You Need to Be Adding Private Patient Rooms—Now!
Gary L. Vance, AIA, ACHA Vice President Continuum Solutions Consulting

Part One: Concept and Rationale

Logical Evolution of Facility Improvements

Throughout the planning and design process for hospitals and healthcare systems, there has been a logical evolution of facility improvements and developments. This evolution has resulted in multiple generational improvements within the areas of strategic planning, architectural planning, equipment planning, technology, design, and construction.

Since the expertise and specialty of healthcare planning and design truly began in the early 1970s, the majority of important healthcare planning and design areas have been through several generations of facility improvements and developments. In most instances this evolution has been continuous and progressive, which has resulted in a continuous improvement philosophy within the healthcare planning and design community. Although it is an informal process, it is used by most healthcare planning and design professionals and has contributed to the process of evidence-based design improvements.

Gap in the Generational Continuum

There is one very important segment of hospitals and healthcare systems that lacks this generational continuum in both specialty services and departmental areas: private and semi-private patient rooms. There are a variety of reasons why this has happened:

• The U.S. healthcare system provided too many patient beds in the 1970s and 1980s, thus oversaturating the market
  
• The predictions of decreased inpatient capacity occupancy in hospitals and healthcare systems were exaggerated and did not materialize to the predicted degree
  
• Permanently closed nursing units were renovated into non-patient care uses and were no longer available for nursing and patient care
  
• Older and underutilized nursing units were renovated for less acute uses such as psychiatric, rehabilitation, and long-term-care nursing units
  
• The emergence of the managed care and DRG reimbursement systems
  

Hospitals Are Significantly Behind

Even as this trend of increasing the number of inpatient rooms is advancing, hospitals and healthcare systems are not positioned to respond. In fact, due to the circumstances of the 1990s, hospitals do not realize how far behind they are in meeting the needs of patients, caregivers, and families for the coming decade. As we move forward, there are a number of factors setting us on a potential collision course.