Construction Report: Four trends in healthcare facility design in the wake of healthcare reform

February 2014
BY Andrew Quirk Senior Vice President and National Director, Skanska’s Healthcare Center of Excellence

For the construction industry, healthcare reform is starting to have a positive effect on business. As providers continue to question and reevaluate their spaces, taking into account the aging population and actual patient and family demand, there has been an increase in request for proposals, including in larger projects that are more than $100 million.

Below are some common themes that have been working for facilities in Houston and across the United States in this new patient-focused model of care. Many of these trends and shifts are gradual, but they illustrate how healthcare facility owners are approaching new projects strategically with an emphasis on the patient in order to increase efficiency and impact revenue. By offering more convenient, modern delivery models and location options, as well as reevaluating space and location of employees and care providers, healthcare facilities are implementing construction projects that enable a more efficient, productive, revenue-producing environment that benefits provider and patient equally.

There has been a monumental shift to create environments that are designed and constructed to provide highly patientfocused care, and therefore new care models, such as Patient Centered Medical Homes (PCMH). PCMH implementation, which has accelerated as a result of healthcare reform, is improving operational efficiencies. For example, one element of a PCMH is shared space for doctors. Shared space enables patients to have all their health needs evaluated in one place. With this model, gone are the days when a patient would have to wait to have a procedure, then a reading, and then a prescription – all in different departments and various locations. Now that entire process takes place at one location, in one day. This model leads to less time per procedure, which adds to overall productivity, profit and most importantly, patient satisfaction. Local providers including Texas Children’s Pediatrics and Memorial Hermann Healthcare System are utilizing the PCMH model.

To accommodate the patient and the aging population, hospitals are breaking into smaller communities in two ways and for two main reasons – to establish market share and provide improved convenience. One common strategy for breaking into a market is constructing a new freestanding emergency (ED) department. Typically, a new ED is part of a healthcare facility’s longterm expansion plan to enter into a specific market in order to provide the regional, suburban consumer with a closer facility that is easier for them to access.

Hospitals are also exploring new alternative space options, such as vacant office space and big box retail space. Office spaces typically feature entryways that are similar in design as those of a hospital; therefore, the space is easily repurposed and does not require much upfront investment.

Vacant space previously occupied by big box retailers are often very well established – people are intimately familiar with these venues, and they are traditionally located in highly populated areas next to frequently used highways. In addition, these locations are optimally designed to create a onestop- shop for healthcare as they are often surrounded by other retailers who present value to a provider’s employees, patients and their families, and other visitors. These spaces typically have many parking options, as well.

There is growing demand to maximize every square foot of space in a hospital to ensure each square foot is profitable. As a result, healthcare providers have begun to borrow methods from other industries to decrease wait time and increase productivity. For example, hospitals have begun integrating kiosks, which are common means of checkin at airports. At Texas Children’s Hospital’s West Campus, kiosks throughout the facility can be used by parents to update patient information, check in for an appointment, or to make a co-payment.

Also, as technology improves, space can be reevaluated. Segments of facilities that used to house medical records are being vacated and repurposed as data centers as electronic medical records become more common.

Overall, these trends show that hospitals are starting to consider every single element as a piece to the revenue producing puzzle. To maximize operational cost, they must prioritize decision-making by reevaluating their use of space, employees, and human capital. At Skanska, we often encourage our clients to question each and every square foot of space when thinking about increasing productivity and influencing revenue stream.

As these trends suggest, in the time since healthcare reform began to take shape, healthcare facilities have begun to move forward in pursuing better solutions for patients while becoming leaner in operations with confidence, rather than uncertainty.