2. Spotlight
ST. OLAVS HOSPITAL - TRONDHEIM, NORWAY
One of the more exciting projects in green elements, including trees, wild stones
healthcare today is St. Olavs Hospital in and bushes. Interior and roof gardens are
Trondheim, Norway. Replacing the century a feature throughout, covering about a
old structure (950 beds, 8,000 employees, quarter of the ground area.
413,000 patients a year) the new facility is
aiming to become the most technologically St. Olavs is also deploying Microsoft’s
advanced hospital in northern Europe by advanced information and communication
2014. technologies, along with single, integrated
Internet Protocol (IP) network. This tactic
In order to become more patient-centric, not only reduces operating costs, it allows
St. Olavs is implementing improvements for services and applications to become
in the healthcare experience from many more flexible and/or integrated.
angles. New efficiencies in energy use
and operations are part of what make this The first of six clinical centres were
ambitious project sustainably fitted to the completed in 2006, and the entire hospital
services they provide. will be ready to treat patients by 2015.
We are building a hospital technology infrastructure
that unlocks the benefits of enhanced communication.
The new hospital will consist of seven St. Olavs will form the basis for entirely
clinical centres, each designed to operate new treatment methods, increased
Arve-Olav Solumsmo
as an organizational unit, with adjoining efficiencies, and better patient care. A
Public Relations Manager
functions. Each of these centres (20-30,000 highly integrated design approach, both
St. Olavs Hospital
square meters in size) are connected via physically and technologically, will
underground passages and sky bridges to allow users to combine patient treatment,
maximize circulation and active transport research and teaching functions. Wireless
of supplies. networks will provide patient information
any time, and from any location, along with
The centre of the facility is future proofed, communication systems, alarms, and calls.
and not fixed to a specific block, rather it
can be adjusted or divided among blocks to Production Increase: 26%
better service patients and staff over time.
Aesthetically, all public spaces feature Headcount Increase: 10%
THE FuTuRE OF HEALTHcARE
3. The Next 5 Years in Healthcare
TRANSITION AND EVOLuTION
Age Sensitivity
Sun + Light + Air
Separated Temp / Vent
Integrated Family Care Model Patient Centered
Energy Efficiency Improved Mechanical Technologies
Zoned Patient & Operations Protocols
Sustainable buildings, sustainable campuses
Proximity of Care / Services
Flexible Facilities / Systems
Shorter Stays Research Conversion Flexible Care Strategies
Acuity Adaptability
Sicker Patients Systemic Re- alignment of Business Models
Preventative Medicine
Robotic Surgery
Surgical Episodes
Tele- medicine Healthcare Treatment Strategy
Technology + Care Delivery Chronic Disease Management
Patient Room Size Real Estate Ontology
HealthVault + Patient Stakeholders 2010 - 2015 IN patient OUT patient mix
Accountable Care, Bundled Payment
Urban Centers / Mix Use Models
Quality Incentives + Penalties
Smaller Footprint Buildings, Linked Services Cost Efficiency
Scale + Service Level End of pure fee for medicine
Transparency (Operating Rooms with Windows)
"greener" facilities, lower OPEX
Adaptive Re-use, Community
Interdependence
Efficient Clinical Systems
Elastic + Adaptable Medical Homes
Networked Treatment
Patient Rooms with Care Spectrum Specialty practices "string of pearls"
Buildings that can change Future Proofing Shared Resource Models
Portfolio Guidelines that Evolve with
Business Model
Healthcare is undergoing profound changes driven by the key issues impacts and responses available will allow healthcare service providers
outlined in this ontology diagram. These “drivers” have many and to re-strategize portfolio needs; creating efficiency, flexibility, improving
varied real estate and facilities implications. Identifying the potential stakeholder satisfaction and increasing or resulting in cost savings.
Healthcare.mmap - 5/3/2010 - Mindjet
THE FuTuRE OF HEALTHcARE
4. Patient centered care
The biggest single driver of a de-centralized portfolio strategy for healthcare providers is
the continued trend toward proximate care availability. Most major providers are facing
a variety of change management scenarios around treatment facilities size and locations
that are driven by:
1. Patient expectations that necessary facilities will be convenient and provide a variety
of offerings close to home.
2. Networked service models create business relationships that may shift over time,
necessitating unforseen facility needs to effectively manage patient flow.
