In the traditional healthcare facility, multiple departments and staff were involved in patient reception, admitting and registration, scheduling, cashiering, insurance verification, and billing, resulting in fragmented customer service and complicated wayfinding. Although many of these departments are located on the first floor of the facility — along with various patient and visitor amenities — only a few staff in each department needed face-to-face interaction with visitors, patients, and their families. The question is: How can a healthcare organization better utilize both its staff and space to potentially enhance operational efficiency and improve customer service?
Current Trends
Read about current trends in utilization, medical practice, care delivery, and regulations and their facility impact.
Generic Administrative Office Suites Provide Efficient Space Utilization
The traditional healthcare facility has many departments involved in the administration and management of the organization in accordance with policies established by the governing board. Most of these administrative services use generic office space with a mix of private offices, open or partially-enclosed cubicles, and open workstations to accommodate different hierarchies of staff dictated by the organizational structure and peak-shift staffing. Patient traffic to these areas is rare. As many of these departments are being forced to resize their staff in response to cost containment pressures and changing skill requirements, vacant offices and workstations are often scattered throughout the organization. At times, growing departments may need to pack multiple people into a single office, while shrinking departments have surplus space. Many departments also have dedicated conference rooms which, although infrequently used, are not available for use by other hospital staff due to an inaccessible location.
Space for administrative staff ― not involved in day-to-day patient care ― is increasingly being centralized into generic administrative office suites with a central reception area, groups of conference rooms, shared office equipment, and flexible workstations. This configuration provides the most efficient space utilization and ensures that space is equitably allocated and distributed among the departments and services that need it at any given time. The intent is to assign offices and workstations according to the immediate need allowing for the flexibility to reassign the space on a periodic basis as demand changes and staffing levels fluctuate. This prevents staff from becoming overly territorial about their space. With more sophisticated information systems, space can still be charged to department or cost center budgets based on use. Conference rooms and classrooms can be scheduled centrally based on daily demand thus ensuring optimal utilization.
The abrupt closure of many offices and workplaces during the global pandemic in the spring of 2020 ushered in a new era of remote work for millions of employed Americans ─ including hospital administrative staff. Video conferencing also replaced face-to-face meetings to allow social distancing, and these trends are predicted to outlast the current emergency health crisis. This will likely impact the amount and configuration of administrative office space and the need for conference rooms and large meeting spaces in the future.
This article is an update of a previous post.
Pharmacists Embrace Expanding Medical Role
After years of adding everything from beauty products to snack foods, pharmacies have a new revenue source. Pharmacists are being asked ― and paid by insurance companies ― to monitor their customer’s health. That could include counseling them on chronic diseases, making sure they are taking their medications, and screening for everything from diabetes to high cholesterol. Although pharmacists have been doing more than dispensing pills over the past decade, this is the first time many have been able to offer such a wide range of medical services. This is due to changes in the way that pharmacists are educated along with legislative changes that have cleared the way for an expanded role.
The Death of the Hospital Autopsy
Autopsies ― sometimes called the ultimate medical audit ― were an integral part of American healthcare a half-century ago and were performed on roughly half of all patients who died in hospitals. Up until 1971, the Joint Commission required that community hospitals perform autopsies on 20 percent of inpatient deaths, increasing to 25 percent for teaching facilities, as part of earning accreditation. Although hospitals are still required to develop criteria for autopsies, and should “attempt to secure autopsies in all case of unusual death” and in cases of “medical, legal, educational interest,” it is rare today when a hospital has an autopsy rate of more than 5% for nonforensic deaths according to data from the Centers for Disease Control and Prevention. Some pathology experts say it is usually only about 1%.
Rethinking the Intensive Care Unit
Many hospitals feel that they never have enough intensive care beds and are constantly pressured to expand existing units or create new units. Historically, intensive care units (ICUs) have provided intensive observation and treatment of patients in unstable condition. Because of the high-tech requirements and highly skilled staff, these units are expensive to build and operate. Insufficient intensive care beds also affects the ED, as high-acuity patients waiting to be admitted backup in the ED when the ICUs are full.
Vascular Centers Are Addressing an Unmet Demand
Historically, hospitals have focused on growing their cardiology programs and services that treat atherosclerosis, or hardening of the arteries, and other heart conditions. However, it is becoming increasingly evident that programs to address systemic vascular disease ― cerebrovascular, carotid, aortic, and peripheral vascular are needed to address a growing and unmet need. The National Institutes of Health (NIH) reports that non-coronary vascular stenosis and arterial breakdown is a prevalent disease in the United States. Up to 12 million people are estimated to have peripheral arterial disease (PAD) compared to the same number (12 to 13 million) with coronary artery disease (CAD). With the emphases on CAD as a serious health problem in the U.S., vascular disease is more often under-diagnosed and as a result is frequently under-treated.