Mergers and consolidations will fuel increased levels of new construction in the coming year. But many providers, lacking resources to build, will delay major projects until there is a better understanding of how healthcare reform will affect delivery of care.
Stronger hospitals will accelerate capital spending, particularly in light of the attractive bond financing market, to accommodate projected utilization increases and to serve new networks and physician-hospital organizations. They'll remodel existing facilities and construct outpatient facilities, primary-care clinics and other projects designed to consolidate and streamline services.
Other projects will be put on hold to avoid unnecessary duplication of services in the community, and proposals will face intensified economic feasibility and value analyses.
A "wait-and-see" attitude is likely to dominate the overall construction industry for 1994, with smaller (less than $5 million) renovations and expansions the most likely to increase. Strategic planning efforts are expected to intensify as adjustments in programs and services occur.
According to a survey conducted in June by Westmont, Ill.-based Tribrook Management Consultants, 59% of hospital respondents are planning expansions or renovations, while another 27% are planning a new or off-site facility. More than 37% have broken ground on projects, and more than 25% already have completed construction projects. Only about 13% had no plans for new construction.
At many facilities, design teams comprising top hospital executives, designers, architects and construction managers already are working together to develop improved models of healthcare design and cost-effective methods of construction.
With continuing technological advances and the pressures of reform, hospitals must become sensitive to convenience and image, as well as the need to comply with requirements for persons with disabilities and certification mandates from the Joint Commission on Accreditation of Healthcare Organizations.