Microhospitals Can Reshape Healthcare Delivery in Suburban, Rural Areas

The physician shortage continues to make access to healthcare more difficult in Texas. With an increasing number of counties in Northwest Texas severely underserved, primary care physicians are left to serve the local population.

According to the Texas Department of State Health Services, there are 28 counties with zero Direct Patient Care Physicians, 16 of which are in Northwest Texas. Furthermore, 11 counties in Northwest Texas have no hospital presence whatsoever.

Without adequate primary and emergency care services, the cost of services and general health of our residents are bound to suffer. The emerging microhospital model offers a solution to this access problem, bringing care closer to home for both providers and patients.

Offering around-the-clock care, microhospitals are small-scale, in-patient facilities with between five-to-15 beds for observation and short stay use. Despite the smaller footprint–typically only 15,000 to 50,000-square-feet–many of these facilities can treat high-acuity patients efficiently and effectively.

Many microhospitals offer the same full-range of medical resources as a 400-bed hospital, including ER, primary care, specialties, diagnostics, and surgical capabilities. Since there is such limited space, the design must be tight, multifunctional, and flexible.

For example, one successful solution E4H, an architecture firm exclusively focused on the healthcare industry, has authored is to position in-patient beds immediately adjacent to the emergency suite. At low census, these beds function as overflow positions to the ER up to 23 hours. The flexibility based upon proximity and acuity reduces FTE’s and allows cross-utilization of space.

Unlike downtown hospitals, the smaller space within a microhospital ensures every resource is closely available. Through smart facility design, the emergency department, pharmacy, lab, and radiology suite can all be positioned to minimize travel, resulting in more convenience for care teams and a safer patient experience.

In fact, it’s believed the healthcare industry is moving towards right-sizing facilities and placing out-patient functions into out-patient facilities. These efficiencies have traditionally improved clinical outcomes, with care options becoming more readily available to the community and more personally served once within the facility.

Clinicians have said they feel more connected to their patients because of the intimate environment and often choose to manage the majority of their case load in this smaller setting. The trend towards taking out-patient services out of traditional, larger hospitals and into more consumer-friendly environments has also been embraced by physicians.

The reality of top flight amenities in a microenvironment being more sized-based on patient acuity and risk is embraced. That convenience and improved environment is reflected in the quality of care and the retention of medical professionals.

Patients and medical professionals demand and expect greater convenience and access to healthcare services. Microhospitals offer a viable solution to access, cost, and quality issues facing suburban and rural areas in Texas and across the country.

Rod Booze is a partner with Environments for Health and is a design leader in the newly-emerging field of microhospital facility construction. To date, E4H has designed 12 microhospitals, or 24 percent of the 50 microhospitals built in the U.S., and an additional six boutique hospitals.

Posted in Expert Opinions.