“There is a renewed focus on medical office buildings,” Griffin adds. “A number of hospitals and physicians are looking differently at the whole contractual relationship. … It is impacting some renovations that hospitals are doing. Having those physicians in-house helps the overall cost control as this Affordable Care idea moves out.”
THE RETAIL MODEL As more emphasis is placed on wellness and keeping people healthy (and out of hospitals), health-care designers are starting to see greater interest in the concept of “retail care,” or customer-friendly, time-efficient walk-in medical clinics that are disconnected from larger, centralized medical centers.
“For instance, a lot of our clients are actually putting clinics in shopping centers or they’re taking some of the vacant big-box retailers and converting those into health facilities,” Adams notes. “We had an interesting project we finished about a year-and-a-half ago where we took a vacant Circuit City tilt-wall construction retail center and converted that into an outpatient surgery center. It was a little bit of a challenging project because the building wasn’t initially designed for that type of use, but we’re seeing more of those types of projects coming along.”
BETTER BRANDING As consolidation of health-care systems and mergers and acquisitions continue, according to Adams, clients will look to design firms that can help them establish consistency in branding across broad territories while simultaneously targeting the needs of smaller communities.
“This idea of ‘one size fits all’ for health care over large geographies, I don’t know that it necessarily is what the really smart health systems are looking for,” Adams explains. “I think what they’re looking for is a brand identity over a large geography, but they’re looking for really good firms that can execute facilities that will truly engage a population in a community in a really meaningful way.”
INCREASED COLLABORATIONS “There’s going to be new collaborations, additional collaborations, closer collaborations with the design and construction community to make … a building design in its construction more efficient,” Griffin says. “I think there will be more and more design-assist opportunities, bringing in subs earlier to help architects and their consultants design a more efficient HVAC system, more efficient building types. The big take-away here is investing in the front-end planning. We think it will result in a better product for the client.”
An Opportunity for Change
As the ACA continues to be rolled out and health-care providers respond to the changes in the market as a result of this new mandate, the challenges facing medical facility professionals and design practitioners alike are many. But so are the opportunities to effect lasting change on a system that has been saddled with excessive costs and less-than-ideal patient outcomes (our life expectancy is significantly less than many nations; infant mortality rates are higher than comparable nations; and child obesity is on the rise, according to the AIA report).
“It’s a really exciting time to be in health care because we were kind of pushing toward this less diseased-focused, more prevention/wellness for quite some time,” Rohde says. “It’s just that the Affordable Care Act pushed that a little harder a little faster. It’s forcing transformation.”