MODERN HEALTHCARE deserves praise for illuminating the issues of how healthcare boards and executives can best invest finite resources to achieve long-term strategic goals (Construction & Design Survey, March 13, p. 35).
To see where we're going by reflecting on where we've been, we looked at survey data going back to 1992. We found some interesting trends:
* Increasing investment in various services reflects both demographic design trends-e.g., adult independent living and assisted living-as well as changes in care delivery models, ambulatory care, new imaging technologies, physical therapy/sports medicine and laboratory services.
* More traditional project delivery methods have been augmented by new approaches, including program management and design/build, which are providing an increasing amount of space.
* The per-square-foot cost of renovation is closely approximating that for new construction.
Issues that bear further review include whether healthcare has turned over too much decisionmaking to third-party developers and whether it's prudent to spend major dollars on renovation rather than building new facilities if the costs are the same.
Edwin Parkhurst Jr.
Prism Consulting Services
Glen Ellyn, Ill.