3. Aging patient population – the baby boomers will create a large base of older
Americans that will require medical care. Mature population require different care
strategies and different facilities.
4. The continuing body of evidence around improved treatment results due to facilities
that provide more natural light, improved air quality and individual control is now
the expectation for patient experiences.
5. The move of family and supporting relationship members into the patient room has
a positive effect on treatment results, creating the requirement for larger rooms and
additional services.
6. Zoned space protocols separate patient and visitor experience from facility
operations and maintenance.
THE FuTuRE OF HEALTHcARE
5. Acuity Adaptability
The combination of advancing technology and treatment protocols with cost
efficiency and patient experience expectations is shortening the time that is spent
in a hospital or treatment facility. Shorter stays with effective monitoring tools
put the patient in a comfortable home setting sooner which has a positive impact
on treatment.
With the continuing development of preventative care models, it is likely a
smaller patient population will require critical care at higher levels. Facilities will
need to “flex” to accommodate a variety of needs at one time or in a progressive
treatment protocol.
Technology + care Delivery
Significant technological advances that are now becoming mainstream are
changing the healthcare we receive and the way we receive it as never before.
• Robotic Surgery and Operations Support
• Tele – medicine
• Larger, more flexible patient rooms
• Integrated care/data management systems
THE FuTuRE OF HEALTHcARE
6. Scale & Service
Urban centers and mixed Use models smaller footprint - mid rise with linked Uses
adaptive reUse transparency
THE FuTuRE OF HEALTHcARE
7. Future Proofing
This generation of portfolio planning principles and new facilities guidelines will need to
provide for more “elasticity” of use and systems than seen before. The changes affecting
the built healthcare delivery environment are multifaceted – driven by technology, care
protocols, patient expectation and more.
• Flexible facilities accommodate changes in use and technologies
• Patient rooms with a broad spectrum of care
Flexible real estate strategies that allow for changes in business models, service delivery
models and patient treatment modality.
(i.e. Mental health is the fastest growing category of disease)
THE FuTuRE OF HEALTHcARE
8. Energy Efficiency
• Improved mechanical / electrical technologies
• Sustainable healthcare facilities
Over the past few years, the healthcare sector has embraced the benefits of energy
efficiencies. Healthcare, as a sector, accounts for a disproportionate amount of energy
usage -- more than twice the amount of energy per square foot of space . As shown on
the left, many healthcare facilities are now experimenting with the benefits of “green”
technologies -- cooling towers, on-site solar and wind power, employee workflow
changes and lighting solutions.
Providence, pictured on the left, is the first LEED Gold healthcare facility in the United
States. The nationally recognized medical center was able to significantly reduce
operating costs, without sacraficing its ability to deliver quality care.
solar efficiencies air cUrtain diagrams
providence medical centre - newberg, or
THE FuTuRE OF HEALTHcARE
9. cost Efficiency
Cost efficency is a difficult subject in healthcare facilities. In order to lower operating
expenses while maintaining the ability to provide quality care, healthcare facilities are
utilizing accountable care, bundled payment models, quality incentives and penalties,
and greener facilities. Accountable care integrators can actually improve patient health
and productivity while lowering costs.The diagram below illustrates how a blend of
Modified fee-for-service and bundled payment models are precieved as most effective to
improve efficiencies.
“how effective do you think each of the following payment approaches would be in
facilitating a more efficient health care system?”
very effective
effective a blend of the modified fee-for-service and
25 37 62
bundled per-patient payment systems
bundled per-patient payment (a single
payment for all services provided to
19 32 51
the patient during the year), with bonus
payments for high quality
a modified fee-for-service system, with
bonus payments for high quality and 5 18 23
efficiency
source: commonwealth fund health care opinion leaders survey. september/october 2008.
THE FuTuRE OF HEALTHcARE
10. Research conversion
Research is being translated into new treatment protocols with increasing rapidity.
Technology, holistic cost models and government support are moving new medicine and
innovative care models into the marketplace.
Treatment Strategies
At every level healthcare services are changing - real estate strategies must support this
by understanding the business dynamic and providing thoughtful solutions.
Networked Specialties
Communications platforms are transforming healthcare centers into highly collaborative
networks of spaces. Efficient clinical systems are necessary (care platforms and
electronic medical record services) to transfer information efficiently among healthcare
professionals.
THE FuTuRE OF HEALTHcARE
