Mark Herzog, CEO and President of Holy Family Memorial and Dr. Steven Driggers, Cheif Medical Officer of Holy Family Memorial provide their insights into how to effectively evolve healthcare facilities over the next ten years.

1. MCD
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November/December 2013 | Volume 9, Issue 6
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2. Healthcare leader
PREDICTIONS
Today’s thoughts on the facility of tomorrow
Compiled by Constance Nestor
IT’S A VERY NEW FUTURE THAT’S FACING HEALTHCARE PROVIDERS.
Healthcare as we knew it is a thing of the past. The Health Care Institute
wanted to know how healthcare c-suite leaders are coping with this reality
and their prescriptions for healthcare facility environments during the next
10 years. Thoughts on these challenges were found while conducting
the HCI 2013 Healthcare C-Suite Leaders Survey. The survey included
healthcare institutions of various sizes and types and from a range of
U.S. geographic regions. Although common threads such as efficiency,
remaining competitive and containing costs will always be at the forefront,
the following is a portion of common themes discovered through the
survey. Additional leader predictions and advice will appear in the next
issue of MCD.
TECHNOLOGY TRENDS AND IMPLICATIONS
ON DESIGN AND OPERATIONS
John White, M.D., surgery
dept. chairman, Advocate
Lutheran General Hospital
The hospital of the future
will have significantly more
technology. The operating
room needs to change in support of patient safety
— the reality of today’s facilities is that we’re
retrofitting technology into an OR configuration
that was designed in 1889 by Dr. Charlie Mayo.
The Mayo design hasn’t changed to embrace
new technologies. The rooms aren’t the least bit
interactive with the patient, which is a big error
with respect to eliminating medical errors in the
ORs. Not enough people are dealing with this.
Mark Herzog,
CEO, Holy Family
Memorial Health
Reducing the need
for and use of
expensive technology and care settings and a population health-management approach are
the only methods that will meaningfully and permanently change the cost
curve. Lean approaches, the safest
care and outstanding quality will be
minimal requirements for successful
healthcare providers in the very near
future.
Tom DeFauw, CEO, Port Huron Hospital
We must rely on more cost-effective use of outpatient facilities. Another
clear capital priority is our current investment in electronic health record
technology, a very costly endeavor. While our age of plant is a concern,
our IT financial commitment must come first.
24 Medical Construction & Design | November/December 2013
EVOLVING PATIENT
POPULATIONS
Eileen Gillespie,
chief nursing
officer, Presence
Mercy Medical
Center
The most important
factor is and will
continue to be the ability to adapt
to emerging disease and treatment
modalities; to handle air flow and
prevent the spreading of infectious
disease. The future demands optimal
environments that prevent the spread of
infections. New and renovated facilities
should be planned and designed with
efficiency and an aging workforce in
mind. Compact, efficient buildings with
short walking distances are needed.
How can we start to cluster around
operationalized pods and teams? How
can facilities help to better engage
families in the care of their loved
ones? Technology must be leveraged
to spare footsteps and accelerate
the timely delivery of care. Real-time
decision support technology for patient
surveillance is critical.
Steve Driggers,
M.D., chief medical
officer, Holy Family
Memorial Health
More room options
should be provided,
especially for the increase in obese patients; and larger bathrooms. Swinging
doors cause a lot of falls. Pocket doors,
that can be left open most of the time,
will be better. Mechanisms need to be
found to unclutter rooms for the sake
of cleanliness and visual orientation.
Facilities need spaces for group patient
forums and meetings. Statistically, diabetes patients treated in groups have
better outcomes — resulting in more
economical, more efficient education
and wellness.
Bryan Becker,
M.D., associate
vice president,
University of
Illinois Chicago
Medical Center
Healthcare executives are more willing
to take risks and contemplate facilities
and technologies from a patientcentered perspective. The ambulatory
setting is untapped.
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Medical Construction & Design Magazine © 2013
PART 1 OF 2

3. EVOLVING MODELS OF CARE
SPOTLIGHT ON MAINTENANCE
David Ennis, senior vice president
(retired), Kaufman Hall Associates
Ultimately, to make healthcare affordable in
our country, it will be essential to lower the
historic rate of growth in expenditures for
care. The pressure to reduce growth and
lower costs will be seen in lower payment rates to healthcare
providers. As payment rates decline, so must the cost structure.
