Decision makers in healthcare companies are spending more time than usual crunching numbers and making projections … and some are shrugging their shoulders. Like every major U.S. industry, they are trying to figure out how to do business in this unpredictable economy.

Although healthcare is traditionally one of its strongest segments (the sick will always be with us), people’s needs, behavior patterns, and priorities have shifted in response to the downturn. And this is all giving rise to new trends. Among the trend watchers are SSOE’s healthcare experts. They are helping clients take advantage of the slowdown’s effect on facilities’ projects.

“Where is the silver lining?” you ask. Lower revenues, tight money, and risk aversion call for rethinking your strategies, but “there’s an upside,” suggests Matthew Kennedy an SSOE healthcare planning expert. “This is the perfect time to focus on your development strategy and careful project planning. Without the sense of urgency to break ground or start filling beds, you have the time to examine a broad range of options related to facilities projects.”

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Essential Services in a Smaller Footprint

People who live far out in the country accept the inconvenience of long trips to a shopping mall or long rides on a school bus in exchange for the benefits of a rural lifestyle. But more than sixty years ago, the government decided that having to make too long of a trip to the hospital was an inequity that needed to be resolved. It committed federal dollars to the construction and improvement of hospitals in underserved areas. Then in 1997, as part of the Balanced Budget Act, Congress authorized the creation of critical access hospitals (CAH) to support the concept of small rural hospitals.

To make it financially feasible for CAHs to offer essential services despite low patient volumes, these facilities receive more generous reimbursements from Medicare and Medicaid than typical hospitals. To qualify, a CAH must meet these specific criteria:

• Provide inpatient care, emergency care, laboratory services, and radiology
• Have a maximum of 25 beds
• Be at least 35 miles from another hospital or be certified as a necessary provider
• Have a 96-hour average length of stay
• Contract with at least one physician
• Have an agreement with a network hospital for quality assurance, patient referral, credentialing, and more

Despite the reimbursements, decisions related to space, staff, and services must be driven by cost efficiency if a CAH is to be fiscally viable.

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If you think of interior design of medical facilities as picking out homey furnishings and a friendly color spectrum, it’s time for a short, friendly tutorial. In reality, designing healthcare environments is a complex discipline that draws on biology, chemistry, patient-outcomes research, psychology, physiology … and the list continues. SSOE’s interior designers explained how this varied knowledge comes into play in the day-to-day work of specifying healthcare facilities.

Saying No To “Nosocomial” Infection

Materials and finishes are among hospitals’ arsenal of weapons to prevent nosocomial (hospital-acquired) infections and to establish sterile areas. In the majority of today’s hospitals, seamless floors and countertops, anti-bacterial carpets and upholstery fabrics are standard, which explains the prevalence of solid surface counters and work surfaces and the popularity of carpet tile or vinyl backed carpeting. Although rubber is low on glamour, it is a popular option for hard floors since it is both naturally anti-bacterial and durable. And even if it sounds like something from a sci-fi novel, there are fabrics that kill bacteria on contact and reduce them to dust.

Manufacturers continue to broaden their product lines to include more anti-bacterial options that are aesthetically pleasing. As an example, ceiling tiles now come with an anti-bacterial finish.

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“Evidence-based design” of hospitals has been credited with laudable improvements in patient care: faster recovery, reduced medication errors, improved staff safety and lower stress levels for everyone. The proponents of this design approach aren’t radicals. They are architects whose design reflects scientific research that proves certain environmental characteristics can create impressive results.

In the last decade, leading researchers proposed the idea that hospital design decisions should be based on documented results. From that point forward, rather than make assumptions about how to design a better functioning hospital, the
profession took the position, “We need to prove it.”

Most of us have first-hand knowledge of the annoying aspects of hospitals—the disruptive noises, harsh lighting, stark décor, uncomfortable furniture, lack of privacy and more. And the staff can cite many design features that make it difficult to deliver the best medical treatment. Thanks to the ongoing compilation and quantification of hundreds of studies on the affects of certain environmental factors, architects know much more about how to improve outcomes.

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