In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Patrick E. Duke is managing director at CBRE | Healthcare (Richmond, Va.). Here, he shares his thoughts on facility asset optimization, the future of printing on construction, and the paradigm shift in project delivery.

1. New way to talk portfolio

No, this isn’t about your 401K or stock portfolio but about how we should approach healthcare organizations regarding their facility assets. Traditionally—and for many good reasons—we’ve focused on the hospital when talking with clients, since that’s where the magic happened. But in the new world of healthcare delivery, the hospital is but one part (and becoming smaller) of a system’s portfolio set-up to provide a continuum of care to effectively manage their population’s health. These assets can include corporate, hospital, ambulatory, urgent care, and wellness centers; population health management facilities; and senior living communities. We need to avoid the “project” talk and instead turn the discussion to “asset optimization.” Which ones support the system’s services across the entire care continuum and do so according to the reimbursement model in place so that they can be profitable? This is a question we must answer together.

2. Hit “print”

Printing a building is not as far-fetched as one may think. The Chinese company WinSun is working on a major 3D building project in Dubai and has already completed several in China. A few years ago, the U.S. Navy embarked on its Print the Fleet campaign that now features custom drones printed at sea. In April, Princeton University and Johns Hopkins presented their work on a 3D-printed prototype outer ear. This technology holds the key to broadening our horizons in the A/E/C and healthcare industries. Will we seize the opportunity and disrupt business as usual?

3. Pushing project delivery methods

Healthcare clients are increasingly adopting Lean as a means to lower their operating costs and stay competitive. There’s not a day that goes by in my small world where a client is not challenging the traditional project delivery models and looking at integrated project delivery (IPD). They want a model where providers are willing to put their profits at risk in return for the owner creating an environment free of the hurdles that often hold back innovation and the ability to drive value for the dollar. Let’s continue to drive this paradigm shift.

4. Keep it personal

We often hear the phrase, “It’s business and not personal,” and I’ll admit I’ve used it often. But recently, my local Delta Airlines gate agent Jesse gave me something to ponder when he said, “Mr. Duke, you know it’s always personal to those who are passionate about their business.” Projects are planned, designed, and built by people and for people. Until we take that out of the equation, our emotions are a variable we must consider. 

5. Organized labor is not the enemy

Healthcare organizations often face the choice of hiring local firms that may not be union versus those that are. Many times the prevailing attitude is that organized labor drives up the price when compared to non-union firms, but this attitude needs to change. As more and more modular options and technological advances become available in the construction industry, labor unions can be a partner to drive a more efficient  process. For example, New York City is pushing for affordable high-density residential housing that will continue to bring more intellectual capital into the city. To answer this call, many companies in the region are offering modular construction to produce lower-cost housing with the amenities and design elements that young professionals value. These models are finding application to healthcare facilities as well. The training programs and numbers of workers that labor unions represent can be a catalyst for widespread adoption of new construction techniques that lower costs for healthcare organizations across the country.

Patrick E. Duke

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