Current Issues in Healthcare Facility Planning

Hospitals and healthcare systems have spent much of the last two years balancing being in a state of emergency readiness while waiting for the next COVID-19 wave and safely delivering routine health services. Many of the challenges that existed before — a shrinking workforce, an aging infrastructure, and narrow operating margins — have worsened during the pandemic. At the onset of the global pandemic, faced with rising COVID admissions, many hospitals canceled elective procedures and redeployed patient care space in new ways to meet the rising demand for beds and new infection control measures. At the same time, U.S. adults delayed or avoided medical care due to their coronavirus-related concerns causing non-COVID admissions to plummet. Starting the third year of the global pandemic, staffing shortages due to burnout are at an all-time high as hospitals still struggle with COVID-19 admissions while treating higher-acuity patients. Concurrently, hospitals and health systems face increasing costs for labor, drugs, personal protective equipment (PPE), and other medical supplies needed to care for higher acuity patients. According to the American Hospital Association, America’s hospitals are experiencing unprecedented financial losses — a net income loss of $54 billion is projected for 2021 that is expected to continue into 2022, according to the American Hospital Association. As a result, healthcare organizations are rethinking their capital investments while existing facilities are being retooled, expanded, and underutilized simultaneously. In this post, you can read about some of the current issues in healthcare facility planning — fluctuating utilization and forecasting challenges, shortage of nurses, new safety protocols, rapid growth in telemedicine, advances in telecommunications technology, and integration of imaging into most medical specialties.

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Rethinking Parking Lots and Structures

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 as possible to the their designated entrance. Because easy and convenient access is a prime indicator of hospital customer satisfaction, U.S. hospitals are rethinking the expansive asphalt parking lot and dreary concrete parking structure. Innovations in design, technology, and financing, along with careful planning, can mitigate shortages and improve customer convenience. Now with a global pandemic, parking lots and structures are also being called into action as part of an organization’s emergency response strategy.

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Private Donors Continue to be a Challenge

CheckbookAny 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.

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Physician Turf Wars Complicate Facility Planning

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.

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Reverse Migration of Outpatient Services to the Hospital Campus (An Update)

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.

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The Hospital Pharmacy — Now a Sophisticated Manufacturing Plant

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.

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