Jay Grinney, CEO, HealthSouth
There are several things facility managers can do to enhance a company’s bottom line: ensure all hospitals are maintained to all applicable regulatory standards; transition from a “reactive” to a “pro-active”
approach for facility maintenance and upgrades; operate each hospital
as cost-effectively as possible and collaborate with operations to identify ways to drive operational improvement through facility design.
Rick Mace, CEO,
Adventist Bolingbrook Hospital
Across the continuum of care services
spectrum, acute care facilities (hospitals)
will become a cost center. Hospitals will
be going through a metamorphosis of
understanding where they fit into the continuum of care.
Patients may not be instructed to go to hospital campuses
in the future. We’ll want to educate the patient to go to the
physician office for healthcare, not the hospital. This may
require the passing of an entire generation to teach the patient
population how to navigate the new health system.
Jay Grinney, CEO, HealthSouth
From a post-acute perspective, I
anticipate our facilities will become more
multipurpose as the healthcare industry
evolves. The facility needs of today’s postacute providers are dictated by Medicare
reimbursement policies; Medicare has created post-acute silos
through rules and regulations that exist solely to determine
how Medicare will pay particular post-acute providers. This
has created a fragmented and inefficient post-acute industry
where the needs of the patient are subservient to the needs of
the payor. In an accountable-care environment, the needs of
patients, hopefully, will prevail. From a facility perspective this
means flexible, multi-purpose post-acute buildings that can
accommodate a broad spectrum of patients.
Steve Driggers, M.D., chief medical officer,
Holy Family Memorial Health
At Holy Family, in addition to establishing medical home physician
practices in local nursing homes, we are developing the concept
of inpatient home where caregiver teams (a set of staff plus 1-2
hospitalists) provide patient care, thus bringing a pool of patients
the continuity of a single provider team as opposed to an everchanging chain of caregivers. Facilities need to reflect this.
Ken Lukhard, south market president,
Advocate Health Care
Historically, hospitals and health systems have
been caught between funding inpatient expansion
projects and addition of private beds, infrastructure
demands and the high cost of clinical technology.
Continuous preventive maintenance programs competed for shrinking
capital as reimbursement has fallen. With the growing demand for
broader outpatient platforms and multiple sites of care along with
aging physical plants, staying on top of infrastructure needs will
remain a challenge. It will be difficult to meet all of those demands.
ADDITIONAL THOUGHTS
Jeff Glassroth, M.D.,
dean of clinical affairs, University of Chicago
The current architectural arms race and the
architectural wow factor that is expected is going
to have to change. A better balance between
architectural/artistic high-end hotel-like environments and the mission must be achieved. There must be a balance
between healing environments, technical needs and cost.
Kevin Larkin, CFO,
Presence Mercy Medical Center
To be successful in the future, it will be critical for
providers to achieve a robust margin, including contributions from Medicare and Medicaid. The formula
for success involves eliminating unnecessary costs
and process steps, while ensuring favorable patient outcomes, wowing
patients and striving to be the best-of-class performers. Key cost controls include risk sharing, managing by exception, optimizing productivity, staffing to daily census/volumes, including support services, avoiding
nice-to-haves and simply being great stewards of business resources.
Doug Silverstein, president, NorthShore
University HealthSystem Evanston Hospital
The industry has experienced anywhere from a
5-15 percent decrease in inpatient business. Yet
in an increasingly competitive consumer-driven
environment, inpatient facilities need to be stateof-the-art. Flexibility is incredibly important. We must be prepared
and positioned for moving in many directions. Strategies are also
needed that will take costs out of our construction/capital budgets.
“Can do” healthcare provider cultures are required where committed
and talented people can make a difference.
Editor’s Note: Health Care Institute survey results and interviews were conducted by Constance Nestor, FACHE, EDAC, LEAN, Health Care
Institute vice president for research and Gary Collins, AIA, NCARB, principal of PFB Architects and Health Care Institute vice president. The
second part of this article will appear in the January/February issue of MCD. For more information, visit http://hci.ifma.org.
www.mcdmag.com
November/December 2013 | Medical Construction & Design 25
Medical Construction & Design Magazine © 2013
Mark Herzog, CEO, Holy Family Memorial Health
Historically, healthcare providers have striven to provide
services in a passive manner, being ready when patients seek
care. Increasingly, we must focus on providing services outside
the hospital’s historical core that help community members
achieve healthier lives. In doing so, healthcare must move
from an inpatient-centric model to an outpatient and outreach
structure as articulated in the AHA White Paper Hospitals and
Care Systems of the Future (Fall 2011).