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April 1, 2022
There is no question that the COVID-19 pandemic has fundamentally changed our view of health care preparedness. The severity of the outbreak challenged health care systems in every direction: sicker patients requiring a higher cost of care; rising expenses across the board for labor, pharmaceuticals and supplies; and fewer outpatient visits and elective surgeries during the pandemic-driven shutdowns have strapped health care facilities and their employees.
Unfortunately, the COVID-19 pandemic will not be the last major health event we face, and health care organizations are having to rethink everything from how hospital workers are protected to the way that hospital environments are engineered and designed.
With an eye toward understanding the specific impact on providers and their subsequent shifts in strategy, Mortenson surveyed more than 100 health care professionals including industry executives, facility and operational leaders from many of the nation’s largest health care organizations at the American Society for Healthcare Engineering’s Planning, Design & Construction Summit & Exhibition in 2021.
All survey participants agreed that the pandemic opened new ways of thinking that will endure long after COVID-19 subsides. At the same time, the pandemic accelerated several important health and community trends that were already taking place. Three major themes emerged that summarize the current focus of health care providers:
• The need for greater flexibility.
• The need to make space changes to maximize safety and comfort.
• The continued advancement of telehealth.
When asked, “What is the greatest long-term impact of the pandemic on your health care facilities?” the topic of flexibility was referenced more than any other. Health care facilities need flexible, multi-functional spaces that can quickly scale up or down in acuity and capacity levels. During the biggest waves, when hospitalizations were at their peaks, the need for additional intensive care unit (ICU) bed capacity and trained staff became apparent. Just as importantly, HVAC, air exchange, ventilation, gas lines and engineering systems lacked the flexibility to control airflow and keep patients and caregivers safe. Future engineering of these systems will need to support quick conversions to negative pressure of isolation of rooms and floors.
Another important element of creating greater flexibility is the use of modular components. Facility components designed and built in a standardized manner can be configured and reconfigured efficiently. Sixty percent of survey respondents reported they were considering modularity in the hospital environment including patient rooms/ICU beds, acuity adjustable spaces, surgeries, isolation, and other uses. Another 34% are considering using modular in the ambulatory setting to reduce cost and drive consistency across their network.
The second greatest long-term impact of the pandemic on health care facilities was the need for design and space changes aimed at increasing safety and comfort for all while underscoring the heightened commitment to the well-being of the caregivers. Space changes included the need for more physical barriers, distancing and touchless designs. Patient and treatment rooms needed to be better prepared to manage infectious diseases requiring more isolations rooms and single-occupancy rooms. More wellness and respite areas were needed for caregivers to rest and take breaks. Common space areas such as waiting rooms, entrances, screening, and patient and provider flows are all receiving more attention now as a result.
POWER OF TELEHEALTH
Telehealth continues to drive agility. Out of necessity, the pandemic accelerated the transition to telehealth and providers quickly recognized the positive impacts to their organizations. All of the providers agreed that telehealth is receiving much more attention now versus pre-COVID-19. Telehealth allows providers to quickly and efficiently triage and direct patients to the right care at the right time. It also helps providers reach new patients and underserved communities, enhance preventative, proactive, or ongoing care, and reduce the overall cost of care. Just as importantly, telehealth often allows patients to get the care they need without the fear of having to go to the doctor’s office or emergency room. Additionally, greater use of virtual care and technology solutions are enabling efficiencies in facility space utilization.
FUTURE FACILITY INVESTMENTS
When asked, “How will your facility investments in the next 12-18 months compare to the 12-18 months before COVID-19?” respondents replied as follows:
• Nearly 40% said they plan to increase investment into their facilities in 2021/2022.
• Eight out of 10 indicated that their facility investments in the next 12 to 18 months will be at, or above, pre-pandemic levels.
• 70% noted they are planning to invest in traditional hospitals and acute care, compared to just 48% in 2018.
While study results have highlighted the renewed attention on the inpatient setting, 51% of respondents also pointed to ambulatory surgery as part of their organization’s investment future, which supports a continued trend toward moving certain procedures and surgeries out of the hospital.
As a result of this shifting landscape, developer/builder Mortenson continues to work with customers to offer innovative capital, development and construction solutions to help health care organizations drive flexibility within their facilities while advancing a community-aligned care delivery strategy.
A recent case in point involves Mortenson’s collaboration with Providence Health to bring its 118,000-square-foot integrated Reed’s Crossing Medical Office Building & Wellness Center to Hillsboro, Oregon. Commencing at the onset of the pandemic, the Providence and Mortenson team stepped back to evaluate potential design considerations that would allow flexibility to adapt to an ever-changing health care landscape. This allowed the team to integrate adaptable exam rooms with the ability to supply negative air pressure capabilities should the need arise for more capacity. The space was also designed for both provider and staff engagement, as well as patient experience with:
• Collaborative workspaces to promote engagement internally and with the local community.
• Improved respite spaces along exterior walls.
• Increased natural light in break room spaces.
Similarly, Mortenson recently mobilized on Kaiser Permanente’s new Specialty Care Center in Everett. An expansion upon the existing Kaiser Permanente Everett Medical Center, the project includes a state-of-the-art 150,000-square-foot ambulatory surgery center with multiple specialty clinics and exam rooms designed with future flexibility in mind to scale with telehealth services. Modular and design for manufacturing and assembly elements such as Dirtt modular partitions for clinic spaces and exterior wall panels manufactured in Mortenson’s off-site factory are being leveraged to increase the speed of delivery.
As the health care industry endeavors to meet the challenges of a once-in-a-generation crisis, the long-term effects of COVID-19 will have a lasting impact, forcing leaders to rethink how they organize, make decisions, serve customers, continue to retrofit existing spaces and expand. Working with a developer/builder who has access to a full spectrum of capital, development and construction solutions can make that journey possible.
Bryan Maggio is health care market director and guides Mortenson’s health care teams. Chantily Malibago is Mortenson’s director of health care real estate development and leads Mortenson Development’s health care vertical sector.