Research studies over the past several decades have indicated the possible harmful effects on healthcare workers from low-level work-related exposure to any of more than 200 medications that are considered hazardous drugs. As a result, the United States Pharmacopeia (USP) — a nonprofit compendium of drug information — published the nation’s first standards on the handling of hazardous drugs from receipt to disposal. Chapter 800, titled “Hazardous Drugs — Handling in Healthcare Settings,” applies to all healthcare personnel who handle hazardous drug preparations and all entities that store, prepare, transport, or administer hazardous drugs, such as pharmacies, hospitals, clinics, and physician offices. Hazardous drugs include those used for cancer chemotherapy, antiviral drugs, hormones, and some bioengineered drugs. Most existing pharmacies will need to modify their workflow, space, and infrastructure to comply with USP 800 when it becomes effective on December 1, 2019.
Any healthcare organization would be delighted to have a private donor fund a building project. Sometimes, however, the donor has no interest in the organization’s long-range capital investment strategy but wants to construct a building or fund a program that is not even on its radar screen. Most institutions are not in a position to reject such donations, and it is a rare administrator who has the backbone to turn down money rather than compromise the organization’s long-range facility master plan.
Physician offices and outpatient clinics typically consists of a patient intake area with space for reception, check-in/check-out, and waiting; exam/treatment space with a number of identical exam rooms, several office/consultation rooms, and one or more special procedure rooms; and associated clinical and administrative support space. Physician office space may be located in a medical office building (either freestanding or connected to a hospital), co-located with diagnostic and treatment services in a comprehensive ambulatory care center, or part of an institute or center organized along a specific service line — such as a Sports Medicine Center, Heart Center, or Cancer Center. Planning space for physician offices (also referred to as physician practice space) and outpatient clinics begins with determining how many exam rooms are needed and two different approaches are commonly used.
Frequent misunderstandings arise when hospital leaders, department staff, planners, and architects confuse net square feet with gross square feet (or net square meters and gross square meters). It is particularly disturbing when facility planners and architects do not specify the exact type of space in their documents.
Sometimes a preliminary space estimate is needed to evaluate location alternatives, conduct a feasibility study, or develop a preliminary cost estimate for construction or renovation. Once the number of operating rooms (ORs) is determined, an estimate of the total footprint required for the surgical suite can be made using the rules-of-thumb in this post.
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.