The IFMA HealthCare Institute has released the latest research report on Future of Medical Facilities. The report was developed from interviews with more than 30 CEOs, strategic planners, facilities managers, deputy administrators, financial analysts and chief medical officers.
The report was directed by IFMA HCI’s Research Chair Constance Nestor, who is assistant vice president, Facilities and Support Services, Presence Health Mercy Medical in Aurora, Illinois. To download the report, visit http://hci.ifma.org/resources/research-reports (Select Healthcare Leaders Survey).
Major trends identified in the interviews were:
- Survive! The next 3-5 years will continue be a time of dramatic change. The ability to adapt quickly is essential. The big lesson “non-profits” can learn from investor-owned hospitals is to make decisions quickly, check performance often and adjust as necessary.
- Do better with less. The downward pressure on reimbursement rates will continue to increase from both government and non-government payers. Also, look for expanded use of “claw-back” by payers for not meeting performance standards. Healthcare organizations that fail to provide and document excellent patient care will be seriously penalized.
- Know the difference between price and cost. Simply telling the facilities department to buy cheaper is not a path to success. Cheaper air filters and other type of supplies result in higher energy costs and worse indoor air quality. The finance department needs to work hand in hand with the other departments to find better ways to be both operationally effective and cost efficient. Conversely, other departments must learn how to communicate with the senior management in operational and financial terms they understand.
- Increase throughput. Healthcare organizations need to figure out how to use existing capacity and assets more efficiently. This means utilization rates need to increase from the existing 60 percent range to the mid-80 percent range.
- Clicks – not bricks. This term is popular inside Kaiser Permanente. It means using technology, not real estate, to meet the needs of their members. Prescriptions are renewed and filled without a member going to a Kaiser facility. Members can get many of their medical questions answered by a healthcare professional online or by telephone, reducing clinic visits. Also, that healthcare professional may be working part-time from home, further reducing the FTE headcount and the demand for bricks and mortar.
- More but smaller facilities. The growth in hub-and-spoke delivery model will cause hospitals to build or lease additional but smaller facilities. However, managing multiple smaller facilities is not as cheap or easy as many assume.
- Expanding continuum of care. Healthcare is being offered in many more settings and by a wider variety of care providers than ever before. The pressure to increase patient satisfaction and reduce costs will push patients towards the lowest cost provider and lowest cost facility suitable for that care. For example, the use of convenience clinics for flu shots and collecting samples for lab work, or end-of-life care in a non-hospital setting.
- Regulations & standards. Healthcare is second only to nuclear power in regulations and standards. As healthcare systems spread across the nation, they are encountering different versions of the Facility Guidelines and NFPA documents; this adds complexity and increases operating costs. Another challenge is regulations such as excessive air change rates that add costs yet offer little or no benefit in patient safety. There are many opportunities for engineering research to help improve facility operations, reduce costs and provide better patient care.
- Technology. Hospitals will need to cope with an ever-increasing array of technology. However, we are putting state-of-the art technology into an operating room configuration designed 30 years ago. That basic design has not changed to embrace these new technologies – this is a big error with respect to eliminating medical errors in the ORs. Technology must reduce footsteps and speed the delivery of care.
