Hospital mergers and acquisitions continue to increase at a rapid rate with precedent-setting deals occurring in 2018. Given that this a primary business strategy for a majority of healthcare organizations, this trend is expected to continue into 2019 and beyond. One of the many challenges that newly merged healthcare systems face is eliminating redundant services and surplus capacity. Realigning services and reallocating resources among multiple campuses requires a unique strategic, operations improvement, and facility planning process. The planning team needs to understand the market and patient population, look at alternate ways of allocating resources, and evaluate the impact on operational costs, before recommending investments in bricks and mortar. This article looks at opportunities for improving efficiency and eliminating surplus capacity, separating major issues from less important issues, and other key considerations.
Existing space in hospitals is a valuable resource that historically has been overlooked as organizations focus on renovating and expanding their physical plants. With fluctuating workloads, rapidly changing technology, staff turnover, and limited access to capital in today’s dynamic healthcare environment, hospital leaders are increasingly looking for ways to better use what they already have. They are also committed to building flexible space when they do renovate or start from scratch.
Often unknown to the general public, physicians in the U.S. continuously struggle to defend and expand their increasingly overlapping empires. Hospitals, freestanding healthcare centers, and other venues are their battlegrounds and facility planners are often in the crossfire. As medical technology continues to evolve ― and reimbursement diminishes ― the traditional boundary lines separating specialties have become blurred and facility planning can be contentious.
When it comes to parking, hospitals seem to never have enough. At the same time, customers ― whether patients, staff, or visitors ― always want to park as close to the their designated entrance as possible. Innovations in design, technology, and financing, along with careful planning, can mitigate shortages and improve customer convenience. Because easy and convenient access is a prime indicator of hospital customer satisfaction, more U.S. hospitals are rethinking the expansive asphalt parking lot and dreary concrete parking structure.
Many medical services are provided both in hospital and community settings, such as physician offices and freestanding imaging or ambulatory surgical centers (ASCs). Services commonly provided in both settings include laboratory tests, physical therapy, outpatient surgery, routine and advanced imaging, physician visits, and noninvasive and invasive procedures, such as endoscopy or cardiac catheterization. When the Centers for Medicare & Medicaid Services (CMS) originally developed the hospital outpatient department (HOPD) designation to establish a higher reimbursement rate for hospital-based outpatient services, hospitals started purchasing physician practices, freestanding imaging centers, and ambulatory surgery centers and rebranding them as hospital outpatient departments to collect the higher Medicare payments. Now CMS is considering site-neutral payments which may result in another 180 degree shift from an on-campus to an off-campus location.
Automation — with the barcode as the foundation — has transformed the hospital pharmacy into a high-tech manufacturing plant that allows pharmacists to focus on direct patient care. Although automation in the pharmacy requires a significant capital investment, it reduces labor costs, lowers the risk of dispensing errors, optimizes inventory control, and provides better security, among other benefits.