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J. Mark Smith, MBA, Assoc.
AIA
Vice President
Easter and Mason Health Care Consulting Corporation
Nashville, Tennessee
Rural and small hospitals
are undergoing the dynamics of change in the healthcare industry that
parallel - but do not precisely match - the trends of large hospitals
in the major cities. These hospitals face the problem of limited resources
which are less of an obstacle for large city hospitals that have a substantial
patient population. This study will review three rural hospitals you
order, to explore the dynamics of facility change integral to strategies
for the improvement of quality care and market share. Although often
the last resort physical changes can be one of the most dynamic solutions
toward improving quality of care, market share, controlling costs, and
increasing revenues.
More than ever, business
factors determine decisions regarding facilities. Among the many business
changes in the healthcare industry, we are aware of certain salient
factors:
| 1. |
Current
trends in type of care indicate growth in outpatient care relative
to traditional care. |
| 2. |
There
is a shift in the level and variety of care for the elderly and
long term disabled, including a "continuum of care" to meet various
levels of need. |
| 3. |
The
major emphasis of healthcare dynamics is now cost-driven, and is
the primary basis for healthcare organizations' responses to managed
care and potential government cutbacks of Medicare and Medicaid. |
| 4. |
Demographics
are changing. Expectations are rising. Consumers are more educated
and "choosy". |
| 5. |
Short
Stay and Outpatient Clinics are expected to be as sophisticated
and thorough as the former longer stays of traditional medicine.
The trend is toward the advanced, high technology Outpatient Clinic,
including the specialty clinic, such as cancer centers. |
| 6. |
Facility
solutions are driven by cost and functional requirements. Facility
changes are often the last resort in the mix of solutions to the
problems of shrinking market share, reduced patient and indemnified
revenues, and rising costs. |
The facility changes
are of primary concern to architects and planners who serve
the healthcare industry. Although
often the last resort at rural and small hospitals, the physical changes
can be one of the most dynamic solutions toward improving quality of
care and market share, controlling costs, and increasing revenues, as
the following cases demonstrate.
Facility planning, design
and development cannot be divorced from the business of the hospital.
An integral relationship exists between the many business strategies
and effective facility strategies in the cases below, and in the general
discussion that follows.
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