The term flexibility has become somewhat overused today. It is repeated as a mantra among healthcare planners and design architects. By definition it means “adaptable” or “adjustable to change.” In reality, achieving flexibility often requires that physicians and department managers and staff relinquish absolute control over their space and equipment for the greater good of the organization. However, with fluctuating workloads, rapidly changing technology, staff shortages and high turnover, and limited access to capital in today’s dynamic healthcare environment, planning flexible space is no longer an option.
Most outpatient pharmacies that are located within a hospital or in an ambulatory care center (on or off-campus) fall into one of four categories ― minimal, small, medium, or large. Assuming that outpatient demand has been established based on the availability and convenience of similar services and potential competition from commercial pharmacies, the primary determinant of an outpatient pharmacy’s size is the average number of daily prescriptions (scripts) that will be filled during the busiest eight-hour shift. This generally determines the numbers and sizes of rooms or areas and overall space.
Prudent Health System planned to construct a new outpatient building on its main hospital campus to provide space for urgent care, ambulatory surgery, and various hospital-sponsored clinics. The organization needed space to accommodate the following ten-year workload projections and corresponding clinical services:
- Urgent care center with 32,000 annual visits
- Ambulatory surgery center with 4,200 annual surgical cases
- Hospital-sponsored clinics: medicine (23,000 annual visits), surgery (15,000 annual visits), neurosciences (6,000 annual visits), orthopedics (16,000 annual visits)
In addition, Prudent Health planned a small express testing area to consolidate routine, quick-turnaround outpatient testing in a single area—including X-ray, electrocardiogram, and specimen collection — along with a small satellite laboratory.
Oncology services focus on cancer detection and the care of patients with cancer and include physician office or clinic visits, chemotherapy treatments, radiation therapy, and a variety of patient support services. Two major facility components include the radiation oncology suite and the medical oncology/chemotherapy infusion area which may be co-located or in separate areas or facilities.
Planning a surgery suite used to be fairly simple. General operating rooms were used for a wide range of procedures with dedicated operating rooms limited to cardiac surgery and orthopedics. Today, the question “How many operating rooms are needed?” is complicated by more stringent distinctions between operating rooms and procedure rooms, changing technology and increasing specialization, and the convergence of diagnostic imaging and surgical procedures. From a facility planning perspective, the number, size, and specialization of the operating rooms (ORs) is the single biggest factor contributing to the overall footprint of the surgery suite (and project cost). Moreover, the numbers and sizes of related patient care and support spaces are planned based on the number and types of ORs. And, from an operational standpoint, the number of ORs drives ongoing staffing and related operational costs.
For several decades, healthcare organizations have been developing Centers of Excellence to better compete for market share, research dollars, philanthropy, and scarce subspecialists. Promoting a specific program within the healthcare organization’s broader portfolio of services helps to attract the critical mass and resources required to make it successful. Centers of Excellence are commonly developed for cardiac care, cancer treatment, neurosciences, orthopedics, pediatrics, and women’s health, although various other clinical programs and specialties may also be candidates. Historically, these centers were envisioned as freestanding facilities with the name prominently displayed on the building’s facade. Before high-speed internet and intranet connections, this concept was promoted to improve collaboration and communication among the healthcare providers as well as to provide one-stop-shopping for the customer.