“We had to blow it up,” House said of the existing plan. Ambulatory and urgent-care facilities were moved to the top of the priority list and hospital-site improvements were moved down. Pardee is built for 220 beds but is now staffed for roughly 150, House said while speaking in Chicago last week at the annual Healthcare Facilities Symposium and Expo sponsored by Trumbull, Conn.-based J.D. Events.
Pardee turned to Los Angeles-based real estate consultant CBRE for advice. CBRE conducted a block-by-by block analysis of where Pardee's patients were coming from.
“We took a retail approach to this,” said Curtis Skolnick, a CBRE managing director based in Richmond, Va. Skolnick explained how, in analyzing where to put new ambulatory facilities, the firm looked at data such as area demographics and housing starts, just as a Home Depot or Starbucks would do in calculating market viability for new locations.
Ultimately, people are not going to drive more than 10 or 15 minutes for emergency, urgent or primary care, Skolnick said. House acknowledged that this was a new way of thinking for the Pardee board. “It was like we were building a candy shop and asked, 'Where are the people who like chocolate?'” he said.
The key for adopting this new mindset, Skolnick said, is for healthcare organizations to get out of their “hospital-centric comfort zones.”
While Pardee may have accomplished this, House said they now face another problem: Figuring out what to do with recently acquired physician offices “that aren't necessarily where we would put them.”
Strategic consolidation of some of these offices is one way architects and designers can help health systems save money, said Daniel Willis, healthcare manager with ECG Management Consultants. Along with a reduction in individual leases, systems can save money with centralized core functions plus shared physician support staff and resources.
While much focus has been placed on attracting patients with attractive architectural designs that promote a healing environment, research was presented by the American Society of Interior Designers that said design can spell increased revenues. But such gains are small when compared to the impact design can have on reducing costs by finding ways to reduce falls, infection and other complications that lead to longer lengths of stay or readmissions.
Reducing infections and increasing patient satisfaction has driven hospitals to do away with “semi-private” two-patient rooms. But William Heun, a partner with Chicago-based Matthei & Colin Associates architects, said merely converting former semi-private facilities to one-patient rooms is not a simple task.
Today's hospital beds are so much larger than the beds of 20 years ago that merely plunking a new bed in an old room may violate space standards or lead to a cramped room and dissatisfaction among staff, patients and their families.
“Despite the cost, the journey to all private rooms is worth it,” said Victoria Navarro, a planning and design manager for Downers Grove, Ill.-based Advocate Health Care. “Healthcare reform is changing the way hospital rooms are designed.”