Healthcare Real Estate

It is said that what we do today defines our tomorrow, and so it is with the buildings we erect for health care. If we build a small, basic facility, we're building a clinic. If we plan for a the broad, sweeping and diverse facilities of a teaching hospital, that is what we are going to have to work with, provide for and keep up with. In the rapidly changing dynamic of health care in this century, design becomes the keystone of any successful medical facility.

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When people visit those facilities, the building itself is the first impression, followed shortly thereafter by the staff. What do patients see, and how do they feel about the facility before them? Does it intimate, or does it lend an air of calm, capable confidence? Do the wings of the drive-up and drop off area convey welcome, indifference or chaos? What we want to communicate , from the very first glance at the very first sign that the patient sees, is a sense of caring, compassion, of comfort . The impression should be that it is a steady institution with professionals committed to providing the very best of care for all patients. Before they even come in the door, they should feel as though they've arrived at a safe haven, so that they relax, and feel more at ease. This initial impression must be reinforced by every member of staff, from the volunteers on through to the doctors and administrators.

The maintenance of minor details can make make a vast difference in the comfort and confidence a patient feels. To that end, paints, signs, finishing touches, artwork inside and out, these must all be chosen to convey the desired impression, and impeccably kept, so that it does not appear to have fallen into disrepair. Government regulations and technical needs are certain to play a part in the design as well, but they need not make the facility overly stiff, sterile, cold or uncaring. Even security measures must be selected, designed and installed such that the patient is made to feel safe, rather than put upon or harassed. From top to bottom, it is of sublime importance that we carefully select the impression we make, because we will make an impression, one way or another.

The shape and impression a medical facility takes is subject to other factors, and can be affected by temporary circumstances as well. A shortage of healthcare professionals, delays in insurance reimbursements, costs of insurances, care for the uninsured, immediate capacity, new technologies, internal disputes, and other factors can place color filters upon the initial and ongoing impressions, and so they must be considered and dealt with as well.

Project Case Study: Alexian Brothers Medical Center Eberle MOB
The project includes comprehensive imaging and non-invasive diagnostics, a cardiology center of excellence, a neurosciences center of excellence, one-stop pre-surgical assessment, women's and pediatric services, outpatient pharmacy, sidewalk cafe, educational resource and conference center as well as an integral 580-car parking structure. View All: HealthCare Real Estate Portfolio

HIPAA (Health Insurance Portability and Accessibility Act of 1996) regulations mandate the privacy of "protected health information" (PHI). This is another factor that the designer must bear in mind, as considerable emphasis has been placed upon acoustic and visual privacy by this regulation. The location, layout, and acoustic treatment of intake as well medical records storage must be designed to comply with the HIPAA, and allow for the high demands placed upon security of medical records and other patient information, both written and electronic. All of this must be done while accommodating the distressed patient's physical circumstances, disease, disorder or trauma.

In a time when every aspect of the health care industry faces strong demands to reduce costs while providing more elaborate attention to its patients, thise factors play a part and take their toll as well. A facility which was initially designed to be large enough to easily handle the needs of its community is ever more heavily beseiged by the increase in aged patients, who are amongst the most demanding of detailed care and sensitively provided services. Add the increase in population to that aspect, and then that we live in a time where medical and techological advances pour out fast and furious, each with its own vast cost to add to the frey, and it's easy to see that health care costs are more likely to increase than to decrease in such times and under such circumstances. Facilities designs must answer to those needs, both in reducing costs and in seeing to it that construction is completed swiftly as possible, without sacrificing quality or health standards.

Project Case Study: Bend Surgical Specialists MOB & Surgery Center
Bend Surgical Specialists is a combined medical office building and ambulatory surgery center housed in a two-story, 46,900 gross square foot building. The project was conceived by two growing Bend-based providers that wanted to improve patient care by offering greater surgical services and musculokeletal care. The new facility provides a single destination for orthopedic diagnosis, treatment, physical therapy, and full-service ambulatory surgery. View All: HealthCare Real Estate Portfolio

Another endless cycle administrators face is the constant search for both competant staff and patients, so that the facilities use is maximized. Costs of health care professionals continue to be high, and patient loads are also on the rise, but creating and environment which is attractive to both staff and patients is well recognized as being a key factor in attracting and retaining quality doctors, nursing staff, HMO and insurance plans, as well as patients. Though the decision may be based on factors such as cost, availability, quality of care, competancy of staff, and their compassionate demeanor, the perception of all of these factors is embodied in the appearance of the facility.

