The boom in outpatient facility construction shows no signs of slowing. But these projects are becoming increasingly complex as medical groups and hospital systems demand spaces that can keep up with their rapidly changing strategic and organizational requirements.

February 14, 2013

3. Look forward to heightened scrutiny of facility quality and operational performance.


To ensure all its facilities meet benchmark levels of quality for patient experience and operational and facility performance, Spectrum Health’s facilities team developed a prescriptive-based facility assessment tool. Using the tool, they score their facilities on everything from the quality of the furnishings to the distance a patient walks from the parking lot. Photo: Justin Maconochie


No other building sector is more keenly focused on the performance and continual assessment and improvement of its buildings than healthcare. This emphasis on quality will be further emphasized with the coming implementation of the Affordable Care Act, which is expected to place heavy pressure on healthcare providers to take a cleaver, not a surgical knife, to operating costs. That means outpatient care centers will have to deliver more care—and higher-quality care—at less cost.

“There’s no doubt that physician groups are more closely analyzing how to turn over the outpatient exam rooms,” says Brian McFarlane, AIA, Principal in HKS’s Healthcare Group, in Dallas, who leads the firm’s healthcare business development. Already, outpatient clients are using kiosks for check-ins, and they’re administering injections outside of exam rooms to eliminate bottlenecks in patient flow and speed up turnover of exam rooms.

“Less time in exam rooms may mean fewer rooms required or less square footage, which means lower rent for each physician, operational savings, and increased revenue. It’s real money,” he says. “The perfect situation is when a patient parks the car, walks in the door, quickly checks in via kiosk or in person, and goes directly to an exam room.”

What, then, does this heightened emphasis on quality and proof of performance mean for Building Teams working on outpatient facilities?

You can expect greater scrutiny of the quality of your work, especially as it pertains to the efficiency, flexibility, and profitability—not to mention the patient experience—of outpatient facilities. Physical mockups and computer simulations are great, but the end product must perform up to expectations and be able to flex as the client’s needs change.

To help assess the design and performance of its buildings, Spectrum Health’s facilities team, assisted by Integrated Architecture’s Kranzo, created a prescriptive-based facility assessment tool that scores everything from the patient’s experience as they approach and enter the facility, to the quality of the work environment for physicians and staff, to the performance of both the operations and the building itself.

Typical questions: Is the reception area clearly visible immediately upon entering the building? Are there landscaped areas at or near the entry? Are there preferred views from and natural light in 75% of the hospitality area? How visible is the exterior signage from the primary access road? How effective are the primary landmark elements in wayfinding? What is the quality of the furnishings?

Kranzo says his team created the scorecard in an effort to develop facilities that are as balanced as possible across the multiple categories. The prescriptive criteria were developed based on evaluations of three recently renovated ambulatory centers, and were used to inform the design of the new Holland facility.

“It really came out of us trying to measure the quality of a design as part of our final approval process of a construction document,” says Kranzo. “We’re not going to focus just on the facility performance. We’re going to rate operational efficiency as well as the experiential side for the patients and staff.”

Before Kranzo signs off on a CD for new construction or a renovation, a design must achieve a certain score level. Most elements are scored using a plus-three, minus-three system, allowing for gradations and some interpretation.

The goal, says Kranzo, is to “have zeros across the board.” This ensures that no single element is drastically underdesigned or overdesigned. “We found that some facilities go overboard in certain areas, such as finishes being well beyond what we need,” he says. “This standard works to balance everything. That then feeds how we utilize our capital and budget on a given project.”

In a somewhat unusual move for a healthcare facility, Spectrum Health placed the physician and administrative workspaces along the perimeter of the structure, thus providing staff with the best daylight and views for completing medical documentation and reports. Photo: Justin Maconochie



Comments on: "5 radical trends in outpatient facility design"