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| Tomorrow Need Clear Thinking Today! |
Our Health Care System is broken and we are fast approaching the "point of no return."
To continue to operate with the mind-set “business as usual” or “we really cannot change the system, so why try” - our ability to meet future patient care needs will not succeed.
According to recent studies, Chapter 11 filings have decreased by 53% nationwide since 2010. In healthcare, during that same window has increased by 305%.
With operational costs continue to escalate (seemly unchecked in patient care, drugs, and other services) and no "government-driven-agenda" offered will repair it especially when they are one of the primary contributors and manage how others conduct business.
First: Rural Hospitals, unlike large facilities, have certainly felt the impact of ACA based on increased closure rate. Any offered solution will require “boots-on-the-ground” to develop reasoning that reflects true innovation. 64 million (rural) Americans depend on the small community hospital environment (25-100 beds) for their primary source in care. Since 2010, there has been some 1,800+ closures, forcing most to travel great distances for care. Staffing, technology, profit margins, burn-out, etc. has been noted as factors that started after ACA's launching. Larger facilities are not exempt, but certainly have the ability to adapt better by simply charging more to the patient.
Second: Best Practice, Lean Design, and Reduction of Carbon Footprint have been the norm in design-development for some time. Its effectiveness is different based on facility usage. We are not opposed to such norms, but such concepts have often become the acceptable standard based on those having the loudness of voice or having the most impressive title. Such norms, however, simply do not look at other critical areas that can reduce annual operational costs, thus continue to offer cookie-cutter-designs. In addition - limitations built-in to hospital budgets force Architectural firms to cut-corners just to be competitive; hence, supporting the need to further such practices as SOP. The best way to considered the affects of these norms is - look at how they interact within other industries. Health care has been very slow to accept advancements in technologies for controlling inventory levels. Questions must be asked and methodologies accepted that have had proven results. The best approach to include these norms into any given design is - attack the problem by stripping away all the assumptions, breaking problems down to their common points, and solve them as if for the time time (i.e. uniqueness approach). Analyze the conditions and not accept common pathways that may or may not add cost to a project. FRAM once stated: "Pay me now or pay me later." Renovations cost more after you go live then changing it on paper now. That is why these norms should be only guidelines, not mandates for acceptable design.
Third: Inventory Management Levels has long been considered simply an "over-head costs;" therefore, the need for Asset Management Design considerations are not typically included in Pre-schematic Phasing or any phasing development. To understand the ramifications and long-term affects to your campus sustainability, proper consideration is required and or outside help needed through a consulting firm who wants to partner with you. Based on inadequately designed Inventory Asset Design Policies, many facilities experience an annual lost in revenue around 30-40%. Such lost contributes to hospitals ineffectiveness to meet patient needs, patient satisfaction levels, and a wide-range of other conditions (i.e. Inability to become a Profit Center, JIT-PAR Inventory Levels, GPO Controls, Cost to Purchase Critical Items, Inaccuracies in Inventory, Lost to Outdated Usage; not to mention Staffing issues associated with increased operating stress and burnout). The success of your facility hinges on inventory control management design-development.
Fourth: To achieve True Transformation Change, you need to first look beyond budget constraints to design our facilities; looking at true inventory needs from an asset perspective, not just an overhead. From software, to the selection of equipment, and space programming, to the mismatch placement of departmental locations all contribute to poor growth potential (building it right the first time). Simply – new facility designs or renovations merely copy previous acceptable ideas, which will not support true sustainability. Without addressing these critical needs, especially in a rural health care setting, many will die do to the lack of proper care and health care as we know it will fail.
Fifth: Hospitals represent the very underpinning of our society; therefore, they need to lead the charge verses being forced to follow the norm. Unanswered questions today will predict the future you have tomorrow! Change must begin and it must begin today.
Summary: We who serve health care must design each facility based on their unique needs. Creative innovations are not the enemy (thinking-outside-the-box), but to sit still and accept the norms will not change tomorrow's results. Those who work daily to make us healthier must ask the questions to get the right answers. Our job is to offer the right answers, but partnering (team work) will achieve a better and brighter tomorrow.
Albert Einstein suggests - "The definition of insanity is doing the same thing over and over again and expecting different results."
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