Balancing Cost and Quality: Healthcare Design Experts Weigh in

Earlier this month, leading healthcare design professionals joined us at the D CEO offices for a healthcare design discussion as a part of our healthcare breakfast panel series. We discussed some of the factors impacting healthcare design, what systems, providers, and patients are looking for in systems, how technology has impacted healthcare design and how the space can be used to be more efficient for employees.

The panel included Tina Larsen the Managing Principal and Healthcare Sector Leader at Corgan, Ian Sinnett a principal and regional healthcare leader at Perkins+Will, Jeff Stouffer the Executive Vice President and Health Group Director at HKS, and Joshua Theodore a Vice President and Global Health Practice Leader at Leo A Daly.

We asked our panelists how they balance the desires of patients and providers to have the best quality facilities while also balancing for cost.

Stouffer: “The way we design the building and facilities really hadn’t changed over the last 60 years, but it started to change maybe about five to 10 years ago. Really it was our healthcare clients that drug us into this century with innovative models. One way we are trying to attack first costs is to find better ways of delivering design constructions through collaboration and process improvement. We are just looking at everything we do and trying to get rid of the waste. Manufacturing is down to about 15 percent waste with construction and design, there is still in some cases over 50 percent waste. There is just no excuse for that in this day and age. We’re really fired up about developing processes that really cut that out, and through repeat work with clients and our great engineering and contractor partners across the country and specifically here in north Texas, we’ve been able to help reduce that first cost through time and material. The other this is looking at life cycle. We’re also focused on life cycle costs because your facilities you pay for once, but the folks in it, the efficiency of it, and how that building operates, the energy it uses, you are going to pay for that every day. Construction cost is still a small proportion – less than 10% of hospitals overall bottom line.

Larsen: “I’m in agreement with the life cycle costs, especially because in America we almost have an architecture that is a throw away architecture. We’re looking at lot of buildings to last 20 years but in healthcare, we need those buildings to last 50 years and then some. And not only just last, but to be relevant. Parkland had that distinct issue to deal with they had a 55-year-old building, and they did a number of studies on whether or not they should renovate that building and keep it or if they would have to start over. There was no way to fix the building, in terms of the way it was built and the constraints that it had. I think as architects we have to continue to think outside the box and how we can build flexibility and adaptability into these buildings. We don’t know what the technology is going to be, but we know its going to be different – how do we prepare for that? There are ways, but we have to make sure that’s built into the initial costs because it will save a tremendous amount.

Sinnett: “Building on that idea, if I put a strategic planning lens on the facilities that we’re putting in, we’re all investing hundreds of dollars per square foot in creating a facility that hopefully is enduring for more than 20 or 30 years if its a 50 or 60-year building. And I think what makes that successful is that your first cost that you put in and you don’t come back with a second cost you spend money because you did something and then you gotta come back and change it all up again. Its really important to have a chassis that can be as flexible as the speed of healthcare over the several decades that it is going to be in place.”

Theodore: “Then the last thing really is to look at the utilization of the building, that the cost seems really insurmountable of its only being operated in from eight to five. One thing that we don’t do very well in this country but we experience all across the globe with our other health systems that work with, international clients, is that third shift, those extended hours make that building be utilized 75 to 80 percent of the day not just 50 percent of the day that really brings the overall impact of that cost way down.”