Wayne Fishback, AIA
Fishback & Associates
Simi Valley, California

Alan Shubin
TPG, Inc
Rolling Hills Estates, CA
Former CFO, City of Hope National Medical Center
Duarte, California

In recent years there have been major divergences developing in the sizing of hospitals. Wasteful is not too strong a word to describe the building programs undertaken by some hospitals.

Until the last 10 to 15 years, hospitals were fairly tightly aligned in terms of space usage. Currently, there seems to be no consensus as to the appropriate sizing of hospitals. With the discrediting of square feet per bed as an indicator of size for both the total hospital and departments, we have even lost the vocabulary for addressing this issue.

This paper reflects on the past methodologies for sizing hospitals, and explores some new approaches for setting benchmarks for required hospital space. As hospitals struggle to stay afloat under the pressures of managed care and capitated payment rates, building cost effective facilities will become an imperative.