There are more than 11,000 acute care facilities in the U.S., and almost 35,000 additional medical-related buildings—all of which need to be assessed for how well they serve their functions, says Aran McCarthy, Francis Cauffman (Philadelphia). And as these buildings continue to cluster together under bigger health system umbrellas, those health systems have a pretty urgent need to figure out (1) what buildings they own, exactly; (2) where they should spend their capital to get these facilities up to speed; and (3) how to prioritize it all.

McCarthy presented an in-depth look on how to approach this massive undertaking in the webinar “Undertaking Health System Facility Assessments,” which was part of the Healthcare Design Education Day program last week.

“Obviously, you’re going to have competing needs,” McCarthy said. “You’re going to have the doctors, the healthcare practitioners, the surgeons who want certain projects, and some folks are screaming louder than others.” For the hospital system he used as the case study for this presentation, McCarthy said, the pressure to assign capital dollars was constant. Between four acute-care facilities and 13 outpatient centers, each one was asking for expansion, renovation, or upgrades to the existing buildings.

Among the many, many questions an owner has to consider are: What’s the ROI on each expenditure? How will it affect patient satisfaction? And market share? What needs to happen now, and what can be back-burnered? Then you have to put a realistic price tag on each project—which also requires a deep dive. For example, “very often, a simple cosmetic project can turn into an infrastructure upgrade project,” McCarthy explained, and there goes the budget.

 When assembling a team to undertake a broad facilities assessment, the owner should engage a blended mix of specific site facility representatives and support services champions. “You need to keep thinking big picture,” McCarthy said, to include those who’ll put the health system needs above the department needs. “If you think big, you get big.”

It was quite interesting, if overwhelming, to consider all the steps necessary to take a complete inventory of facilities and assign values and priorities to building programs and projects. But McCarthy did a good job of breaking it down step by step. If you missed the Education Day program last week but would like to learn more, you can still register and watch the recorded sessions via this link.