By Peter Bulgarelli / Special to Healthcare Facilities Today

The future of the healthcare industry is shrouded in uncertainty, thanks in no small part to the never-ending debate about healthcare reform in Washington. Revenue projections are a seemingly impossible task. The impacts of major regulatory issues hang in limbo. Still, a hospital or healthcare system must forge ahead and plan for the future, asking difficult questions to create its own vision. One central question ties directly to facilities: Where do we want to be and what services should we offer?

Everyone’s answer is different, but the underpinning looks the same: smart facility plans must put the patient at the center and be flexible enough to withstand inevitable change. Maintaining steady, forward momentum will require one hand to carefully manage the day-to-day building management minutia, while the other hand prepares facilities to meet the major forces reshaping the landscape. As future planning discussions take place, every healthcare provider needs to raise five critical questions about facilities:

Question 1: How can we put existing space to better use?

Reimbursement changes are pressuring hospitals to get patients out of the expensive main campus as quickly as possible. Hospitals are focused less on putting heads in beds and more on improving the quality of the patient experience. The result: existing space is getting a fresh look. Nearly one in four architect and design/build companies in Modern Healthcare's 38th Annual Construction & Design Survey reported an acute-care hospital renovation or expansion project on their books.

Many healthcare providers are looking to their facilities for gaining operational efficiencies, improving patient safety and giving patients more privacy. As hospitals rethink how the square footage on their main campus can be put to its best use, administrative offices are being pushed to off-campus locations in favor of clinical space. One way to ensure every square inch of space is maximized is by tapping into technology to track occupancy patterns and traffic patterns, such as sensors that can detect when people enter a room and generate data about its usage.

Question 2: Are we addressing changing risks?

As health systems disperse care via more outpatient centers, ambulatory facilities and other off-campus buildings, a new set of risks emerge in managing a growing array of buildings. How can you ensure consistency in quality and safety? How are maintenance issues and problems prioritized? Who is accountable for addressing facilities issues? A seemingly minor problem at one facility, such as a ventilation issue, can quickly turn into a major reputational problem for the entire brand when it’s ignored. Having centralized protocols sometimes isn’t enough; being proactive about facility maintenance and repairs can save massive headaches down the road. Centralizing facility management under a single umbrella can help reduce inconsistencies and make it easier to prioritize problems and proactively address routine issues.

Question 3: Can we improve the convenience factor?

How far are patients traveling for different services? A patient with cancer is much more likely to go the distance to get to a reputable research center than a person receiving weekly allergy injections. To bring care closer to patients, healthcare services increasingly are shifting to smaller off-campus medical office buildings (MOBs). Of MOBs developed in 2016, Revista research found that 447 were developed off-campus, averaging 63,585 square feet each. Only 186 MOBs were on-campus developments, averaging 97,949 square feet each.

More hospitals are taking a page from the retailer playbook on where they set up shop, making a concerted effort to increase their brand visibility. New one-stop shop medical villages are emerging, integrating complementary services such as hospital care, wellness centers, elder care, rehabilitation services and primary care offices.

As health systems consider opening new facilities, it’s critical to consider ease of access for patients not only now, but with an eye toward the future given the area’s demographics, competitive landscape and other factors. If a hospital or health network doesn’t make an effort to get closer to patients, a competing provider certainly will.

Question 4: How can we use facilities data to inform our decisions?

Healthcare facilities and operations generate a wealth of patient data, but much of its potential lies untapped or sitting in different buckets across an organization. Advanced analytical tools can now be used to bring together information on buying patterns, patient addresses, competition and market trends to help predict an ideal location for a facility. Next-generation geographic information (GIS) technology can provide visualizations of different data points for decisionmaking.

However, tools only provide part of the answer. It’s equally important to have someone involved in the data analysis equipped to ask the right questions and mine data for informative answers. For example, what can intelligence about population growth and new housing starts tell you about services that may be needed in the future? How will an aging demographic influence decisions about your location? New technologies will continue to emerge to help healthcare providers make smarter use of their data.

Question 5: How nimble are our facility plans?

Healthcare is constantly changing shape. Today’s landscape will likely look much different in another decade. We’re only at the early stages of understanding the influence technology will have on healthcare, from robotics to telemedicine to digital health tools. The only guarantee is that all healthcare organizations will have to continue to adapt to new influences. How do you plan for this level of uncertainty? Carefully analyze leasing decisions with an eye toward how a facility might need to change over time, building in as much flexibility as possible. Above all, closely align decisions with the future vision of the organization to ensure that facilities help advance big picture issues, such as population health goals and the organization’s mission.

Keeping a sharp edge

Constant vigilance is necessary to keep healthcare facilities at the top of their game and competitive. Facility managers must be open to new tools, data and strategies that can give them an edge as they look toward the future. Regularly asking about, analyzing and revisiting evolving patient needs within facilities will be key to remaining financially viable. Are your facilities ready to survive the changing terrain?

Peter Bulgarelli is the Executive Managing Director for the Healthcare Solutions Group, JLL.