As the number of specialty hospitals in the U.S. continues to increase, the debate over the merit of these facilities rages on. The issues surrounding specialty hospitals are as complex as the myriad motivations for building them.
In 2004, Inova Health System opened its own heart hospital, the Inova Heart and Vascular Institute, on the campus of Inova Fairfax Hospital. This 156-bed "hospital within a hospital" is dedicated to the innovative delivery of cardiac care. Inova not only built the hospital, but also, working with physician leadership, implemented a system of cardiovascular care across the other five hospitals within the Inova Health System.
Inova Fairfax Hospital, located in Falls Church, Va., is an 820-bed, regional tertiary-care center. It is one of six hospitals in the not-for-profit Inova Health System. In 1999, with the continued unprecedented growth in Northern Virginia, Inova Fairfax Hospital clearly needed to expand.
A decision was made to take a creative approach to this opportunity and build a facility adjacent to the main hospital that would be dedicated to cardiac care. Cardiac care was, and remains, one of the hospital's leading service lines. The result is the Inova Heart and Vascular Institute. Today this facility offers a full spectrum of diagnostic and interventional cardiac services.
The hospital-within-a-hospital concept allowed us to break down the traditional silos of care in the hospital and create a facility committed to providing the highest quality comprehensive cardiac care. Building the heart facility on the campus of the main hospital allowed us to create a niche facility focused solely on cardiac care while retaining the connection to a full-service hospital able to meet the overall healthcare needs of any patient.
Construction of a dedicated heart hospital allowed nurses and physicians a unique opportunity to design a facility for optimal cardiac care. Efficiencies result from having all services under one roof, facilitating the right care in the right place at the right time.
The opening of the Inova Heart and Vascular Institute forced us to look at Inova's entire cardiac service line. As a result, we have developed an integrated network of cardiac care among Inova's six hospitals.
The Inova Heart and Vascular Institute provides one-stop shopping in a facility that offers easy access to care for patients, visitors and physicians.
Building this heart hospital gave us a rare opportunity to explore various options of physician and hospital integration and partnership. We continue to attract the best and brightest physicians who desire to be part of the Inova Heart and Vascular Institute.
The challenges facing our heart hospital are no different from those faced by other specialty hospitals. Careful analysis and understanding of the complex issues are imperative to success.
Management needs to be realistic about the amount of capital required to build, sustain and operate this type of facility. The larger footprint adds operating cost. Managing expectations and budgeting for disruption are key.
In consolidating all Inova Fairfax Hospital cardiac patients within the heart hospital, it was imperative to devote the vacated space to programs that would bring in additional volume. Otherwise, the result would be lower margins as the same volume is spread over a larger footprint.
A dedicated team with more than 100 work plans managed the transition. In many ways, opening a new hospital would have been easier than moving the existing service and team into a new building.
The risk inherent in making a 30-year investment in one clinical area is significant. The question of where cardiac care will be in five years, let alone 30, remains unanswered as technological advances may reduce the need for certain procedures and surgeries. The need for flexibility and alternative strategies for the long term is crucial.
In the case where the specialty hospital is connected to a full-service hospital, managers and leaders must successfully balance its operation with the integration into a larger campus.
In themselves, niche hospitals are not unique--a specialty hospital is merely bricks and mortar. The overriding goal is to develop a delivery system that uses new space wisely to focus on optimal quality, service and cost-effective care. This requires hard, collaborative work between administrators and physicians.
As healthcare providers, we need to constantly be on the lookout for innovative ways to meet patient needs while staying competitive. Service line management and specialty facilities, if done well, can provide a better patient experience, improve quality, efficiency and physician integration, and give a distinct identity and brand to the program.
Douglas Cropper is administrator of Inova Fairfax Hospital, Inova Fairfax Hospital for Children and the Inova Heart and Vascular Institute, and executive vice president of Inova Health System, Falls Church, Va.
* Be realistic about the amount of capital required to build, sustain and operate a facility.
* Leave room in the budget for disruptions and the unexpected.
* Explore various options of physician and hospital integration and partnership-a good relationship will help your facility attract high-quality professionals.