Are Healthcare Facilities Ready for Change?

Glenn Grube
How can healthcare executives and managers ensure their facilities are ready to accommodate clinical program changes and institutional growth?

Despite uncertainty surrounding healthcare reform, most hospitals, healthcare systems and long term care providers can be sure that their facilities must adapt, improve and grow, to cost-effectively compete for patients while providing high-quality care. In this changing economic and regulatory environment, with limited capital resources, it’s vital to plan and prepare facilities to accommodate change.

Healthcare facilities are among the most technically and logistically complex of building types, with dense mechanical, electrical and IT systems, and stringent performance requirements. They house a diversity of functions, including diagnosis and treatment, inpatient care and outpatient services, with each facility involving high cost and complexity. Future-proofing is a major consideration. Alongside changing modes of patient care, healthcare facilities face changing roles in supporting delivery of care. Adaptable design concepts are needed, allowing reconfiguration and expansion, with minimal disruption to ongoing services and providing payback across the life of the investment. When assessing versatility and adaptability, typical considerations include:

  • What else can our facilities do?
  • Can our buildings be repurposed? Reused? Rebuilt?
  • Can our 80-year-old iconic facility be renewed or adapted for efficient, appropriate use?
  • Can our outdated inpatient facilities be converted to ambulatory services or administrative uses?

Building repurposing may work well, where building components and systems can be updated to current standards of performance, and the quality of interior space allows conversion or reassignment of the building use.

Healthcare facilities are among the most technically and logistically complex of building types, with dense mechanical, electrical and IT systems, and stringent performance requirements.

A detailed understanding of the facility portfolio is needed to determine its future suitability. Faithful+Gould’s Strategic Facility Consulting (SFC) service provides accurate, up-to-date information on buildings and systems, to aid strategic decision making and long-term planning. Our assessment, analysis and prioritized recommendations support investment strategies coordinated with lifecycle capital plans. Our SFC service utilizes Facility Condition Assessment (FCA), a powerful knowledge gathering tool, to collect data from all aspects of an institution’s built environment.

Ideally this includes:

  • Physical structure of the buildings and their components
  • Elevators
  • Infrastructure and MEP systems
  • Utilities condition, capacity, location and reliability
  • Resiliency/disaster readiness
  • ADA accessibility
  • Energy conservation and sustainability
  • Space efficiency, quality and flexibility
  • Image – quality, identity, history and reputation

FCA generates a large volume of data, which must be translated into an accessible form for decision making and action. Organization and analysis of the data allows us to define individual projects by scope of work and system, and to estimate capital costs. Projects can then be assembled into a prioritized program by quantifying risk based on the observed conditions and the potential impact on patient care.

Budgetary challenges reinforce the need for accurate cost information. Changing healthcare delivery and payment systems, combined with diversion of funding to profitable clinical programs, typically limit capital. The prioritization of capital projects through risk analysis of the FCA data ensures that resources are aimed at the highest areas of need. Our expertise in cost estimating and cost control allows accurate cash flow forecasting for increased efficiency in capital spending.

Budgetary challenges reinforce the need for accurate cost information. Changing healthcare delivery and payment systems, combined with diversion of funding to profitable clinical programs, typically limit capital.

FCA also supports flexible master planning that is responsive to future technological, demographic and economic changes. For an existing hospital portfolio, not all facilities will survive the assessment and planning process where conditions indicate the end of life. FCA’s predictive function allows for timely decisions on building retirement and replacement. This avoids the continued investment of capital to support buildings that have reached the end of their useful life. Faithful+Gould understands the complex and changing nature of healthcare facilities, providing services that ensure timely and cost effective execution of facilities projects. Our expertise in facilities consulting and project management allows our healthcare clients to fulfill their mission to deliver the best in patient care.

Our recent healthcare experience includes New York Presbyterian Hospital where we provided strategic facility assessment services, and Lawrence Hospital, New York, where we are currently providing owner’s representative services on a new oncology center.

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