Hospitals Seek Space Solutions For Patient Crunch That Never Abated

Monday marks the fourth anniversary of the World Health Organization declaring that the spread of the novel coronavirus had evolved into a pandemic. Those who manage hospitals and health clinics are still dealing with patient population numbers that never returned to normal.

“We all expected patient volumes to go back to pre-Covid levels. And we thought that we were going to get a break,” Amanda Mewborn, group vice president for Advocate Health Group, said at Bisnow's Atlanta Healthcare and Life Sciences Summit last month. “Unfortunately, that’s not what we’ve seen.”

Hospital bed occupancy nationwide has been above 70% every week since at least October 2022, according to the Centers for Disease Control and Prevention. Georgia's hospitals have been slightly fuller than the national average, at nearly 79% in March, compared to 77% across the U.S.

Elevated patient levels are among a litany of challenges facing hospital and medical systems as they attempt to expand their real estate footprints and incorporate more technology and hospitality features to attract a younger, more affluent patient pool, panelists said at the conference, held at the Crowne Plaza Atlanta Midtown. 

“So one of the big challenges that we're facing is how to care for all of these patients without having the space to do so, which requires innovation in our processes and how we deliver the care,” said Mewborn, who leads planning and construction design for a North Carolina-based nonprofit healthcare operator with 68 hospitals and more than 1,000 medical sites in six states, including the Atrium Health brand in Georgia.

Urban hospitals are experiencing especially acute capacity issues, particularly those like Grady Health System, which specializes in trauma care like gunshot wounds or injuries from vehicle collisions, said Thomas Lemieux, the former director of Grady's facilities development who oversaw the hospital's expansion to 1,000 beds and the renovation of more than 1M SF.

As more patients come in, Grady has needed to expand beyond its central Downtown Atlanta campus and into the suburban areas of Fulton and DeKalb counties, especially after Wellstar Health System controversially shuttered two urban hospitals, flooding Grady with additional patients. 

Grady executed a $60M deal with the Fulton-DeKalb Hospital Authority and Fulton and DeKalb counties to open five neighborhood health centers. But Lemieux said a challenge isn't only the number of new patients at Grady but also that many of the acute patients are staying longer. 

“The inner-city hospitals cannot handle the sheer volume that we have. You know, we've already done three expansions, and we're still already doubled and tripled up in some of the rooms,” Lemieux said. “It takes a lot more staff to deal with gunshot wounds and things that are very intense. We need our volume to grow. But we also need to make sure that we're cognizant of the critical illness of the patients that are coming in so that we can deliver that best care.”

Medical facilities and hospital systems haven't had a break from the challenges of the pandemic era, wrestling with cost inflation, supply chain issues, shortages of medical staff and burnout, according to a 2023 McKinsey & Co. study.

Nevertheless, health systems are trying to adopt a more consumer-centric approach to their services and facilities.

“[Patients] will pay more if they feel like the person taking care of them actually cares who they are, actually listens to them,” said Chris Ressler, the regional healthcare director of the design firm Page. “To put it bluntly, we are very much in the hospitality industry right now. And whether you believe that or not, our healthcare systems are being judged and being critiqued based on the patient experience in hospitality these days.”

Hospitals and medical practices have embraced and emulated features and experiences more often associated with hotels as the industry chases patients with employer-funded healthcare. What patients expect out of their healthcare system has also changed, especially among younger generations that want physicians and staff to be more responsive and faster in their services, experts say.

“What people want is they want everything now. They don’t want convenience. They want access. They want to be treated [with] tons of hospitality,” Anchor Health Properties Executive Vice President Mervyn Alphonso said. “You may have beautiful facilities, but if the perception is that … I’m not getting that patient service, expect that I’m not going to go there.”

Hospitals and outpatient facilities are incorporating more technology to help serve patients as staffing shortages plague the system.

Lemieux said some hospitals are using cameras in patient rooms designed to detect strokes in real time. Healthcare groups are installing check-in kiosks, designing tech in rooms with artificial intelligence that will fill out patient questionnaires and incorporating automated wearables that monitor vitals and take blood samples throughout the day to avoid requiring nurses to do the same thing, Ressler said. 

“One of the first things you learn in computer science is computers essentially get exponentially faster every two years. Now that healthcare is so digital, is so driven by technology, healthcare is starting to get on that level where the care available and technology available is exponentially growing every two years,” Ressler said. “We're going to see some radical changes in how healthcare is delivered, how patients are cared for and how disease is prevented, essentially, in our lifetime.”

Technology is also being used as a marketing differentiator among healthcare systems to lure in patients, Lemieux said.

“People are just used to that technology,” he said. “All of a sudden, you go to some place that doesn't have that, it does frustrate people.”