Hospital Impact: Despite constraints, innovation is necessary in hospital design

Pictured is a hybrid operating room at one of the hospitals Petra ICS works with. The Siemens C-Arm that is mounted on a robotic arm is the same robotic arm that is used to build BMW automobiles, an example of taking ideas from other industries. Image: The Innovation Institute

When I think about innovation within strict regulations in construction and design requirements, I think about how pressure, restrictions and even episodic moments in time have caused great innovation to happen.

If you look back at World War II, for example, the country turned to innovation to address major challenges, resulting in Radar Detection and Ranging (RADAR), Sound Detection and Ranging (SONAR), nuclear power, computer advancements, synthetic rubber, jet engines, underlying technology for multitrack recording, penicillin and more.

When innovation takes place, we see markets shift to compensate and compete. When Amazon stepped in with a new way to shop, others followed with online shopping platforms. When Uber dared to introduce a competitor for transportation, others took notice to invent similar programs.

In healthcare construction and design, we look for ways to stand out from others through diligence and innovation, but we know that we will always be challenged by the fact that we must work within our industry’s strict code requirements. That only makes us try harder—just like when a war threatens a nation, or when an inventor creates a new norm that threatens a product or company’s existence.

Our challenge today in healthcare design and construction is that we need to be experts at flexibility to better serve changing health systems. Therefore, the whole idea of modular construction, prefabrication or lean-type construction is very appealing.

Ready-to-go clinics

We have gotten better at what we do by watching how other companies like Walden Structures innovate within code requirements. They practically built a state-of-the-art hospital overnight in Missouri, after a natural disaster wiped out the existing one. They built the modular hospital, shipped it, then fabricated the rest onsite. A 150,000-square-foot facility was built within 8½ months from the date the contract was signed.

Project Frog prepares prefabricated building kits that reduce traditional construction schedules by up to 50%. They’re mostly for educational facilities, but big names like Kaiser Permanente have used them to build medical office buildings.

ADITAZZ has designed a data-mapping microchip that provides computationally enabled, scenario-based planning on a massive scale, offering flexibility at every stage of design, manufacturing and assembly, with ongoing retrofitting and adaptation every step of the way.

A major healthcare shift is most likely happening in these next four years. The idea of “doc-in-a-box” and “wellness clinic,” similar to what they have at Walgreens, Walmart and CVS, are models upon which we are prepared to design and build.

In the meanwhile, we need to stand out above the rest to continue to succeed. I think that those of us who can easily adapt to change will lead the way in healthcare design and construction.

I emphasize that we must be ready to accommodate what the market demands. How do we accommodate telemedicine, for example, as Medicare reimbursements change to favor that type of care?

Perhaps remote high-tech wellness clinic kits designed in accordance with affiliated health systems will need to be ready for installation within rural communities. These kits would include HIPAA-compliant, cutting edge infrastructure systems with standalone tablets, computers and cameras. Google Glass would be a good possibility in these kits, too.

As innovations happen across other industries, we need to be more than just curious about them. We need to take a closer look to determine how new technology and design can benefit where we are today and where we are heading tomorrow, even if we are not sure.

Automation

Self-driving cars are being developed, similar to self-flying airplanes that are programmed to map out a destination ahead of time. So for the construction industry, why not self-pouring concrete or automated construction to reduce risk and save money? It wasn’t that long ago that it was commonplace for people to die from building a bridge, a hotel or even a big hospital.

Not one size fits all

New generations are dominating our populations, and Generations X and Y are much more consumer-driven than the “take what you get” baby boomers. But will they demand more hospitality and service? Yes and no. It’s all about economics.

People who have money may want to spend more on care, similar to how they pay to stay at the Ritz Carlton. We need to be prepared to provide them with the high-end care and private suites they aspire to. We’ll also need to provide a lot more choices beginning with the basic standard of care that all are entitled to.

If you think about it, it’s almost like how the HMO and PPO work. With HMO, you get the doctor and hospital they assign you to, which is most often just fine. With the more expensive PPO insurance, you select your hospital and specialist.

As we dig deeper into our work today, we must be cognizant of the strict code requirements and how they apply to the types of projects we have under construction, whether it be for acute care facilities, medical office buildings or something different.

We can certainly innovate and try new techniques; we just need to make sure we all have accessibility to the various code manuals to ensure that we address those while also thinking about how to prepare healthcare organizations for imminent change.

As an assistant vice president of planning with Petra-ICS, Jun focuses on facility planning, visioning and early design activities that help to solve the healthcare business challenges that face hospital and health system leadership.