Thursday, April 24, 2014

“Are you sitting on a Gold Mine?”

By: Dick Richard, AIA, is Associate Principal in TRO Jung|Brannen’s Birmingham office

For healthcare facilities everywhere, your greatest asset is your people; doctors, nurses and various members of your staff. They represent your biggest investment, by far, so it’s clear that having the right people on staff is the foundation of success for any business or healthcare entity. Your physical facilities likely represent your second largest investment. How they are configured and how well they perform plays a major role in whether or not you are positioned to weather the economic and regulatory storms in today’s turbulent healthcare environment. While there is uncertainty about the future of healthcare reimbursement, regulations and market forces, one thing certain is that maximum utilization of all of your most valuable resources is a must for survival.

Princeton Baptist Medical Center in Birmingham, Alabama recognized the importance of making the most of their existing facilities several years ago as they explored many ways of expanding the hospital. The goal of the Princeton East Expansion project was to create new state of the art Surgical, Endoscopic and Instrument Processing facilities and to replace outdated & undersized 1960’s era OR’s. Studies were done to determine the comparative costs & benefits of simply building all new facilities to replace the old Surgical Suite, and the resulting analysis revealed that utilizing a combination of new construction and renovations of existing space would provide a more sustainable and cost effective solution. Consequently, the final design involved constructing 90,000 square feet of new space and repurposing over 60,000 square feet of existing space to maximize both the utilization of the existing plant and improve staffing & operational efficiencies. For example, the existing facility had thousands of square feet of existing surgical support space that could be utilized either “as is” or with minor renovations. The combined approach saved construction costs by preserving more of the $100/square foot existing/renovated space and constructing less of the $300/square foot new space.

There are obviously many factors to consider when embarking on a significant facility expansion or renovation project. First, experienced management of complex phasing is important. The East Expansion Project involved more than two dozen phases of construction and renovation, causing hospital departments such as Surgery Pre-op to be moved several times. In Princeton’s case, the staff members who were affected by these moves were more than willing to be inconvenienced temporarily, knowing they would have state of the art facilities when construction was complete. Second, experience with complex systems analysis is part of the mix. When considering the degree to which it made sense to repurpose and renovate existing facilities at Princeton, other factors such as structural grid, floor to floor heights, condition of the building’s HVAC, Plumbing and Electrical systems and Life Safety and Building Code deficiencies had to also be addressed and evaluated carefully. Third, experience offering a comprehensive solution and a focus on patients, staff, and the visiting public should be required. By commissioning the right team to evaluate your existing facilities, the most cost effective, sustainable and intelligent solutions for facility renovation and expansion projects can be determined and implemented, as at Princeton.

Construction of new facilities can be expensive, so why not take time to evaluate opportunities to make better use of the space you already have. More and more, with evolving trends in healthcare and with the need to operate efficiently in order to remain competitive, you may find great value in making more of the latent gold mine you already have in your existing facilities.

About the author – Dick Richard, AIA, is Associate Principal in TRO Jung|Brannen’s Birmingham office. The architects and staff with TRO JB have offered design services for projects, large and small, to healthcare clients in Alabama and the southeastern region for more than forty years. See more about TRO JB at Dick can be contacted at 205-324-6744, ext 248 or

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