Healthcare institutions in the greater Philadelphia area are embracing strategies to broaden access to care, including expanding outpatient facilities and exploring adaptive reuse.

Given rising construction costs, there is pressure to build facilities that address today’s needs and have the flexibility to accommodate future advancements, while also keeping their spending in check, said Saul Jabbawy, principal and regional director of design at architecture and engineering firm EwingCole.

“The cost to make upgrades today is higher than what it was, say, seven years ago,” he said. “If they don’t do those upgrades now, they’ll end up spending more in a few years.”

On Oct. 27, Philadelphia’s healthcare leaders will gather to discuss the most pressing topics in the market — including how to distribute and prioritize capital, expand service lines, transform and modernize old infrastructure, and more at Bisnow’s Philadelphia Healthcare Real Estate Summit.

Jabbawy will speak on the panel State of Pennsylvania Healthcare CRE: Where Systems Are Expanding, Consolidating and Repositioning Care. Click here to register.

Jabbawy spoke with Bisnow to discuss the challenges of building amid rising costs and how some healthcare institutions are approaching strategies to increase access to care.


Bisnow: How would you describe the current state of Philadelphia's healthcare market?

Jabbawy: Healthcare systems vary significantly in their level of facility modernization and in their ability to continually invest in their physical environments.

More modernized systems are going beyond basic upgrades, incorporating artificial intelligence into their platforms as well as incorporating spaces with one patient to a room instead of two, new surgical platforms, updated surgery areas and expanded ambulatory facilities. They’re able to continually update their facilities, expand their offerings and bring in new equipment. Other systems, on the other hand, are working to catch up in terms of what they can provide.

Some systems are also able to differentiate their facilities, for instance, by bringing all systemwide cases of trauma and higher acuity cases to their tertiary or quaternary facilities, rather than addressing them in their community hospitals. This specialization eliminates redundancy and allows hospital systems to operate more efficiently.


Bisnow: What is one challenge healthcare institutions are facing today?

Jabbawy: One is figuring out how to incorporate flexibility while controlling spending. Many institutions are borrowing to build these facilities, and some are struggling to build in the flexibility they need in the long term, as it often implies additional costs due to increasing square footage requirements. The changing standards and added requirements are driving some difficult choices.  

In the past, healthcare institutions had a wish list and enough resources to get 90% of what was on that list. Now we are seeing systems that are lucky if they can get 50% of what they need. So the question becomes: When the drivers are resulting in escalating costs, how do you prioritize what to put in and control spending?

We are also transitioning from a long era where patient experience and spending were unchallenged to an era where we have to provide the right patient experience but also make sure that it does not result in nonimpactful, excessive spending.


Bisnow: Can you give an example of a notable hospital project that EwingCole worked on? What made the facility stand out?

Jabbawy: We’ve worked on cancer centers and ambulatory centers in the Philadelphia metro area, but the one we worked on in Duluth, Minnesota, is a good example of a facility that factored in both the needs of the client and the greater community, while being diligent in cost controls.

The hospital was located in a rural environment, with two other hospital providers in the area. It was made up of 10 buildings, some of which were from the 1890s. The decision was to build a replacement hospital. 

The community was small, so they wanted the hospital to be part of the public realm. They introduced a lot of amenities that aren’t typically found in a hospital. The public main entry floor was designed to be open to and welcome the public and had a cafe, restaurants, a conference center and a Catholic church.

The key to the project’s success was specifically not to value-engineer items that directly affect the patient’s experience because that was going to be its market win. This strategy worked beautifully, and now they could use more capacity to accommodate the occupants as their market share expanded.

It is a great example of ‘build it, and they will come,’ and how quality makes a big difference for an institution.


Bisnow: What is the main takeaway you hope attendees will have from Bisnow’s Philadelphia Healthcare Real Estate Summit?

Jabbawy: I think it’s important to understand what’s on the horizon for these institutions and the trends driving the marketplace. AI, for instance, is beginning to significantly affect planning. When AI systems can actually monitor patients better than staff, that begins to represent a shift for the industry, as well as in the cost to accommodate the massive electrical and IT infrastructure. It’s important to look at the industry trends as a whole and how healthcare leaders are responding to them.

This article was produced in collaboration between Studio B and EwingCole. Bisnow news staff was not involved in the production of this content.

Studio B is Bisnow’s in-house content and design studio. To learn more about how Studio B can help your team, reach out to studio@bisnow.com.