It’s time to talk about adaptability, multiple futures and how our health buildings can live longer

If health organizations really want to move the needle when it comes to sustainable design, they need to truly commit to creating buildings that can stand longer tests of time.

The historical discussion on sustainability in healthcare facilities has largely focused on reducing energy consumption, incorporating high-efficiency technology and seeking out options for renewable energy. Leadership in Energy & Environmental Design (LEED) has been a key driver in pushing our industry forward when it comes to these measures, and for good reason; hospitals—by their nature—are one of the most energy intensive commercial building types. The conversation needs to now expand. Yes, we need to create energy efficient buildings, but we need to create ones that can live for a long time. A recent report from the Preservation Green Lab of the National Trust for Historic Preservation identified it can take between 10 to 80 years for a new energy efficient building to overcome, through efficient operations, the climate change impacts created by its construction. That means that even our most efficiently designed health facilities may not outlive their environmental damage. However, if we create facilities that drive value for just 10 additional years than their predecessors, we will be extending the impact of a facility's energy efficient features and significantly reducing climate change impact.

The Preservation Lab's projections indicate we should be looking for ways to revitalize and reuse our existing building stock. However, the reality is most older facilities weren't designed with the foresight to include options for adaptability that would allow them to be relevant today. Many health organizations are going to need to build new facilities. And, moving forward, they need to focus on making them remarkably flexible, resilient and adaptable so they can maintain relevance as long as absolutely possible. Here are a few ideas for health organizations looking to help their new buildings live longer.

Design with Universal Intent
Health organizations need to have agile real estate assets that allow them to rethink service offerings and reconfigure physical spaces as necessary. Utilizing a standardized structural grid provides one solution to the elusive goal of "future proofing" a health sciences facility. A "universal grid" consisting of the optimum set of vertical and horizontal dimensions for a building's structure can help. Vetted for engineering soundness and construction efficiency –health facilities that employ a universal grid are designed to accommodate a wide range of potential uses while maintaining adaptability to support other functions over time.

Designs employing the universal grid have proven almost extraordinarily adaptable. Moreover, facilities leveraging the grid can reduce the typical 10- to 18-month span from facility planning to groundbreaking up to 80%. This saves money and means a building can begin it's useful life even sooner – accelerating the deployment of its energy-efficient design. At Washington University Medical Center in St. Louis, groundbreaking for a 750,000-sf biomedical research facility based on the universal grid approach occurred in less than five months from the start of design, fast-tracking occupancy, thus saving in excess of $5.5 million in planning costs and accelerating revenue cycles. Moreover, this level of adaptability will allow the medical center to maintain its usefulness longer into the future.

Be Modular, Be Flexible
Along the same lines as the universal grid concept, health organizations also need to embrace modular planning. In ambulatory care settings, modular planning can allow health organizations to flex up and down based on clinic size, demand and specialties required to support diagnostics for this patient population. For example, if you have two providers in the afternoons on Tuesdays and Thursdays and now want to add a third, you need a facility that can flex to accommodate use patterns based on day of week and time of day.

At a Midwestern health system's Regional Cancer Center, the organization took extensive looks at how they could balance open vs private environments to best meet the needs and desires of their patients. Ultimately, the Health System determined the best way to achieve this balance was with flexible planning. The team decided to pair private rooms in the cancer center with a modular center wall. The wall can exist to establish privacy or be removed to create a space for three patients with greater connectivity among those patients. This simple decision to use a removable wall increases the flexibility of the center and will eliminate the need to build additional space down the line.

Talk About and Plan for Multiple Futures
Health organizations need to consider multiple futures from the outset of any facility project so they maximize their value, life and resiliency. This often leads to more up-front costs, but it better prepares organizations to leverage their real estate into the future. At a base level, multiple futures imply that if you're considering two different sized pieces of equipment, design for the larger piece even if you buy the smaller one. The future flexibility is worth the nominally higher initial investment.

A Pennsylvania tertiary hospital's leadership team brought this foresight into their recent efforts to expand and renovate their patient tower. While their original goal was to add three floors to the facility, analysis revealed the amount of work to strengthen the columns could be increased slightly and allow for six additional floors. Creating this space allows the Hospital to realize greater possibilities for their future without extensive additional investment.

Ultimately, healthcare's primary role in society is to improve and sustain life. It's time for our healthcare facilities to exude a similar message – buildings that live long, meaningful lives and adapt to the changes and curveballs life throws its way.

Tonia Burnette is CannonDesign's Health Practice Leader out of the Baltimore office, and has specialized in the programming, planning and design of medical institutions for more than 30 years. She is committed to helping health organizations advance care delivery models that meet the healthcare industry's ever-changing demands.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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