Whether providers choose to acquire, affiliate, or ally, many of them are seeking to "own" all of the components of an integrated care network. Like the marriage that follows an initial courtship, they vow to provide for all of the healthcare needs during a lifetime-from neo-natal care to playground injuries; from heart surgery to step-down rehabilitation; from physical therapy to nursing homes, hospice, and home care. Within an integrated network, the provider can move the customer through its system, up and down levels of care, to deliver a quality outcome in an appropriate setting at the lowest possible cost. Each link in the chain of care must be in place, with a primary physician group as the essential key to the chain.
As business initiatives move toward integration, hospital management is being challenged to develop and maintain competitive facilities that will serve a continuum of care. Working together with expert physical planners and designers, savvy facilities managers are creating flexible environments that accommodate a variety of care needs and the dynamics of today's rapidly changing delivery modalities, both on- and off-site at satellite locations.
Addressing the two basic customer populations of the critically ill and the ambulatory, the hospital environment itself is being radically transformed through more efficient operations, cross-disciplinary staffing, and optimized space utilization. Creative design strategies are helping to achieve lower space requirements, initial capital outlay, and operating costs necessitated by shrinking budgets. For example, hospitals of the past decade, divided into a series of distinct territories, such as surgical care or medical care units, are being replaced by designs based on platforms without boundaries, such as critical care units that accept both surgical or medical cases. The number of new patient beds is diminishing, while diagnostic scanning and imaging, surgeries, and other revenue-producing services are rising.
Under-utilized, inpatient space is being reused, and major campus expansion programs are being undertaken to fill the gaps in the continuum of care: ambulatory pavilions with their own entrances, amenities, and conveniences; handsome medical office buildings that attract physician groups and patients alike; clearly understood, safe parking garages that provide ease of access; sub-acute and transitional care centers that reassuringly assist patients in the transition home; and rehabilitation units and revenue-producing wellness centers designed to keep the patient away from inpatient beds but within the system of care.
Integration is also spurring the provider beyond the hospital's campus to reach out to the community and to bring services to the doorstep of the patient. Moving patients out of the inpatient unit as early as possible is creating demands for lower-cost transitional settings, home and hospice care, and telephone case management. The emphasis on prevention, wellness, and education is giving rise to outreach programs, family medicine, community-based primary care clinics, and smaller primary satellites in accessible locations. The increasing aging of the population is driving a full range of developments, from traditional nursing homes to luxurious retirement communities for independent, extended, and assisted living. Medicine and self-care programs are being utilized with electronic connections back to the provider, creating global networks of specialists.
As the vision for a network of care comes into focus, healthcare facilities are being designed as integrated environments for the healthy, as well as healing environments for the ill.
Julian Arhire is a Manager with DtiCorp.com - DtiCorp.com carries more than 35,000 HVAC products, including industrial, commercial and residential parts and equipment from Honeywell, Johnson Contols, Robertshaw, Jandy, Grundfos, Armstrong and more.
