Justin Cooper
Vice president of project development, Saunders Construction
With the cost of both health care and construction in Colorado on the rise, the process of building/designing new hospital facilities continues to evolve. The “hospital of the future” looks far different from that of the past, and the trend toward innovation will continue in all facets of the sector – from the care administered by health care professionals to the way hospitals are built. It starts with a shared vision that is translated to the design and construction of the facility itself. By using new technology, engaging in early collaboration with contractors, and creating more flexible and adaptable spaces, hospitals are embarking on a new chapter.
Bob Latas
Vice president of health care, JE Dunn Construction
Early Engagement Manages Risk
The process of designing and building a hospital is among the most complex and costly construction projects out there. It is ever-changing and requires a tremendous amount of upfront capital as well as a deep understanding of local health care building requirements. The key to creating a “smart” hospital of the future requires that, first and foremost, the contractor is involved in the design at the initial stages. When the contractor works closely with the caregivers, administrators and designers early in the planning process, they can inform what assemblies and methods are best utilized to balance capital, system integration, speed-to-market as well as mitigating market pressures such as constrained labor resources. The contractor also can offer valuable insights into how to create much-needed flexibility within the life span of a hospital facility while accounting for often complex code requirements specific to the patient care environment.
Key to ensuring early cost and schedule certainty is integrating workforce strategies that help mitigate labor shortage issues into the early design phase. The amount of skilled labor required to build and operate a hospital is one of the largest capital costs to consider for the hospital of the future. On the construction front, labor-intensive building assemblies such as brick or stone masonry can be evaluated against prefabricated assemblies such as composite or metal panels that require a fraction of the on-site labor resources. In the future, integrating technologies such as wearables and virtual 3-D planning also will allow builders to optimize workflow processes and crew productivity in real time on hospital construction sites.
Implementing lean processes into the design of the project can identify efficiencies through rapid prototyping processes where caregivers work alongside designers, engineers and builders to “mock up” work processes and an entire patient care unit together. One of the biggest benefits of increased collaboration is identifying a shared vision of what the hospital of the future means to each facility owner. Through a shared vision, hospital operational efficiencies, capital constraints, implementation of future technologies and built-in flexibility requirements can be identified and aligned.
Implementing New Technologies Provides Concrete Benefits
Optimized user, design and build teams are more likely to test and implement new technologies, and implement systemwide efficiencies that save on cost and time and improve the overall quality of the build. This also lends itself to implementing alternative strategies such as prefabrication – a growing trend in health care construction. Prefabricated interior components, mechanical and electrical assemblies and exterior facades are changing the world of health care construction with a technology-driven approach to building. Prefab methods can improve building performance while also reducing waste and up-front capital as complex assemblies are built in a conditioned environment that leverages manufacturing technologies robotics and automated fabrication. Prefabricated assemblies also contribute to improved indoor air quality and can offer modular flexibility to change changing needs such as converting a medical/surgical patient room unit to a labor and delivery care unit. Many times prefabrication can help cut time off the traditional schedule when speed to market is a driving force for the project.
Aligning the Built Environment to the Needs of the Patient
The ever-increasing cost of providing population care has created a new pressure to change and adapt. Much like the cost to a patient, the most expensive areas to construct in a medical facility are that of inpatient and emergency care facilities. In the past, hospitals were built to accommodate the admitted patient with close proximity to administrative, outpatient care and emergency care services. This paradigm has changed as campuses seek to provide well-patient and outpatient services and colocate these services with administrative and support operations in less expensive “B” occupancy constructed facilities. Contractors need to improve their overall health care IQ to truly help hospital owners create facilities that can address the numerous health care challenges – including providing high quality care at an affordable price.
For example, more facilities are opting to put administrative and support functions in attached, adjacent or in some cases, off-site buildings with less expensive and less stringent code, system and construction requirements. This allows for new synergies to partner with fitness, retail and primary care partners in a truly integrated health and wellness campus setting. This also allows optimization of the traditional hospital environment to be focused on providing acute, diagnostic and treatment areas that allow for flexibility and continuous modernization. The next evolution in challenging the paradigm is further leveraging efficiencies while balancing code requirements that often require the separation and duplication between outpatient and inpatient service lines. Allowing these services to coexist together while preserving what’s best for the patient via the code process is underway in many locales resulting in the reduction in the cost of patient care and the built environment.
Innovations in design and technology, and collaboration with key stakeholders are the central themes required when embarking on the development of a new health care facility. This applies to the design, build, operation and full continuum of the facility.
