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    Misc

    The Future of Hospital Facilities

    April 17th, 2007

    by Tony Chen

    Now I may be a little biased (I've met 2 of the 3 authors of this article and really respect/like them), but this article in Healthcare Design Magazine is simply the most compelling article I've read on the future of hospital facilities.

    A few key take-aways for me:

    - We all already know that outpatient care will grow much faster than inpatient care. Certain outpatient services will grow REALLY fast. PET/CT volume will increase 120% in 10 years! A ton of surgical procedures as well as oncology will grow dramatically.

    - The 2-day hospital stay will become a mainstay. 2-day discharges will almost triple in 10 years. Should hospitals set up staffing / flow / dedicated units solely for the 2-day patient?

    - Healthcare is notoriously complex and extraordinarily interlinked. Nonetheless, some services are completely unrelated. Thus, care facilities must be strategically decentralized and strategically adjacent. This is a gross oversimplication, but it's like the advice you hear about your desk & productivity. Use it everyday? Keep it within arms length. Use it monthly? Put it in a file. Use the same group of things together once a month? Put it all in a box in your drawer.

    - Hospitals are typically set up by service lines. Since most service lines are dominated by inpatient care, outpatient care / strategy never gets enough attention. At best, outpatient care developments are uncoordinated. Why not put someone in charge of all OP services for all service lines (like this hospital)?

    - Too many hospitals are designing their facilities with growth-limiting oversight and don't even know it. When I read this article, I couldn't help but think about Blokus (the only board game I play now - it's a game about fighting for space). Like many strategy games, every decision you make to put down a piece limits you and/or opens doors for future expansion.

    - This article would make my wife really happy. She's been "an inspiration" for me to plan better.

    - As they say, begin with the end in mind. The end is made much more clear in this article through all the data, so definitely read up!

    Combine this strategic facilities intelligence with the Planetree philosophy, and you start getting at the ideal hospital of the future.

    Comments, Pingbacks:

    Comment from: JAM [Visitor] · http://healthcare20.blogspot.com/index.html
    Great post (I also enjoyed the very interesting description of Healthcare 2.0 of your previous post)

    My take on hospital design:

    1) Structure follows strategy (or at least it should). Design thinking should ideally come after a deep reflection on what the hospital should be in the future. Perhaps this is too obvious but too frequently this thought is ignored and inertia (doing things as they always were done) prevails.
    2) Two big problems with hospitals are their lack of focus (the generalist hospital is still the dominant form) and the inadequate coordination with outpatient activities. We need more focused delivery models.
    3) The hospital of the future will probably not be "a place" but rather a collection of inpatient and outpatient facilities interconnected through a shared IT infrastructure and culture.

    That said, I do also believe that new thinking in hospital design is much needed.
    Permalink 04/17/07 @ 16:02
    Comment from: hospitaltony [Member]
    would definitely agree with your assessment.

    I think so much energy is poured into getting the hospital construction project approved, that many of these longer-term issues are often neglected.

    your "place" comment hits the spot for me - say goodbye to the "centralized place" - the hospital really becomes a system of hubs and spokes sprinkled strategically across a broader geography
    Permalink 04/17/07 @ 21:04
    Comment from: Adam [Visitor] · http://www.characterplanet.com
    Whatever the case is healthcare certainly is broken..I went to the ER the other day because my brother hurt his back...5 hours later we finally start to diagnose the problem...nothing serious but still it's ridiculous.
    Permalink 04/20/08 @ 01:17
    Comment from: Jeff [Visitor]
    I don't agree jeff
    Permalink 04/20/08 @ 01:24
    Comment from: Jerri [Vistor] [Visitor]
    Did you know that we pay a facility usage fee to seek medical attention. Walk through the door and you have to pay.
    Permalink 07/01/08 @ 10:02
    Comment from: Andrew Needleman [Visitor] · http://www.claricode.com
    Thanks for pointing out the article in Healthcare Design Magazine with its list of potential facility improvements.

    My hope for the future is that remote monitoring will be able to increase the quality of care and reduce the need for new hospital facilities. Then, we can focus our resources on keeping people healthy rather than building buildings.
    Permalink 01/24/09 @ 23:09
    Comment from: Dr. Rajat Dhameja [Visitor] · http://www.linkedin.com/in/rajatdhameja
    The ALOS @ 2 day seems not too distant in the future. As provision of care is becoming more focused through focused delivery models (cardiac, oncology, radiology, etc) centers) with seamless integration of IT infrastructure, patient flow management will be at its best.

    In addition to PET/CT, it is also projected that angiography/angioplasty procedures will dramatically rise given the anticipated increase in coronary episodes.

    Permalink 02/25/09 @ 16:54
    Comment from: Michael [Visitor]
    When it comes to long term planning, many businesses fail on this. One major reason is because many CEO's just don't care what will happen in 10 years from now, since they only care about short term gains. This has always been a problem when it comes to running a business (or hospital in this case) and thinking about long term gains.
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    Permalink 06/17/09 @ 16:20
    Comment from: rocky [Visitor]
    My hope for the future is that remote monitoring will be able to increase the quality of care and reduce the need for new hospital facilities. Then, we can focus our resources on keeping people healthy rather than building buildings
    Permalink 07/03/09 @ 00:20
    Comment from: medical assistant work junky [Visitor] · http://www.alliedtech.org/category/medical-assistant/
    Ya i can see how businesses tend to do this, but after all we are human, we tend to go after whichever carrot is hanging in front of our heads today. It seems far more difficult to set or even visualize that long term goal. For something like that on ereally needs to have a vision of the future of the company and even more importantly the discipline to see it through.
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    Comment from: Kevin [Visitor] · http://www.picktorrent.com
    It's a very interesting approach! I agree that care facilities must be strategically decentralized and strategically adjacent.But here is how I see it. Outpatient services is one core, inpatient is another. I think there will be time when we'll return to the system where there will be one place with almost all outpatient facilities. Then health care will take much less time and you won't have to pay whenever you open every door.
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    In the current context of reform and the RAC the successful hospitals will transform themselves into the matriarchs of the medical home. What this means is primary to hospice care that is comprehensive, coordinated and evidence based. By the way, a 2 day stay is within the Observation status window for a medical drg - can you run a hospital on those dollars?
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