For the first time at the HEALTHCARE DESIGN conference, some of the biggest names in the industry will be together on stage to share their unique views on trends in healthcare design and the effects those trends have on the professionals who design and build healthcare facilities. 

HEALTHCARE DESIGN Editor-in-Chief Todd Hutlock will moderate the general session “New Directions in the Future of Healthcare Design—The Experts Speak Out,” which will be held at 8:15 a.m. on Tuesday, November 15, 2011, in Delta Ballroom A of the Gaylord Opryland Resort and Convention Center.

Panelists include: Debajyoti Pati, PhD, MASA, FIIA, LEED AP, vice president, director of research, HKS Architects; Jain Malkin, CID, AAHID, EDAC, president, Jain Malkin Inc.; Sheila F. Cahnman, AIA, ACHA, LEED AP, group vice president/regional healthcare leader, HOK; Kim E. Shinn, PE, LEED AP BD+C, CxA, senior sustainability consultant, TLC Engineering; and Rosalyn Cama, president, CAMA Incorporated.

Thomas Gormley, vice president, healthcare and life sciences services, URS Corp., also will be among the panelists and says the discussion will likely be hinged on one very key topic affecting the industry on all sides: the economy.

“Given the economic situation, fiscal responsibility and cost control are key issues. I think all owners have to really think a lot harder about capital expenditures, given the uncertainty on the reimbursement side,” he says, referring to the continued unknowns that surround the Affordable Care Act and what shape healthcare reform will eventually take.

However, while cost is a paramount factor in weighing capital expenditures on the construction side, Gormley says that doesn’t mean business is going away for the healthcare design industry altogether.

“Some of the underlying reasons for capital development are still there and are maybe getting worse. The infrastructure is not getting any younger, so we have tons of 1950s model and older facilities out there. You continue to see some hospitals doing replacement facilities just to walk away [from their current facilities] because they can’t really upgrade anymore,” he says.

In addition to aging infrastructures, Gormley says industry trends toward technology upgrades and private patient rooms also are pushing owners toward considering taking on building projects.

Gormley sits on the Facility Guidelines Institute’s board, where the organization is currently working on its 2014 edition of the Guidelines for Design and Construction of Health Care Facilities by reviewing about 2,000 proposals that came in during the public comment period that ended in late October. Gormley is part of a team that introduced a cost-analysis component to the review process in order to not only weigh the merit of proposals, but also whether the expense associated with them subtracts from, or altogether supersedes, the benefit.

“These are things we’re weighing and trying to figure out how to get a handle on so we don’t just continue to pass rules,” he says.

And when it comes to the bidding process that exists today, Gormley says firms on both the construction and design side are struggling with increased competition and expectations for lower fees. “The fees are very competitive, so it’s somewhat of a buyers’ market,” he says. “I think there is more of a bid effort going on with owners and negotiations than there were before because the owners see there’s an opportunity to get a deal right now.”

From construction managers to architects, the pricing landscape has been transformed and more firms are going after projects to alleviate some of that pain.

“The firms that in the past didn’t pursue the $100 million job because they were only doing $200 billion jobs, now they’re going after the $50 million jobs, so everybody is taking one step back or even two steps back. There is a lot more competition for smaller projects,” he says.

Subsequently, another change in the industry landscape Gormley notes is the loss of firms that have gone out of business and the acquisition of others. “Only the really solid firms that have a good diversity of workload and a good client base continue to be doing OK,” he says.

However, the outlook isn’t quite as bleak as it may seem thanks to another key trigger influencing the future of the industry. Aging baby boomers progressively push all healthcare systems toward addressing the need for growth to manage the 80 million people who are turning 65 in the next 10 years, Gormley notes.

At the same time, that need for growth is tempered by the ongoing economic stressors healthcare systems are feeling.

“I think there’s going to be a lot of cross-pressure between cost and access. Somehow, we’ve got to get better,” he says.

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