|Real estate is critical in keeping patients safe, boosting quality of care, and keeping hospital budgets in check, leaders of world-class healthcare insitutions told the 260 attendees at yesterday'sBisnow Healthcare Summit.
|The esteemed panelists: Whelan Associates co-founder Bill Whelan, Children's Hospital exec director of capital planningPaula Quan, Boston Medical Center project director Jane Barry,and Skanska SVP Andrew Quirk, who directs national healthcare strategic development. They discussed changes in building design, operations, and financing. Jane says that when a hospital considers space, the first thought is about providing safe care; a treatment room overcrowded with staff and equipment can lead to confusion and mistakes. However, ROI still counts.
|Massachusetts is already five years into healthcare reform. Now that the state has achieved universal coverage, Jane says hospitals are focused on slowing the growth rate of costs—and real estate is a key expense for all hospitals. When planning capital projects, her team works with providers to evaluate which services must be closest to patients and therefore in the most expensive space. (For instance, medical administrative offices don't need to be in the costly ambulatory care unit.) Another top design priority: complying with ADA regs in older buildings, which she says will take years to implement due to the scope, cost, and operational impact of the work.
|While Children's reimbursement levels have declined in recent years, its space needs have increased. An OR that once was 450 SF now needs to be 650 SF to fit the newest equipment; standardexam rooms are now 135 SF vs. 100 SF. In the crowded LMA, expansion is tricky. So when a nearby property is for sale, Children's tries to buy and land bank it. Like many other hospitals, it has opened satellites in suburbs where space, parking, and operating costs are lower. Paula says that developing a new building in the city can take up to seven years from concept to construction start because buildings are complex and permitting is complicated.
|Andrew, whom we snapped with colleague Laura Oneissimo, says hospitals are also rightsizing. While expanding patient care space, they're shrinking optional space like front lobbies and scrutinizing every square foot, since improving building efficiency is imperative. But those seeking recession-driven construction price reductions face disappointment. They may have found cheaper construction in '09 and '10, but that's over, he says. Now, it's a matter of pushing more patient care into the home and reconceiving real estate design and use.
|Bill, whom we snapped schmoozing, says that last Wednesday, client Stewart Healthcare put up 11 buildings totaling 350k SF for sale, paring down its recently acquired portfolio. Jane says that BMC is re-evaluating the long-term use of all its real estate and the possibility of monetizing some assets. In the meantime, it seeks philanthropy and government funds to finance capital improvements. (Recently, it used new market tax credits plus traditional bonds for three projects.) Paula says that for the most part, AAA-rated Children's self-finances construction, then sellsbonds for the long-term take out.
|We chatted with sponsor Comcast Business Class director of enterprise services Trent Bartlett, who tells us that Comcast's new fiber optic-based products have larger bandwidth, providing healthcare users a more diverse, robust IT network. For example, a hospital could use it to connect several locations so everyone can communicate with each other via voice or data.
|Real estate executive search firm Keller Augusta managing director (and soon-to-be mother) Jodi Dakin tells us that for thefirst time in three years, her firm has been asked to filldevelopment jobs at companies building life science andmultifamily projects. With her is architect Leslie Saul, who recently completed the interior fixture, furniture, and equipment for the new 180k SF library at UMass Dartmouth (a job with Design Lab andAustin Architects).