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.
Current Trends
Read about current trends in utilization, medical practice, care delivery, and regulations and their facility impact.
Hospital Emergency Departments Are Focusing on Seniors
Many hospital emergency departments (EDs) have specialty areas for children. Now some are developing separate areas for seniors with geriatric team-based care, more comfort, and less noise and confusion. The focus of the specialized team is to not just treat the immediate problem, but to uncover underlying problems ― from depression to dementia to a hazard-prone home environment. Seniors already account for more than million ED visits a year and by 2030, 20 percent of all Americans will be 65 or older. Older adults have different needs which are often at odds with modern EDs that are best equipped to handle crises like gunshot wounds or car crashes. Geriatric patients often need lengthy detective work to unravel the multiple ailments that they tend to show up with and may exhibit different symptoms than younger people. Their illnesses may cause confusion that can be mistaken for dementia. At the same time, cognitive problems may not be obvious when these patients are describing their symptoms or the onset of their medical problem. Seniors also have a high rate of recurrent visits to the ED.
Demand for Pain Management Centers is Increasing
Whether episodic or chronic, pain is the most common reason patients visit doctors and hospitals. Because of this, pain represents a growing market for healthcare organizations. According to an Institute of Medicine report, pain costs the U.S. over a half a trillion dollars each year in medical treatment and lost productivity. As a result, hospitals are creating pain management centers that use a variety of procedures and therapies and are staffed by multidisciplinary teams including anesthesiologists, interventional radiologists, and acupuncture practitioners.
Transforming Primary Care With the Patient-Centered Medical Home Model
The patient-centered medical home (PCMH) model ― also referred to as advanced primary care and the healthcare home ― holds promise as a way to improve American healthcare by transforming how primary care is organized and delivered. This team-based model of care is led by a personal physician who ideally provides continuous and coordinated care throughout the patient’s lifetime to maximize health outcomes. The PCMH practice is responsible for all of a patient’s healthcare needs or appropriately arranging care with other qualified professionals. This includes the provision of preventative services, treatment of acute and chronic illness, and assistance with end-of-life issues.
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.
The Functionally Obsolete Hospital
Hospital buildings and wings have a tendency to become functionally obsolete for specific services before they become physically obsolete — often resulting in inefficient space utilization, high labor costs, and staff and patient dissatisfaction. The cost of renovation may exceed the cost of new construction and may even take longer if multiple construction phases are required to maintain existing operations. However, this depends on the services to be accommodated, the age and general characteristics of the space, building codes, replacement alternatives, and the reuse potential of the vacated space.