With 450 Newcomers Arriving Every Day, Master Planning Never Stops For DFW's Healthcare Industry

While some healthcare systems plan 10 years down the road, the healthcare industry in North Texas has doubled that time horizon when it comes to constructing real estate built to last in areas where people are congregating.

The reason? Continued explosive growth in the region.

With more than 450 people moving to the Dallas-Fort Worth area each day, the region's healthcare systems are in a nearly constant state of expansion and reinvestment in aging infrastructure, panelists said Wednesday at Bisnow’s Dallas Healthcare Summit at the Hilton Anatole.

And as project budgets swell, healthcare systems are doing everything they can to make those facilities as future-proof as possible. That means preparing for new innovation, finding partners to help with master planning and meeting the growing population wherever they are.

“Think about just the sheer magnitude and scale associated with that [population growth],” Perkins & Will principal Ian Sinnett said. “That's driving a lot of growth, which I think is both a strength and a challenge at the same time because that growth leads you to labor issues, it leads you to economic pressures, both from international material coming in but also local material, and how do you get access to it?”

To achieve flexibility at aging healthcare campuses, Cook Children's Health Care System Senior Vice President Spencer Seals said the process of master planning is never done, and it is vital that providers connect with a partner that can walk them through what is going on in the market. 

“Five to 10 years is really just a blink of an eye in healthcare,” Sinnett said. “We're looking at projects and projections that are talking about 2040 and 2045, so we're talking about 15 to 20 years out, and that's really the biggest challenge.”

While many hospitals are dealing with buildings that are decades or even a century old, Baylor Scott & White Vice President Charles Shelburne said new construction in the healthcare sector must be ready for whatever innovation or new technology may come along down the line. 

“You think about that adaptive reuse, you think about acuity [and] adaptable rooms,” Shelburne said. “How's the future us going to think about how these are used? Building in that flexibility is always … supporting that future need.”

In some cases, that support is just being smart about floor-to-floor heights because there is a great chance those buildings will eventually need to incorporate service lines that haven't even been invented yet, Sinnett said. 

For huge expansions or renovation projects, it is imperative to be aware of the next steps that are likely to be taken by the healthcare system. 

“We're always master planning, because what you don't want to do is have to spend good money after bad money, especially at this scale,” Sinnett said. “We have to think slow to think fast, and mock-ups … will pay dividends over time with bigger projects and making sure that you're going the right direction.” 

Healthcare systems are innovating for future uses by utilizing wireless technology that allows for fewer fixed items in patient rooms and hospital facilities. 

“We've got to be able to have that flexibility to be able to move with new people who come in,” Rees Regional Healthcare Leader Michael St. Clair said. “When I look at an environment where people have been working in for several years, one of the questions that I do ask is, ‘What can be movable?’”

With several different healthcare systems in North Texas, the region sees a variety of strategies when it comes to rejuvenating campuses, Sinnett said. And while there is constant reinvestment happening at existing campuses, the timely acquisition of new equipment has emerged as a headwind for redevelopment.

“We can only go as fast as procurement can happen,” Sinnett said. “That means [healthcare providers] need to have durable decisions that are lasting over time.” 

The healthcare industry is usually about 15 years behind innovations in retail and hospitality. That means it is now looking at Apple Store-type concepts that would allow providers to interact with customers and focus on wellness in addition to helping patients dealing with sickness, Shelburne said.

The industry is also focused on increasing its retail presence and giving patients easier access to the medical system.

“Getting to the communities [is important] not just for the growing markets but the underserved markets and locations we can really stretch out to,” Shelburne said. 

That growth is vital, especially for simple things like imaging that patients don’t want to have to go all the way to the hospital to get done, UT Southwestern Medical Center Director of Planning, Design and Construction Gena English said.

But growth can present new hurdles. When it is determined that a campus needs to add a tower to accommodate growth, it can take upward of seven years to get that built, even if a clean site is already in hand.

Without that, finding the right spot for a tower can turn that into a project that grinds on for more than a decade, Sinnett said.

That kind of planning becomes tricky when the industry could be upended by new technology, emerging health issues or scarcity of providers in a growing market like the Metroplex.

“Providers are being really, really stretched thin,” St. Clair said. “We're going to be planning for quality of time with providers as opposed to quantity of time.”

That could lead to more biometrics being done ahead of visits to allow more substantive visits with providers. Parkland Health is moving in that direction with a move to add more community clinics away from its main campus.

“That way we can decrease the people coming to [the] main campus and also increase access,” Parkland Health Senior Vice President Carmen Bowling said.