Facilities:
Introduction to Women's Services
Women's services may be defined as addressing the physical, psychological, and financial well-being of females of all ages as well as their children. Programs and facilities range from hot lines for counseling on abuse, adoption, birth control, depression, and pregnancy through to small satellite neighborhood centers focusing on testing and disease prevention. Large tertiary regional centers contain sophisticated facilities for treatment of cancer, infertility, high-risk pregnancies, and low-birth-weight babies. Large academic medical centers and freestanding facilities associated with medical schools may handle between 3,000 and 8,000 births a year and offer neonatal intensive care facilities at the highest level, Level III, as well as labor delivery recovery suites (LDRs), labor delivery recovery and postpartum suites (LDRPs)—often in combination.

The majority of facilities are hospital based for efficiency and backed up with specialists in case of a complication. There is still a strong tendency to make the facility appear as "unbig" a hospital as possible, often through dedicated entrances or separate pavilions.

The following information compares a range of market-sensitive, operational, and facility programs that vary from a restricted budget, all-renovation project, to a blend of new construction and renovation, to an all-new freestanding, comprehensive facility. The data measure the square foot and cost of each project, which may be referenced back to the volumes and revenue stream of patients treated or new babies delivered.

Shifting Market Influences
Not too long ago, a number of studies showed that women made the decision in 70 percent of the country's households as to which hospital would be used for the family. Statistics also showed that 50 percent to 60 percent of the time, a woman would choose a hospital first rather than a physician for a birth. Her decision would be based on its facilities, birth experience philosophy, and convenience, rather than a particular physician on staff. The advent of managed care and encouragement for a 23-hour stay for a birth, followed by some home care, are economic forces that may be altering the criteria by which a hospital is selected. Nevertheless, for a hospital to even qualify for consideration as a provider of women's services, obstetrics, or perinatal care, it usually has to meet certain criteria in terms of the quality of its staff and facilities, as well as the cost for a range of services. The degree to which facilities are up-to-date and allow for secure, quality, and pleasant care at a competitive price is now taken into account by both managed care providers and the family who is the consumer.

In addition to maintaining or protecting market share, the majority, if not all, of the institutions reviewed felt new or improved facilities were required if they were to keep valued staff or recruit new staff or specialists.

LDR and LDRP configurations as well as nurseries and postpartum facilities are reviewed. The analysis of the plans draws attention to what each facility was able to achieve for the amount of space and money available.

The criteria by which the decision was made to renovate or mix renovation with new construction are discussed, together with square footage, phasing, and cost data.

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