Whether a single-practice medical office building or a multimillion-dollar hospital campus, or anything in between, a healthcare facility represents the physical manifestation of an organization’s vision, values, and mission. Healthcare facilities are integral to their communities, connecting patients, family, and care providers while delivering critical services to keep people healthy and thriving. Over time, these facilities have evolved from simple brick-and-mortar locations where patients seek treatment to diagnostic centers complete with smart sensors, built-in safety features, and state-of-the-art equipment to care for patients and their families. As facility types have evolved, so too has the facility development process.
Given the demands on these facilities to provide a wide variety of healthcare services and adapt to future technological and service-delivery innovations, the development continuum starts before a facility is designed and continues past construction to the first patient and beyond. It is key for facility leaders and healthcare executives to understand the nuances within each phase of the continuum to ensure their organizations can keep pace with industry, facility infrastructure, care delivery, and patient demands.
High-Level Overview of the Healthcare Facility Development Continuum
Conceptual and Strategic Planning
To assess capacity needs and inform the eventual design of any healthcare facility, healthcare organizations must measure the surrounding market demand, predict changes in long-term healthcare needs, and balance the resulting information with existing patient volumes, bed counts, and building infrastructure. As ambulatory volumes shift from acute care to the outpatient setting, it’s important to build conservatively and strategically, allocating space and resources for future growth. Every facility addition and modification should result from decisions made during the strategic planning phase, making this phase a critical first step in the facility development continuum.
Facility Master Planning and Pre-Design
Once the strategic direction has been determined, it is time to begin facility master planning efforts to turn strategy into tactical execution. These plans determine how many assets—beds, operating rooms, exam rooms, imaging modalities—will be needed to serve the anticipated patient demand and community need, while building in flexibility to adapt to changes in the healthcare landscape.
During this phase, organizations also hire architects and construction contractors to begin assessing, massing, arranging, and phasing the specific buildings or projects planned. Strategic and operational expertise are essential to ensure that design decisions are made with a complete understanding of how the facility is related to the organization’s strategic vision (upstream) and how it will operate and deliver patient care (downstream).
Activation and Transition Planning
Activation and transition planning, which typically occurs alongside and throughout construction, is one of the most exciting phases of the facility development process because it is the phase when a new facility becomes tangible. During activation and transition planning, multiple work streams are occurring simultaneously to get the people ready for the building and the building ready for the people. While planning for the actual operation of the building is an important element of this phase, facility readiness, staff education, medical equipment management and installation, and overall change management also require attention. Above all, patient safety should always be the guiding principle for every decision made during activation and transition planning.
Stabilization and Optimization
The stabilization and optimization phase begins after the facility opens and continues for the lifetime of the building. The first few days and weeks after an opening can be a frenzy of excitement and activity. New processes and workflows begin for every impacted department. Even with the best planning, some processes become suboptimal once staff and patients inhabit the new spaces, leading to decreased throughput and wait times, wasted resources, and potential confusion due to unclear responsibilities. Ongoing evaluation of the process flow is a critical element of facility management, not only to stabilize a facility after opening but also to ensure optimal operations moving forward. Regular performance measurement at the department and organizational levels will help ensure that the facility and its operations meet the expectations set before and during design and that areas requiring additional resources or attention are flagged.