Content area
Full Text
The classic rules of thumb for hospital construction have been rendered obsolete by the recent revolution in outpatient care. Instead, the strategic focus has shifted, and hospitals are struggling with the complex answers to some basic questions: how to plan outpatient facilities and where to locate them.
"Ninety-five percent of hospitals have the same problem--facilities that were designed for inpatients. Now, architectural needs are very different," says Roger Panther, president, facility development division, Quorum Health Resources Inc., Nashville, TN.
An outpatient facility requires a distinctly identifiable entrance, pleasant, non-institutional surroundings, and greater space for added traffic and new technology.
Unfortunately, existing hospital buildings--which typically have a large base of two or three floors housing support services in the middle, and bed towers on the outside--are not easily adapted to these new needs, says Bill Heun, partner, Matthei and Colin Associates, an architectural firm in Chicago.
Newer hospital designs involve several linking buildings. "Low-level, separate buildings allow more latitude," says Bob Pfeifer, senior hospital and clinical planner, Universal Medical Buildings (UMB), Milwaukee.
Outpatient sites shift. Location preferences for outpatient facilities have changed in the 20 years since hospitals began building them. "Ambulatory care started out in acute care buildings, then was moved into separate facilities, and now we see it moving back into the hospital," says Harry Varwig, senior vice president of HBE Corp., a planning, design and construction firm in St. Louis.
Scarce capital is an important factor behind the trend back to the main campus. "You can't make the original structure and the accompanying debt go away. It's contrary to good business in some peoples' minds to build new when rooms are empty," says Al Seeley, president and CEO, Mediplex Medical Building Corp., Dallas.
"In a small community with a need for more outpatient services accompanied by a falloff in inpatient services, hospitals haven't much choice. Outpatients will be served...