Hospital design elements can lead to ROI

When it comes to hospital construction and design, the decisions around what is built and how it’s built all have significant impact on not only an organization’s bottom line, but also the quality of care given to patients.

For many years it was difficult to get hospital executives interested in the concept of certain healthcare building design features, as well as “green” initiatives that could have a substantial impact on a hospital’s long-term bottom line and ROI, said Roz Cama, board chair of the Center for Health Design and president and principal interior designer of Cama, Inc., a healthcare design firm.

[See also: Hospitals save money by ‘going green’]

“It seemed we had to find a direct correlation between design and patient outcomes,” said Cama. One of those correlations came when it was realized that having single-patient rooms resulted in better patient outcomes because fewer people in a room reduced the spread of infection. “This caught peoples’ attention and for the first time we could build the business case,” Cama said.

Cama added that with healthcare reform and cuts to reimbursements for unnecessary readmissions and hospital-acquired infections, higher quality care and “doing more with less money” has become even more important to hospitals. Making sure patients are exposed to a lot of natural lighting as opposed to more artificial lighting, and appropriate noise levels on each floor to reduce patient stress are both factors that can lead to better patient outcomes and faster healing, said Cama.

When designing any of their new facilities, Princeton HealthCare System, based in Princeton, N.J., keeps in mind two categories of design elements that lead to cost savings for the hospital, said Barry Rabner, president and CEO of the health system: sustainability elements that reduce energy costs and operational elements that keep staffing costs down and improve patient care.

For example, when the healthcare system began planning the design of its University Medical Center of Princeton in Plainsboro, N.J., in 2003, their goal was to reduce energy costs by 25 percent and their carbon footprint by at least 50 percent compared to what energy costs and their carbon footprint would have been had they used conventional technology within the new building.

The hospital has been opened a little over a year now and so far their plans are on track, Rabner said. “Any sustainable feature within the building had to have a payback to us within 15 years and preferably much sooner,” he said. “So far, most of these features are on the track to payback within three years.”

Some of the sustainable features built into the hospital include a co-generation natural gas plant with the ability to buy and sell power, a chilled water energy storage system and solar cell panels powered by the employee parking lot.

Rabner added that the operational design elements within the hospital have also been successful.

“When we were designing the building, we got a lot of consulting help to think through how materials enter the building and move through it – ultimately to the staff and patients,” he said. “We designed it so nurses can access all materials right in the room instead of hunting and gathering and wasting time.”

At Kaiser Permanente, based in Oakland, Calif., John Kouletsis, vice president of facilities planning and design at Kaiser, said the organization has made the commitment that any new healthcare facility they build must be, at the very least, Gold LEED certified by the U.S. Green Building Council (USGBC) for sustainable designs, green building materials and energy-efficient systems.

LEED stands for Leadership in Energy and Environmental Design and is the accepted benchmark for sustainable building practices in renovating existing facilities or building new ones. Using a stringent rating system, the USGBC certifies projects Silver, Gold or Platinum.

“Kaiser has a long-standing commitment to sustainability, and we have a strong business reason for it,” said Kouletsis. “We believe very strongly that the degradation of the environment causes problems to human health.”

Kouletsis added that when healthcare organizations are considering redesigns, many are concerned about the extra costs involved with making sure the facility has sustainability features.

“There’s a perception that LEED can be expensive, and while that might be true in some cases, we’ve discovered that we’ve been able achieve Silver or Gold status with no cost increase or a very small cost increase,” said Kouletsis. “Even the extra costs that were spent, in the long run, these things will dramatically lower healthcare costs in many cases.”