In the era of rapidly changing health care regulations, increased mergers and ever-growing patient demand, hospitals and health systems are restructuring facilities to provide more effective patient-centered care. They are not only focusing on enhancing operational efficiencies and coordinating care across the continuum, but also implementing patient-centered solutions to stand out in a highly competitive health care environment.

At the American Hospital Association Leadership Summit in San Diego in July, a group of hospital and health system executives gathered to discuss how they are implementing innovations in infrastructure to enhance patient care and satisfaction, support quality and safety, and eliminate unnecessary costs. The discussion was moderated by Crystal Vasquez, director, solution innovation, AHA Health Forum, and sponsored by United Technologies, a leading provider of high-technology systems and services to the building industry, including the health care sector.

As highlighted by the executive discussion panelists, here are three considerations driving how hospitals and health systems build, repurpose, update and locate facilities to support patient-centered care:

1. Be flexible to meet the community’s changing needs

Ronald Beer, chief administrative officer for Danville, Pa.-based Geisinger Northeast Region, said, “Right now, my market needs more inpatient beds. Do we invest in retrofitting, adapting an older facility or building a new tower to accommodate them? And then we have to retrofit or build in a way where we can reallocate that space for other uses when the inpatient market starts to decline.”

Richard “Chip” Davis, president of Sibley Memorial Hospital in Washington, D.C., agreed. “You have to look for where there’s a need within your population for any service you’re looking to add, as well as whether it can be a competitive differentiator. And you need to look at how buildings could be used in the future.” As an example, his organization moved inpatient beds from a facility built in 1961 to its new tower, and converted the older facility into an ambulatory hospital “because we’ve grown out of our ambulatory space.”

2. Satisfy patient and consumer expectations

Patients’ expectations of how care is delivered has changed. Davis explained that patients expect a more efficient, value-based care delivery model, making it important to shift care on an as-needed basis from acute-care settings to lower-cost settings. Furthermore, “They no longer want to drive a distance to the medical center and wait an hour and 45 minutes to see a very busy doc,” he said. Distributing facilities geographically in a “hub and spoke” model — such as by moving outpatient services (like ambulatory surgery centers) out of the hospital and into the community — makes care more convenient for patients.

Patient convenience also drives hospitals’ retail strategy. Saint Luke’s South Hospital in Overland Park, Kan., places nurse-practitioner-staffed clinics within area grocery stores. “An average store has up to 40,000 shoppers every week. It’s a lot of visibility for us, but it’s also a lot of convenience for our patients,” said Saint Luke’s President and CEO Bobby Olm-Shipman. Geisinger offers low-acuity medical clinics that either stand alone or are embedded in primary care sites or local retail chain stores. “The model is similar to CVS or Walgreens clinics, but we’re not competing with them; we just happened to be first to market there,” said Beer.

Several panelists noted that they seek input from patients and families on the design of hospital spaces to ensure patient satisfaction and encourage loyalty. “When building new facilities, in addition to engaging patients in interviews, we’ve created full-sized room mockups for them to consider,” said Stephanie Beever, executive vice president and system chief strategy officer for Urbana, Ill.-based Carle Foundation. “And we discovered that patients waiting with their families in our digestive health outpatient space wanted a comfortable, family room experience, so we put in a fireplace. We’ve also built lots of family space into our new patient rooms; without visiting hours, families like to stay and hang out.” Beer mentioned that patients also wanted conveniences such as access to USB ports for their devices, and so he included ports in bedside lamps.

3. Implement innovative technology

The technology needed to maintain and remotely manage current, and potentially aging, infrastructure, or to update acquired facilities, can be costly. When building new facilities, however, opportunities often exist to invest in technology that will reduce operating costs. “If you’re thoughtful, you can achieve efficiencies at a lower cost. As one of the 50 greenest hospitals in the country, we made investments that weren’t expensive: green roofs, recycled rain water, and employee gardens instead of shrubbery,” said Davis. Geisinger is building an $18 million central utility plant that will “provide incredible return on investment, with $1.5 million going to the bottom line every year,” said Beer.

Some hospitals are responding to staff and patient demand by installing electric car charging stations. Others, like Carle Foundation, are still struggling to provide staff and visitors with robust mobile phone access due to inconsistent service among providers. Rajan Goel, senior vice president of United Technologies’ Building Solutions Group, said his company is constructing an intelligent building where employees’ mobile phones will act as a personalized access and control mechanism — allowing them to access appropriate areas and control lighting and temperature in some of their work spaces.

For help in making investment and maintenance decisions, hospitals are relying on data analytics. Some hospitals are using data to drive purchasing behavior. “Data coming out of our power plants drives our utility purchases,” said Carle Foundation’s Beever. Other hospitals are mining data to demonstrate cost savings and using the information as a tool to request funding for other capital investments. A consortium of health care engineers in Saint Luke’s area shares data that demonstrates savings, thereby helping them and their peers to obtain capital for projects. Last, actionable data is a powerful tool that hospitals are using to more economically maintain equipment and manage assets. Geisinger uses data to predict equipment end of life before it spends too much on maintenance.

Hospitals must also leverage innovative technologies to enhance security for both people and property. As hospitals face the consequences of the opioid epidemic and increasing gun violence, they are investing in technology — some visible, some hidden — to heighten patient and staff security throughout their facilities, including emergency departments and supply rooms. “It’s a travesty to walk into a hospital and see a uniformed guard. Passive security components — controlled access, lighting, security cameras and monitors — are the better way to do it,” Beer explained.

What the hospital of the future looks like depends on the needs of each hospital or health system’s local community. Some hospitals are redesigning interior spaces with innovative technologies to enhance the patient experience. Others are integrating disparate, acquired facilities with building systems that increase operational efficiency. No matter what the future holds, hospitals are already actively considering and implementing building solutions that not only help to reduce the costs of health care, but also improve the delivery of patient care.

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