The hospitals of tomorrow are under construction today. Health system executives must analyze current trends—and anticipate their trajectories—to ensure their investments withstand the test of time.
It can take two to three years to get regulatory, financial and administrative approval for a new facility. And that's "before you even put ink to paper, then put a shovel in the ground," Dr. Angela Nicholas, chief clinical officer of Jefferson Health's North Region, told Newsweek.
Depending on a project's size and complexity, a decade can stand between the blueprint and the ribbon cutting.
A lot can change in a decade. But 2024 medical facilities can strive for 2034 relevance, according to the people who design them. Here are some trends they're adjusting for.
1. Universal Rooms
During the COVID-19 pandemic, infected patients needed to quarantine in negative pressure rooms, which prevent contaminated air from moving into shared spaces. Hospitals and skilled nursing facilities did not have enough of these units to accommodate the surge in communicably ill patients, and infection control measures suffered.
This is just one factor fueling the "universal" room concept, according to Grant Geiger, founder and CEO of EIR Healthcare, a hospital construction and design company with health system clients from New York to California. Perhaps hospitals could be nimbler if their rooms were designed for multiple purposes, with multiple capabilities.
"The adaptability of rooms has been discussed for a long time, at least the last 10 to 15 years, and I think that's going to continue to trend," Geiger told Newsweek. "How do we take the actual design of our patient rooms and make them so they can step up or step down?"
Flexible rooms are easier discussed than designed, Nicholas said. Pediatric units often have tiny seats and toilets, while bariatric wings require more supportive fixtures.
But the aging population will add some strain to hospitals, requiring them to adjust their capabilities. People are living longer and will require more treatments in the later stages of life. Nicholas, who used to have two patients over age 80 at her family medicine practice and now has "lots," expects more demand for cancer and cardiology services.
"Now, maybe we're going to operate on that 80-year-old that we didn't operate on before, because they would have died of something else previously," Nicholas said. "We've kept [people] a lot healthier, and now they're needing to come into the hospital. So it's a shift."
The younger population is also poised to shake up health care. With the rise of weight loss drugs like GLP-1s and an increased focus on preventative care, Gen Z will likely experience old age very differently from baby boomers. Health systems are leaning into infrastructure that can service both, according to Geiger.
"What we've been hearing in the last six months is that GLP-1s and other drugs are [influencing] the strategic thinking process in health systems," Geiger said. "It's giving them pause and it's making them think about what types of services they really need five or 10 years down the road."
2. Hubs and Spokes
Traditional 400-bed hospitals are losing their hold on construction plans, Geiger said. Many health systems are building outpatient centers, or "spokes," that can refer patients to existing hospitals, or "hubs."
To diffuse traffic at the main hub, some organizations are leaning into freestanding urgent cares and emergency departments. Others are building "micro-hospitals" with about a dozen beds. Regardless of their delivery method, most hub-and-spoke systems share common goals: making care more accessible for patients and improving health in the long run. People are more likely to access health care sites that are easy to navigate and close to home, Geiger said.
Spokes can also help a system crack into a new market or reach an isolated population, according to Nicholas.
"Every day, [we're asking ourselves,] how do we provide care to our community?" Nicholas said. "What are the communities that we're not providing care in now that we should? What are the venues of care that are appropriate for that community?"
"Because it's not always inpatient hospitals, you know," she added. "If we need to grow into a community, we might grow in an outpatient center first."
3. Modular Builds
Smaller outpatient centers are also cheaper to build than hospitals. That's an important consideration for health systems facing heightened construction costs.
"When I sit down with the VP of construction or CEO of a hospital, they'll say to us, 'We want to build XYZ—a clinic, dialysis center, urgent care—but with the cost of construction right now, we can't afford to do it,'" Geiger said.
Modular construction is one solution gaining traction in health care, according to Geiger. Hospitals can build new facilities in offsite factories, which is both cheaper and faster than traditional construction methods. While new medical facilities can cost up to $1,100 per square foot, EIR can complete a modular build at around $300 per square foot. And construction is contained, shielding hospitals (and patients) from dust, noise and scaffolding.
This format is EIR Healthcare's specialty—and its capabilities aren't limited, even though construction takes place in a factory, Geiger said. The company is currently building a 10,000-square-foot, four-story medical office that will be delivered, complete, to its commissioned building site in Brooklyn, New York.
4. Built-In Tech
Many of EIR's modular hospitals contain built-in technology. Through a partnership with the manufacturing company Siemens, EIR can install automatic light fixtures that also have administrative functions. The Bluetooth-activated lights conserve energy by shutting off when people exit the room—and keep track of clinicians' and patients' movements throughout the facility.
This data can illuminate flow issues within the space, allowing hospital designers to respond by moving or adding certain features, Geiger said. If the fixtures record frequent crowding around a single nurses' station, leadership can add a second.
Forward-looking exam rooms should also be equipped with virtual care capabilities, according to Nicholas.
"Sometimes we do telemedicine in offices, so we need to make sure they have the appropriate screen sizes to be able to accommodate telemedicine," she said.
5. Protective Designs
Any new wing or office at Jefferson "needs to be patient-centric but provider efficient," Nicholas said.
It also needs to be safe. Violence against health care workers has been rising, with 44 percent of nurses reporting that they experienced physical violence during the COVID-19 pandemic.
Nicholas considers clinicians' safety when designing a space, ensuring they can call upon colleagues quickly and are never alone in an observation unit. Furniture placement is also critical.
"We do think about how you put a bed or an exam table in a room, so that if you need to get out quickly, you can always do that," Nicholas said. "I never design so the provider can't get out without crossing the patient. And you hate to think of it that way, but that's the reality, and so we have to plan for that."
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