If you’ve ever wondered what keeps the c-suite of your organization up at night, one panel during the ASHE Annual Conference and Technical Exhibition being held this week in Seattle offered at least some glimpse into what's likely on their minds.

In a plenary session, facility executives offered their two cents on a variety of topics. Here are some highlights from what the group shared with the ASHE Annual attendees:

Healthcare reform

Tommy Hobbs, chief executive officer, Illinois Valley Community Hospital, Peru, Illinois, says that with healthcare reform on the horizon, the creation of accountable care organizations remains a looming challenge, as well as the reality of changes to reimbursements and hospital/physician alignment. However, one word remained top of mind for him: capital.

“I think access to capital is going to be a significant challenge for organizations of our size, and maybe for all organizations,” he says.

As for what facilities will look like in the future, Hobbs said there are still plenty of unknowns, though some certainties are that they will be closer to home and outside the standard acute care hospital. “We don’t know what it’s going to be, but we know it’s going to change,” he says. He adds that facility managers will take on a crucial role in the coming years as organizations face the planning that must be put into place to maintain the equipment and technology required for these additional access points.

Patti Clausen, RN, BSN, MBA, nurse executive, Swedish-Cherry Hill, Seattle, also notes that while the highest quality and safety that will be expected requires human capital to succeed, organizations will likely be tasked with engaging in additional work without any more resources.

“Healthcare reform isn’t going to bypass any of us,” she says.

Facility challenges

Paul Shackelford, MD, senior vice president, medical affairs, Pitt County Memorial Hospital, Greenville, North Carolina, says that it’s clear the model of care in the United States is going to shift closer to home, with families administering care as well. It will likely be very difficult for organizations not only to provide this model in a way that results in an acceptable margin, but also to maintain it.

Timothy M. Peglow, SASHE, MBA, associate vice president, patient care and preventive facilities, University of Texas, MD Anderson Cancer Center, Houston, says MD Anderson is facing similar challenges as expectations grow for more convenient cancer care centers to serve the sprawling Houston area.

In addition, Peglow discusses the barriers that exist for the facility that strives to bring its patients the latest in care. For example, when exploring a new technology, MD Anderson must discern whether it is cost-justified and assess to what level it may interrupt care at the facility in order to best measure its overall benefit.

At Swedish-Cherry Hill in Seattle, Clausen says she is seeing a shift in the sickest of the sick coming into the hospital, whereas the lower acuity patients are expected to go into more of a home care model. Clausen said facility engineers must be able to understand how this trend may affect patients going forward.

The future facility managers

With all of the changes coming on the healthcare horizon, the defining characteristics of the facility manager are shifting as well.

Clausen says a new standard will be developed for the technical skills that must be possessed in addition to other prerequisites, such as an acute ability to communicate well with different areas of an organization, the ability to be highly focused on the business and operations side of a facility, and a focus on regulations.

Also noted by the panel was the need to not only avoid creating silos within an organization but to be equally able to speak clearly to board members, offering the unique knowledge they possess on the intricacies of a building’s operations and, perhaps, why a new project needs to be undertaken.

Peglow adds that while being able to handle change in a positive way is an ability up-and-coming facility managers must possess, the inherent and more defined culture of an organization must be balanced by that individual as well.

“Each organization does have a defining culture and if you want a good fit, you’ve got to find someone who fits into that culture, unless you want a change agent,” he says.