Trends in Healthcare Continue to Drive Construction

by Steve O'Shea, AIA

Healthcare construction in the Pacific Northwest is responding to trends that have been evident for more than a decade. These industry changes along with new medical technologies are continuing to create the need for new and renovated facilities.

Incentives for efficiency and quality

The movement toward managed care has brought incentives that encourage efficient delivery of services and a better understanding of the factors that lead to successful medical outcomes. This has resulted in an increased need for facilities designed for outpatient care and a new appreciation of design quality as a factor in healing.

Outpatient Emphasis

The shift to outpatient care has continued to generate a need for creative re-use of, and well-planned additions to medical buildings. One of the most important factors in designing these projects is "way finding" to help outpatients easily find their way to services they require. Way finding is best accomplished by creating a coherent linkage of comfortable, well-designed spaces that lead from the arrival point to a patient's final destination, or point of service. These appealing spaces have the beneficial side effect of adding significantly to the a hospital's healing environment, while attracting and holding both clientele and talented staff, in an increasingly competitive healthcare marketplace.

The way-finding challenge was encountered in the design of Providence St. Peter Hospital's new outpatient Concourse, the central element of a $60 million project that also included an Emergency Center and Laboratory. The Concourse links multiple entries, patient tower, outpatient services, and Emergency waiting with a series of serene spaces and filled with natural light.

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Renovate or Rebuild

As was the case at Providence St Peter, a great deal of work in healthcare architecture involves renovations of existing buildings. As changes in healthcare create demand to remodel, the old buildings themselves are becoming increasingly outof- date. In order to significantly alter these structures they need to be brought into compliance with current seismic, accessibility and life-safety regulations. In addition they need to accommodate the latest in environmental systems and medical equipment and procedures. Bringing these buildings up to date can be very expensive.

These expenses, along with other economic factors such as staffing and operating costs may make renovation unfeasible and force abandonment of these structures for medical use. When this occurs on a hospital campus, a replacement facility is usually built; and the old facility is put into service for non-medical uses or demolished to make way for future expansion.

The recently completed Surgical Services and Regional Vascular Center at MultiCare Medical Center in Tacoma is an example of this replacement approach. The new facility is a vertical expansion of another part of the main hospital and the old wing, parts of which were built nearly a century ago, now houses non-medical uses but can eventually be removed to make way for new construction. The new facility itself is designed to respond to another key healthcare trend, that of minimally invasive surgical procedures.

Affective Healing Environments

The one trend in healthcare design that has been most gratifying to architects, hospital administrators and staff, as well as patients' families, is the emergence of the importance of "healing environments." Recent research confirms what many in the industry have intuitively understood; that serene, attractive spaces can positively affect medical outcomes. A very deliberate approach to creating just such an environment was taken during the design of Mary Bridge Children's Health Center in Tacoma. Inside and out, the project presents a series of spatial and aesthetic experiences thereby reducing the stress and anxiety associated with illness and treatment.

As they strive to stay medically up-todate and competitive, successful healthcare institutions will continue to re-examine their facilities in light of their communities' healthcare needs.