One of the ongoing decisions those responsible for planning and building healthcare facilities face is whether to renovate a current facility to fit the evolving needs of patient care, or to build a new facility altogether.
As 2013 begins, decision makers within the healthcare sector will have many new factors to consider when planning building projects — the potential (and largely yet unknown) ramifications of implementing the Affordable Care Act and the reduced reimbursements from Medicare, to name just a few.
But they will also continue to face the standard challenges of building and maintaining cost effective facilities that serve as healing patient environments — challenges that include accommodating developments in medical technology and the expanding healthcare needs of the aging baby boomers, both of which require infrastructure upgrades to current facilities and lead to the debate over whether to remodel or move on.
Healthcare architects have written tips and shared advice on how to make that decision a little easier, and there are many examples of best practices in both renovation and replacement. Here are just a few standouts:
In his article “Renovate or replace? Advice on making the billion-dollar decision” in Health Facilities Management magazine, architect William Mead offers tips on how to determine when it is best to renovate a current space or build a new space to address future needs.
Mead begins by suggesting the creation of a long-term campus plan (or master facilities plan) to best understand the potential for growth at a current location. He then goes on to make the arguments in favor of both replacement and renovation based on the needs of the facility and the available options.
Mead suggests replacing facilities when there is no physical space for expansion or it is cost-prohibitive to modernize an aging facility. This was the case at Palomar Medical Center in Escondido, Calif. where the state’s seismic upgrade requirements were going to be too costly to implement in the current building.
According to an article in Healthcare Design magazine, Palomar Medical Center CEO Michael Covert took the opportunity to build “the hospital of the future” utilizing such concepts as evidenced-based design and sustainability to create an expandable space ready for future renovations — the crowning jewel an “undulating, 1.5-acre green (vegetative) roof over the diagnostics and therapeutics wing.”
The argument for renovation, according to Mead, is best made in instances where the campus is already in a great existing location, is in good condition and has space to grow and adapt.
Such is the case with a series of projects at Froedtert Health. Located in a suburb of Milwaukee, Froedtert and the Medical College of Wisconsin are long-established healthcare providers in the Midwest. The campus has been undergoing expansion for years, including both new construction (the building of a new cancer center in 2007) and renovation.
In a November article in Building Operating Management magazine, John Balzer, VP of facility planning and development for Froedtert Health, discusses the process of transforming the existing operating rooms into hybrid surgical suites capable of accommodating the new imaging technology used in surgery.
The focus on emerging technologies will remain a major theme in healthcare building projects. This is why in a September 2012 Building Operating Management article, author Scott Rawlings, VP, healthcare design for RTKL Associates Inc., suggests hospital construction should be flexible.
“Whether designing a new space or optimizing an existing space, one thing is inevitable: Technology will continue to evolve. In planning for health care facilities, it is essential to keep the future in mind,” Rawlings writes.
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