It's more than just bed counts

An architect and hospital executive worked together on a 265-bed hospital. Thirty years later, they did the same, only the facility opening in December 2010 was almost 80% larger than the one that had opened in the fall of 1980.

When comparing hospital size, “if you're counting by beds, you're counting the wrong thing,” said William Heun, an architect and partner with Chicago-based Matthei & Colin Associates, explaining that bed counts no longer offer a valid comparison.

Heun and Neal McKelvey, a consultant and “semi-retired hospital executive,” worked together on the 285,000-square-foot Mercy Hospital in Davenport, Iowa, and the 510,000-square-foot Meritus Medical Center in Hagerstown, Md., and they compared the two projects in a program called “Why Are Hospitals Getting Bigger” which closed the 25th annual Healthcare Facilities Symposium and Expo on Thursday in Chicago. The symposium is run by JD Events, Trumbull, Conn.

Heun noted how there are now entire service lines and administrative departments that didn't exist 30 years ago, and McKelvey said these include “outcome management” staff and others who get their own private office, storage space and department conference rooms.

“Facility folks have to find room for them,” McKelvey said, adding that in-house education and training have also been increased and space is needed for “ongoing competency and skills enhancement” facilities.

Heun listed several other differences, including how Meritus (which originally opened under the name “Washington County Hospital”) has four cardio catheterization suites and shell space for one more while Mercy had none when it opened.

In order to meet requirements included in the Americans with Disabilities Act, patient rooms and bathrooms got bigger and, in order to meet energy conservation goals, exterior walls were made three inches thicker, Heun said. All these add to a new hospital's total space needs and total cost.

In addition, factors to promote environmental sustainability and accommodate patient families have all been incorporated into facility design. He noted how some patients can be accompanied by “three generations of guests—who don't leave until the patient leaves.”

Designers and hospitals administrators must do what they can to accommodate them, he said.