By Patricia Shpilberg and Jessica Anderson
The old cliché that “healthcare is always changing” rings truer now than ever. Advances in medicine and technology, combined with lessons learned from the pandemic, continue to shift the way care is delivered. They also impact how ambulatory facilities are being designed, whether you’re building or renovating an on-campus medical office building, surgery center, community provider clinic or other type of practice.
Focus on an Outcomes-Driven Approach
These days, providers distinguish less between inpatient and outpatient environments, and instead plan for universal design across the continuum of care. To ensure the desired outcomes, it’s critical to align strategy, business objectives, design and user buy-in. A diligent planning process, facilitated by experienced healthcare design experts, ensures that spaces are adaptable and can accommodate fluctuations in patient volumes while also incorporating sufficient standardization for constructability and consistency.
An outcomes-driven planning strategy yields many benefits, including:
- Speed: Accelerates site and facility concept creation and the schematic design process
- Predictability: Minimizes unbudgeted design and construction costs and project delays
- Growth: Data-driven space programs support expansion without overbuilding
- Flexibility: Adaptable spaces balance revenue-generating and support areas
- Productivity: Efficiencies in FTEs, decreased steps and increased throughput improve staff and physician productivity
- Experience: Patient-centric environments enhance the patient experience
Functional Planning Considerations
A functional plan can mean the difference between a profitable facility completed on-time and on-budget and one delayed by overruns and unforeseen costs. The planning process must establish key drivers including service line mix, preferred care model, staff workflow, planned capacity and a room-by-room space list.
Here are some important questions to address:
- Will volume or provider FTEs drive the exam room count?
- How will growth and/or additional capacity be addressed?
- What kind of care model will be deployed in the facility, and what are the design implications?
- Will telehealth or other technologies be integrated into the service continuum?
- Will there be centralized or shared services for patient, building and/or staff support?
- Do specialty rooms specific to any services need to be included?
Based on information gathered, a functional narrative is developed detailing operational parameters and optimal space utilization. This helps inform a concept plan that addresses patient care workflows, location of services, number of exam and procedural rooms and how they all fit together.
Space Planning Essentials
The space planning process includes conceptual layouts to determine key adjacencies and relationships for the building programs as well as how the plan works within the context of the site.
Key considerations include:
- Can interventional services share support areas such as prep, recovery and staff support?
- How will circulation paths in the building accommodate staff, patients and materials?
- How will public areas and waiting spaces be addressed?
- Will there be adjustments made as a result of lessons learned from COVID?
- How can future growth and expansion be accommodated?
- Are there mobile units to be considered in the site development?
Careful, flexible planning is vital to meeting current and future clinical needs and creating a roadmap to profitability. For example, MedCraft recently worked with the leaders of a new ambulatory center seeking to substantially lower construction costs without reducing surgical capacity. After reassessing anticipated needs and revising project scope, a design alternative was developed that provided an initial savings of $1.7M in upfront costs.
This was accomplished by reconfiguring the existing OR suite and prep/post areas to create two OR and two GI procedure rooms rather than constructing two dedicated gastroenterology (GI) procedure rooms plus four operating rooms (OR), as initially planned. MedCraft also created expansion plans for two future multi-purpose ORs that could easily and cost-effectively be constructed over a weekend.
Leveraging an Expert-Led, Cross-Functional Team
Ensuring buy-in, effective change management and successful implementation of new operating models requires engaging key stakeholders throughout the planning process. Organizational leaders establish overall strategic direction, define care models and determine project scope, while service line users offer insights on how they currently use space and would ideally use it going forward. Physicians, nurses and other clinical staff provide input on how future environments could improve productivity and their ability to provide high-touch patient care.
User group sessions provide valuable opportunities to discuss ideas, test guidelines and generate consensus. Healthcare design experts serve as highly effective user group session facilitators, bringing the unique skillset needed to finesse dynamic personalities, encourage the free exchange of ideas and maintain the guidelines established by leadership.
According to Dr. Adil Baig, Yuma Regional Medical Center, Primary Care, “The user group meetings were an effective way to provide input and incorporate feedback from our administrative dyad team, ensuring we utilized the space in the most efficient manner possible from an operations and clinical perspective.”
Achieve Results with Winning Solutions
Another recent project demonstrates the value of engaging an objective partner who understands facility planning, has strong knowledge in clinical operations and is highly experienced in innovative healthcare design. The MedCraft team identified several opportunities for improvement for a clinic whose initial goal was to replicate its existing “hub and spoke” model, which featured centralized registration and core functions along with dual entry exam room corridors distributed to preserve clear patient lines of sight.
By re-envisioning and refining the clinic prototype while maintaining key operational drivers, MedCraft helped the facility:
- Reduce construction costs by 27%
- Exceed target goals
- Provide access to new and expanded services
- Increase provider and staff satisfaction
- Become a preferred practice location for many of the health system’s physicians, leading to expanded hours for specialty care
Whether you’re designing a large medical office building or a community-based provider clinic, functional outcomes-based planning can help you meet all your operational and clinical goals – from patient and staff safety, to clinician productivity, to future growth.
Patricia Shpilberg, serves as Vice President of Planning & Development, and Jessica Anderson as Director of Physician Services, for MedCraft HealthCare Real Estate.