How Health System Leaders are Planning their Next Hospital

How Health System Leaders are Planning their Next Hospital

Andrew M. Ibrahim MD, MSc is the Maud T. Lane Research Professor of Surgery, Architecture and Urban Planning and Vice Chair of Surgery at the University of Michigan. He previously spent 6 years as the Chief Medical Officer and Senior Principal of the global design and architecture firm, HOK.

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I had a chance to review this timely survey from New England Journal of Medicine Catalyst (March 2024) on healthcare building and renovation plans. The survey included >700 healthcare system leaders across the globe including those large & small, for-profit & non-profit and those within the US or outside of the US. The findings, found in next months volume of NEJM Catalyst , are striking and give a clear direction for 2024 and beyond.

Here are my 5 take aways:

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Busy Years Ahead. For all of the concerns about hospital margins and pause in capital projects during COVID, hospital construction plans are full steam ahead. The majority of health systems are actively planning new construction (51%) or renovation (61%) within the next three years.

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Hospitals Still Dominate. COVID forced all of us to get more creative with telehealth, remote visits, home care and alternative sites of care, but that has not dampened the need for inpatient hospital beds. Hospital towers remain top the list (45%) on type of construction being planned by health systems leaders. Notably, 84% of US leaders said telehealth had no impact on their building initiatives.

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Capacity. Capacity. Capacity. When leaders were asked why they are building, the majority (62%) cited capacity (inpatient beds) as the top priority. Ask any clinician at a major hospital center, and they likely will tell you they are consistently above 90% capacity. This is particularly true for centers providing specialty care that require intensive inpatient resources. We can and should continue our efforts in preventative and primary care, but its clear that for the foreseeable future, inpatient beds will remain in high-demand.

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Architects Missed Opportunity. When asked about the impact of their new building on care delivery, nearly all (91%) said improvement in patient experience. This is good news for architects and reflects well on our ability to demonstrate how our design matters to patients. However, less than a third (29%) of US health systems leaders felt their new buildings would impacts costs of care. This reflects a major missed opportunity for architects to demonstrate the cost impact of our design solutions.

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Sustainability in All Design. It was not long ago that sustainability in a hospital was a, “nice to have.” The 2024 survey signals a real shift. Now 87% of healthcare system leaders state the impact of climate change is “Important” to “Extremely Important.” I suspect this will now remain a standard expectation, but there is still a long way to on the carbon footprint of hospitals.

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Over the next few weeks, I’ll take a deeper dive on some of these findings and unpack their implications for how architects design moving forward. What results stood out most to you? If not the 5 above, let me know below and I’ll do my best to address in the next post.

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