Healthcare Megaprojects: They Do Exist
What is a healthcare megaproject and where are they being built? A literature search was surprisingly difficult— there are few databases on the largest hospitals being constructed in the world. More often, there are lists of the “best hospitals.”
The results, however, weren’t surprising: The largest projects are overseas, mostly in Asia and the Middle East, and top out at more than 1,000 beds and 1 million square feet.
In the U.S., the few very large facilities are funded by governmental or quasi-public entities like public hospitals, Veteran’s Affairs and Department of Defense facilities, or those affiliated with state universities.
The largest new U.S. hospital under construction is the public hospital Parkland Memorial in Dallas, at 865 beds and 2.7 million square feet. Significantly, most large U.S. hospital projects under construction are similar to the Ohio State University Wexner Medical Center, encompassing more than 1.1 million square feet but having only 276 new beds, illustrating our national trend toward more outpatient treatment and declining lengths of stay.
The story is different overseas, though. Government-sponsored healthcare allows for a centralized management and funding mechanism. Countries are rushing to catch up due to population growth, extremely obsolete or undersized facilities, and transformation from Third World economies. In most cases, projects include major bed expansion; many countries are adopting the U.S. model of private patient rooms.
In addition, these projects include large diagnostic and treatment platforms and subspecialty clinics. Many anchor “medical cities” that include research, education, staff housing, and supporting amenities.
In Ankara, Turkey, AECOM peer reviewed the Bilkent Integrated Health Campus, the largest new single healthcare site in the world at 3,662 beds and 12.9 million square feet. This public hospital is replacing multiple existing hospitals in the region, some more than 130 years old and poorly maintained. In addition, Turkish hospitals have some of the highest levels of overcrowding in Europe, with only 26 beds per 10,000 people (compared to 32 beds per 1,000 in the U.S.).
The project consists of five approximately 500-bed towers that include general and specialty hospitals on a single diagnostic and treatment platform and subspecialty clinics at the base of each tower, with parking underground. The surgery suite alone has more than 100 operating rooms. There are also adjacent freestanding psychiatric and rehabilitation hospitals.
The Turkish Ministry of Health anticipates 35,000 people on site each day, including 4,100 staffers. The operational challenges are enormous.
While megaprojects in the U.S. continue to decline, there’s a huge appetite for these projects in the developing world. These projects offer unlimited opportunities for healthcare design firms but also come with significant challenges.
In my next blog we’ll discuss lessons learned from AECOM’s global megaprojects.
This is the first part of Sheila Cahnman’s two-part special blog on healthcare megaprojects. Read the second blog, "Healthcare Megaprojects: Challenges and Opportunities."