How To Determine If An Inpatient-to-Outpatient Conversion Will Work
As we enter this new year of 2015, it seems so long ago that we were celebrating the new millennium in 2000. Of course, it’s only been 15 years according to the calendar, but in terms of the criteria and metrics associated with healthcare facility planning and design, a lot has changed since then.
We’ve experienced a dramatic transformation in all aspects of healthcare, including facility planning and design.
One of the most significant changes has been a new focus on outpatient facilities rather than inpatient ones. In fact, since the beginning of the new millennium, there have been thousands of healthcare organizations that have directed their planners and architects to explore facility conversions.
The successes of these many projects have varied significantly, depending on several variables.
An analysis of success factors actually doesn’t support transitioning any existing healthcare space into an outpatient center, instead showing that the most effective and appropriate solution is to spend capital on either new construction of an off-campus facility or renovation of an appropriate off-campus facility.
This position can be supported with the use of an existing facility assessment, which measures predetermined success factors to create an objective success factor rating that hospital decision-makers can use in their evaluation.
What makes this a powerful and effective tool is its comprehensive nature, including criteria for site, functionality, architecture, engineering and equipment/ technology. These categories are scored on a scale of 1-5, with 5 being the best. For example:
- 5—requires refurbishment of basic interior finishes
- 4—requires minor renovation and MEP systems work
- 3—requires major renovation and MEP systems work
- 2—requires complete demolition of interior spaces and MEP systems work, including renovation of major infrastructure systems
- 1—requires complete demolition and replacement of interior spaces and MEP systems work, including replacement of major infrastructure systems.
Using this scoring system, the following criteria should be assessed within each category:
- Site—access, parking, and building entrances
- Functionality—wayfinding and public, outpatient, clinical, inpatient, and support areas
- Architecture—exterior features including building envelope, canopies, windows, and roof; interior features including finishes, architecture, casework, furniture, and signage
- Engineering—civil, structural, mechanical, electrical, plumbing, fire protection, and commissioning, as well as floor-to-floor heights, structural grid, vertical expansion options, and MEP infrastructure
- Equipment/technology—available equipment and information technology.
It’s important to note that the renovation and repurposing of existing space is an important and effective solution to meet the changing requirements and demands of healthcare organizations and can be successful in lieu of new construction. Using this tool will help determine if this route is an appropriate one to take.
Gary L. Vance will speak more on this topic at the Healthcare Design Academy being held Feb. 26-27 in Bethesda, Md., where he’ll be joined by Derek Selke, director of architecture for BSA LifeStructures, and Tim J. Spence, regional director, Raleigh, for BSA LifeStructures, in the session “New Facility Planning Criteria & Metrics: Five Takeaways to Share with the C-Suite.”
Gary Vance, AIA, FACHA, LEED AP, is the director of national healthcare for BSA LifeStructures. He can be reached at firstname.lastname@example.org.