Ambulatory Expansion: Best Practices And Common Pitfalls
There are few topics in healthcare right now that are as hot as the shift to ambulatory environments. Providers are focusing on more distributed networks that reach into communities to provide easily accessible care to patients and help answer population health mandates, and all at a lower cost to boot.
But exactly how this trend is translated to an organization’s master plan for facilities isn’t quite as clear.
To shed some light on best practices as well as what to avoid was Kate Rose, a vice president in JLL’s healthcare solutions group, during the session “Ambulatory Facility Planning: Strategy for Success” at the Healthcare Design Conference in November.
So what exactly should a provider and planning partners consider when growing an ambulatory network? Well, a few things.
First, Rose said, start with objectives. “It’s good to be really specific,” she said. So that means identifying what exactly it is that an organization wants to accomplish. Perhaps it’s to grow a service area or establish a new center of excellence in cardiac or cancer care, for example. A long-range financial plan and business strategy should be identified here, too.
Next, think about what’s driving demand, specifically focusing on an area’s demographics, including gender, age, and socioeconomics—who are they, what do they need, and how can you give it to them? And don’t skimp on the patient satisfaction piece here, either. Rose said to plan to satisfy those particular populations and how that might be achieved, which should guide where dollars are spent.
Core competencies should be identified, too. Think about big-picture things like capital and leadership, drilling down to capabilities in IT or care delivery models, and then deeper into outcomes like increased efficiency and quality of care, Rose said. Consider how these become part of the ambulatory strategy to grow the brand or maybe shift gears in where the brand was heading.
And, finally, it’s time to look outward. What exactly is the competitive landscape? After all, any great idea can be short-lived if a market is saturated. With the advent of retail clinics upping the convenience ante, Rose warned that patients will value that convenience over maintaining continuity or relationships with their health system, so thinking about providing care when and where patients want it is crucial.
But even with these planning basics covered, there are still a few pitfalls teams might encounter.
Rose said to first watch out for “clinic envy.” Remember, just because a competitor built a big, beautiful outpatient center doesn’t mean that’s the right move for everyone. A new space might actually be an inefficient use of capital compared to simply repurposing space that an organization already has. And, she warned, any race to open a facility on a short schedule often results in compromises in quality.
And speaking of that decision to build new space being a mistake, that’s Rose’s next pitfall: expansion bias. Sometimes the best bet isn’t to grow but rather to consolidate. Maybe there’s an underperforming department that could be moved to clear space for an outpatient clinic? And it’s not just dollars that are being saved in real estate costs but also in operational efficiencies realized in utilities, administration, and labor.
And, finally, Rose’s number one pitfall of planning for ambulatory expansions is a fear of numbers. The day of building without digging—really digging—into analytics of the local market are long gone. You don’t have to be an accountant to find value in spreadsheets, so it’s time to think of numbers as your friend and have as much data available as possible in order to make the right decision.