Some 60-75 percent of hospital expenses are found in labor. This mandates that designs increase productivity, efficiency, and reduce staffing needs. It is estimated that one full-time staff member is carries the same debt service as $1,000,000 of borrowing (Architectural Record, May 1997.) When operations and maintenance costs constitute as much as eighty percent of the costs incurred during the average fifty-year life of a hospital, it becomes clear that any reduction in costs, any improvement in efficiency which a designer can provide will reap vast rewards for that facility, for a relatively small investment.

Project Case Study: Elmhurst Memorial Lombard Health Center
This three-story downtown clinic houses several physician groups and hospital departments, including urgent care, physical therapy, radiology, laboratory, and The Elmhurst Clinic, a multi-specialty clinic. The aggressive target budget was maintained within CON (Certificate of Need) guidelines while matching the "Frank Lloyd Wright" style architectural elements of Elmhurst's flagship "Center for Health." View All: HealthCare Real Estate Portfolio

In these times of rapidly changing rules, needs, diseases and technologies, any new health care facility must be designed to be flexible, if it is to maintain its vitality. Such considerations drive facilities towards increasing out-patient care, including stand-alone diagnostic and treatment facilities. An emphasis is being placed upon special care units, and upon satellite facilities to provide that care, rather than the more traditional mammoth centralized care facilities. Also amongst those specializations are nursing homes (including Alzheimer's Related Dementia (ARD) units,) psychiatric facilities (including psychiatric hospitals,) rehabilitation facilities, hospices, assisted living facilities, congregate housing, and adult day care facilities, as well as other specialized outpatient facilities.

One source of relief is that, generally, sanitary and sterile procedures are become a given, whereas historically such were potential causes of the spread of communicable disease, and posed major health problems. While cleanliness continues to be important, it is now possible to place greater emphasis upon the pleasant ambiance of the therapeutic or healing environment, and this , too , leads to greater success. Modern medicine recognizes that the appearance of its facilities must fit the emotional needs of the patient, and that the patient's recovery is affected by the feel of that facility. A trend towards a more holistic, preventative and constant care of both health and wellness seals the face of the future towards facilities which are warmer in their atmosphere, more pleasant and friendly.

It is important to recognize and addrees that those situations which bring one to visit a hospital or care facility most often are fraught with uncertainty, fear, stress and distress. The patient and relatives rely upon the medical facility and its staff for comfort and direction, depend upon it for guidance in those distressful times. Here again, the designer's job is to ease their fears , and a large part of that is found in creating a medical environment that is at once perceived as cleanly and as a safe harbor.

Project Case Study: Gateway Medical Building
The Gateway Medical Building is located within a 25-acre, mixed-use project that includes hotel, retail, restaurant, residential and office uses. The building's design, including colored split-face masonry and decorative metal work, creates a striking modern building worthy of the prominent community position the facility holds. The two-story building features an elegant full-height entry lobby and separate surgery center entrance. View All: HealthCare Real Estate Portfolio

Finally, both the structure and sustainable energy sources need to be sustainable in the years to come. Proper and efficient use of daylight, energy and water conservation, nontoxic materials and finishes,, easily maintained facilities and other such factors must all come into play. As of this date, a health care facility's energy and water conservation standards must meet the EPAct 2005 as well as the requirements of Executive Order 13423. The Energy Independence and Security Act of 2007 (EISA) adds even more requirements regarding energy conservation.

As health care facilities move on into this century, all of these factors and far more must be taken into consideration if a facility is to be viable. It must, by design, be both strong and yet flexible enough to change easily with the changing demands being placed upon it both now and in the decades to come. Accordingly, the single most important factor in any facitilty's success may very well be its designer.