooms. “A strategic focus allows the hospital to design facilities that match its strategic objectives regarding patient care delivery,” Zuza explains.
Smaller institutions often rely on outside consultants to formulate their strategic master facility plans because they do not have that expertise on staff. On the other hand, large health systems that have their own planners will often bring in an outside consultant to gain a fresh, unbiased perspective. SSOE assists both types of health care clients with strategic master facility planning.
We believe that having a former hospital administrator on the team who understands the business side of health care is boon to the planning effort. We involve our architects, electrical, mechanical, and civil engineers as integral parts of the planning team. The proactive thinking that goes into developing a plan energizes the institution’s vision and leads to adoption of common goals.