Outpatient care is undergoing a profound transformation. As health systems reimagine how and where care is delivered, a growing share of procedures — from cardiology and orthopedics to endoscopy and imaging — are migrating to freestanding ambulatory settings.
This shift is projected to continue. Total outpatient volumes are expected to increase by nearly 11% between 2023 and 2028, with a considerable portion of that growth driven by ambulatory surgery centers.
As health systems invest in and build facilities beyond the main hospital, it’s critical for leaders to make design decisions that deliver the greatest return for their construction dollars.
To gain deeper insight into how healthcare leaders are approaching facility design, service placement and investment strategy for outpatient care, Becker’s Healthcare recently spoke with two executives from Gresham Smith: Jim Langlois, executive vice president, healthcare; and Jude Wessels, senior healthcare designer.
Ambulatory care facilities: a win for hospitals, patients & staff
Three key factors are driving the shift of certain services from hospitals to ambulatory care settings, Mr. Langlois explained.
The first is relieving pressure on the main hospital facility. Shifting care to outpatient settings immediately creates more capacity in the hospital. “Decanting patient volume from the main hospital to ambulatory centers enables clinicians to do better work in the hospital, while also expanding access to care in outpatient facilities,” he said.
Second, ambulatory facilities offer a more economically sustainable model. Constructing outpatient care centers is less costly than traditional hospital structures. In addition, it often takes less time to develop an ambulatory facility on a new site than to build on an existing, land-locked hospital campus.
“A lot of leaders make expansion decisions based on how rapidly they can grow their market and revenue,” Mr. Wessels said. “Not only are ambulatory facilities a less expensive type of construction, but they also can increase speed to market. As a result, hospitals generate revenue faster by shifting care to an outpatient setting.”
Healthcare organizations are also drawn to ambulatory settings for their potential to improve both patient and staff experience. Oftentimes, these facilities are built in areas that are easier for patients to access and provide a more comfortable setting. Staff also appreciate more convenient access and parking.
The benefits of ambulatory facilities are evident in a freestanding emergency department (FSED) that Gresham Smith recently designed and built for a client. The FSED relieved the pressure at the main hospital’s congested ED, improving patient care and the patient experience. In addition, the FSED has helped the organization build its brand in a new community and is driving increased patient volume to the main facility.
The business potential in thoughtful design
Healthcare leaders must strike the right balance between centralized and decentralized care delivery. Some of Gresham Smith’s clients, for example, are concerned that their organizations may lose their identity and civic presence if they pull too much care out of the medical center.
Mr. Langlois emphasized that when organizations transition certain procedures or service line components to ambulatory centers, it’s essential to maintain a clear connection between those centers and the main hospital or health system. Strong branding and thoughtfully designed, high-quality facilities play a critical role in reinforcing that connection.
Many healthcare organizations are focused on applying retail concepts like easy access and convenience to outpatient ambulatory care facilities. At the same time, however, the building design must inspire confidence among patients. “Care facilities don’t want to be seen as a Burger King or Wendy’s,” Mr. Langlois said. “You want patients to feel that they will get the best care possible by going into an ambulatory care facility.”
As hospitals and health systems expand their ambulatory care footprint, it’s important to keep several best practices in mind. For example, Mr. Wessels recommended identifying a strategic location that will support the community.
Also, standardization across facilities pays dividends in terms of branding, costs and flexibility. One way to achieve this is by incorporating common elements across multiple ambulatory care locations. “Those prototypical elements become branding opportunities because they are recognized in the community. Standardized rooms and components also give you greater adaptability to grow into other areas or replace services without doing construction,” Mr. Wessels said.
With rapid adoption of AI, automation and robotics in healthcare, the importance of planning ahead for technology cannot be underestimated. Both leaders noted how investing upfront to support future technologies is often money well spent.
Looking ahead: ambulatory care facilities as pillars of community wellness
Many healthcare organizations are increasing focus on wellness and illness prevention rather than reactive “sick care,” which has a significantly higher cost. Outpatient facilities have the opportunity to reinforce this wellness philosophy and demonstrate an organization’s commitment to healthy communities through design.
For example, Gresham Smith recently built multiple outpatient centers with a wellness focus. One included a bike and walking trail, as well as a bike repair shop and a dog watering station. Another site included space for an outdoor farmer’s market and community-focused meetings. In addition, the organization invites community groups such as Boy Scouts and Girl Scouts to hold meetings in the lobby.
“They have made this building feel like it’s part of the community and is a healthy place,” Mr. Langlois said.
