Today, many healthcare organizations are challenged to envision how their investment in facility can keep pace with the ever-changing healthcare market place. Strategic planning efforts typically look to a three- to five-year horizon, while master facility planning often takes on a 10-year planning cycle. This mismatch can become even more challenging for hospitals and health systems given the recent COVID-19 challenges and the pace of changes in many markets across the US.
The shift to the outpatient care setting (including the booming trend of ASCs) for many surgical procedures, the intensifying inpatient technologic changes across multiple specialties, the incorporation of physician practices across the full continuum of care spectrum, and the growing focus on the patient and family as healthcare consumers are just a few of the changes that must be considered.
As Corazon works with our clients across the country, we often facilitate discussion related to strategic planning across the niche services of cardiovascular, neuroscience, and orthopedic care, along with the associated facility needs of an organization. When discussing facility requirements, our team often challenges key stakeholders to put on “vision goggles” to imagine what the facility would look like if they could build from the ground up. Although most organizations do not have the luxury of a full “re-do,” this exercise often allows planning participants to think outside the box and challenge existing constraints.
The following represents Corazon’s top tips and best advice related to building facilities for the future:
• Planning starts with strategy, but the devil is in the details. The planning process should start with a solid strategic plan. It requires intense communication between service line leadership—both physicians and administrators. Then facility design, equipment purchase, and process re-engineering must be coordinated to assure that the organization is building for the future.
• Design space with end point of new workflow in mind. New facilities cannot fix bad or broken processes. The intent is not to transpose current processes to new space, but rather challenge front-line caregivers to envision a best practice care model that takes into consideration multiple perspectives across the care delivery continuum.
• Build for the future with flexible space. It is always important to consider future technology and a plan for the next “chess move”… whether that be migration to a hybrid OR or the addition of the “next” cath lab. Opportunities continue to arise that allow for dual-use space, which saves time and money in the planning and implementation phases, and leads to more efficient use of resources, supplies, and equipment once up and running.
• Carefully scrutinize the setting of care from a business and clinical perspective. The shift to outpatient care and ASCs has the potential for tremendous impact on the overall bed needs of an organization. Likewise, organizations must evaluate future site-neutral payments, along with opportunities to partner with physicians for joint venture ASCs. All parties need to work together to craft a sound business and clinical strategy, especially since any significant shift of cases to OP or ASC will result in the need to backfill the time and space of an empty in-hospital lab.
• Focus on transformative service offerings as a must-have aspect of the facility of the future. One transformative service that has moved to the forefront is telemedicine. Corazon believes that telemedicine is poised to be the infrastructure that extends advanced care deeper into many communities, and will continue to impact care at many hospitals, even as I viable strategy in post- pandemic times.
• Consider all patient entry points to the healthcare system to eliminate barriers to access. Evaluation of the “top of the funnel” for each service can be accomplished by considering important entry points such as the emergency room and diagnostic testing areas. Careful scrutiny about patient flow across the continuum from the entry point through discharge is an important driver that captures patients as loyal patients of the hospital.
• Make tough decisions about whether to renovate or replace. Organizations are often challenged to prioritize capital resource expenditures across competing patient care needs and service lines, especially for a significant project such as a facility renovation or rebuild. When considering these decisions, questions related to new construction vs. facility modernization must be considered so that the financial and other resources aren’t in short supply from the start.
• Consider Electronic Health Record (EHR) implications early in the building process. Considerations for efficient processes for registration and EHR integration across the whole care continuum are essential to acute care delivery, ambulatory services, and the physician practice setting. Consumers and caregivers should benefit from the power of new integrated information technology (IT), and not be burdened by duplicative and time consuming processes.
• Create a patient and family advisory council to assure focus on the patient experience. Today’s healthcare consumer has many choices and their perspective can influence an organization’s ability to capture and keep patients and families engaged in their system of care. Creating an official forum to incorporate end-user feedback is essential to an effective facility design.
For many cardiac, neuroscience, and orthopedic centers, new facilities can create a competitive advantage with a new ‘front door’ presence, cutting-edge technology or techniques, and better reputation from an improved patient experience. All these components and more will convey a ‘top-notch brand of healthcare’ to the community… Facility additions and upgrades can likewise showcase a ‘Center of Excellence’ concept that negates the need to travel outside the community for care.
For a more complete review of the topic, see Building Facilities for the Future: TIPS from The Service Line Experts as seen in Healthcare Business Today October 2018.