Healthcare Form Meets Healthcare Function
I recently attended a meeting of the Built Environment Network (BEN), a group of senior-level facility executives from around the U.S. and Canada who are dedicated to improving safety, quality, and sustainability in healthcare. During the meeting, the conversation turned to the connection between the high-level strategic plan of a healthcare organization and its building or renovation programs and how, more often than not, these two are completely disconnected.
This disconnect provides an opportunity for the design community to build a bridge between the healthcare C-suite and the facility planning process that can have a significant and positive impact on an institution for decades to come.
Often the decision to build new or to renovate is in response to a perceived need for additional capacity, updated facilities, or expanded service offerings. These are all legitimate reasons for a capital project and should position an organization to be prepared for the future. But how do you prepare for a future that’s changing so rapidly that the healthcare system that existed when a building was designed will likely not be the system that exists when the facility opens its doors?
We try to mitigate this impact by designing in flexibility or using modular systems to make adapting to change easier, but what if the shifts are more fundamental than incremental?
BEN members felt that all too often projects get completed that don’t necessarily have longevity, because they were designed to solve a single problem or fulfill a single need. Rather than strategy informing design, buildings are dictating organizations’ strategy. Or worse yet, after a building is completed, a realization comes that it doesn’t actually solve the problem it was meant to solve and the process starts all over again.
The big question is, how do you design for a future care delivery model that hasn’t yet been conceived? So many forces are pushing on the healthcare landscape. Take, for example, retail health. We have only begun to see the impact giants of the retail world like Walmart and CVS will have in the healthcare space. What started out as a convenient place to visit for common vaccinations, simple wellness services, routine lab tests, and the diagnosis and treatment of everyday ailments such as pinkeye and strep throat is now providing much more complex offerings, like infusion services.
It’s no secret to the design community that the building is the largest capital investment an organization will make and the decisions made around the design will set the stage for fixed costs for years to come. In the best-case scenario, there’s an overall strategic plan for the organization that then informs a campus design strategic plan, which then informs the building strategic plan.
This allows the building to be a direct outcome of the strategic plan, which helps define the building’s size and location (on the main campus or out in the community, for example) and may even inspire a solution to not create a building at all. The organizational strategy should always drive the facility solution, but this best-case scenario isn’t the status quo of our industry. As member Don Orndoff, senior vice president of national facilities services at Kaiser Permanente said during the BEN meeting, “Strategy feeds function feeds form.”