Today's changing business environment goes far beyond banking and industryit reaches into our healthcare system and the unique challenges that growth puts on hospital administration. One area that is being stretched to the limits is the healthcare provider's ability to deal with increased parking demands and traffic flow.

While yesterday's design firms simply looked at a facility's bed count to determine parking needs, this approach no longer addresses the com-plex myriad of variables that arises as operations switch from inpatient care to outpatient and specialty services, while accommodating a changing workforce in terms of hours and amenities. Yet another concern: Use of scarce surrounding land for parking may limit the future growth of new ancillary services and offerings.

For healthcare administrators, the formula for success is not as clear-cut as it once was. The dynamic nature of the healthcare business environment tends to introduce chaos into long-term planning and hampers the ability to address future parking demands. The need for a clear vision and master planning is more critical than ever.

In view of all this, surface-based parking solutions, for all their luxury and affordability, have given way to parking structures that can aid hospitals in their attempt to recapture the necessary land for continued building expansion. Fortunately, today's parking structures offer options for satisfying a hospital's long- and short-term needs while providing an affordable amenity for patients and staff.

Balancing Growth and Service

Many hospitals and healthcare facilities, especially those in suburban settings, have become victims of their own success. When many facilities were built, there were plenty of outlying lots available for future growth. As demand grew and new facilities were constructed on campus, a rush by medical office providers to grab strategic adjacent real estate capped the ability of many hospitals to expand and serve their clients' needs affordably. Administrators now realize that such land is too prime a piece of real estate to simply turn into surface parking, no matter how badly parking is needed. Compound this challenge with the realities that patients demand ease in today's frenzied world and that competition for patients and staff has never been more difficult. Convenient parking is an obvious must.

Needed: Master Planning

Lack of a master business plan is often a critical mistake for hospital administrators when assessing their parking needs; it cripples both short- and long-term success. Too often, parking issues become reactive decisions instead of seen as proactive opportunities. For example, one of the busiest areas of the hospital is the emergency room. While the instinctive reaction might be to create additional parking in front of the emergency room, since this is where the action occurs, this decision may hinder long-term growth opportunities for the hospital by limiting expansion in that lot. As such, the long-term goals and objectives of the hospital need to be mapped out in relation to its infrastructure. The master plan should not be so rigid that there is no room for flexibility. Rather, when parking issues arise, the master plan should provide choices for the owners, based on projected growth and financial expectations.

As already alluded to, constructing medical office buildings near hospitals is becoming the norm. These buildings not only sit on land that typically would be used for surface parking, they require their own parking spaces. During normal business hours, the lots for both the hospital and medical offices become completely full.

A parking structure that builds up instead of out is an attractive solution to this and other accessibility problems. If hospital expansion or the addition of a medical office complex is reflected in the master business plan, then parking structures can be designed to accommodate this expansion. Structures can be designed to expand horizontally and/or vertically, based on the objectives of the master plan.

The national shortage of nurses and other healthcare professionals also enters into the parking equation. With more employees working late into the night, today's employee seeks a flexible, convenient, and safe working and parking environment. A well-lit parking structure that provides open visibility is crucial. Many healthcare organizations have recognized that a parking structure can be a perk of employment, especially through the addition of services such as car wash areas, which are relatively inexpensive to install. Furthermore, a parking structure, in providing shade on hot days, reduces the temperature in parked cars. In areas prone to harsh winters, a parking structure eliminates the need for employees to scrape frost and snow off their vehicles after having already worked long hours.

The increasingly elderly patient population is another consideration. Beyond providing closely situated parking spaces, sufficient and easy-to-read signage is necessary. Strict ADA (Americans with Disabilities Act) codes play an additional role in this. The proximity of parking spaces to accessible entrances as well as their size are important considerations. Clear pedestrian paths need to be detailed as a part of the master-planning process.

Planning Construction

A true design solution will address not only the hospital's long-term needs, but will also minimize the short-term inconvenience of construction. Using modern construction techniques, parking decks can be constructed quickly and efficiently if the proper elements are incorporated into the design process. The design-build delivery method provides a cost- effective solution to the challenge of parking construction, consistently delivering a quality project faster and more af-fordably.

Design-build encompasses architecture/engineering and construction services within a single contract, thereby combining the vital roles of de-signer, constructor, and other subconsultants. Already validated as a viable solution in the parking industry, application of design-build principles provides healthcare owners with a value-enhanced delivery meth-od. The process allows for early collaboration and exchange of ideas, as well as the opportunity to maximize team knowledge of systems and products. Such early collaboration also serves to solidify the relationship building and trust needed to take the project to completion.

Conclusions

Today's parking structures are more than just mere boxes or places to park cars; rather, they are an asset to the healthcare organization. Appealing design and convenience can create a structure that not only fulfills your parking needs, but serves as an extension of your image and service to both clients and employees. Just as a change in mindset has occurred regarding how service is provided to patients through more convenient operations and procedures, a change in thinking must occur about today's parking dilemma. It is time to consider a vertical parking structure to provide safety and convenience for patients and employees, as well as minimize the impact of losing prime real estate on the business plan. Your parking master plan should have a direct correlation to your short- and long-term business plan to ensure success. HD

Randy Simmons is chairman, R.R. Simmons Construction Corp. of Tampa, Florida.

Sidebar

Today's Parking Analysis

Historically, parking needs for hospitals were determined using two methodsone based on the number of full-time employees and another based on the Institute of Transportation Engineers' parking generation rates, as determined by the historical relationships between patient beds and parking demands for general hospitals. The first option serves as a quick assessment of need in lieu of a detailed study and does not account for growth in higher-intensity areas. Also, since many hospitals are now choosing to build their businesses without merely adding beds, but rather by performing outpatient surgery and offering specialized services, the second option does not account for an increase in services that do not require a hospital stay. Traditional parking analysis thus falls drastically short with both methods and does not support solutions in today's environment.

Realizing the limitations of these options, many parking design and planning consultants use a third method of analysisone that accounts for patients of all kinds and numbers of employees and allows room for growth. By accounting for patients and employees, both current and in the foreseeable future, plus allowing an allotment of spaces for medical offices, one can determine at least an approximation of parking needs. This modern approach to critical parking analysis will help healthcare managers keep pace with a dynamic business environment.

Randy Simmons