Construction
for the health care community is particularly unique. The technology propping
up modern medicine changes at lightning speed with the advent of each new phase
of equipment. Exacting conditions and specifications for laboratories must be
met or exceeded for research efforts to expose disease, pinpoint preventions,
promote wellness, and alter our views on longevity and mortality. Provider work
environs have an impact on dispensing patient care, and patients themselves
often reflect the mood of their environment. It is imperative that those of us
who have experience in constructing health-related institutions support health
care advancements with flexible designs, the latest technology and materials,
and surroundings conducive for the medical community to have its best chance to
do its best work.
I've been privileged during my career to be associated with
building medical centers, emergency departments, diagnostic centers, biological
research facilities, university projects, classified laboratories, "clean
rooms" of all sorts, heliports and other medical provider infrastructure, and
so much more. I've learned that construction for health care is an unceasing
education to be persistently pursued and refined.
One construction method that has
evolved over several years is a design-build approach. It presents the best
opportunity for collaboration among principals, especially important in the
fluctuating health care arena. With design-build, the contractor's
responsibility begins and ends with a collective consciousness among the
designers, construction entities, the financiers, the clients, and the users.
Under a single general contractor, these parties become members of a
single-minded team, saving precious time and resources while eliminating
anxiety-ridden logistical and communications issues. The decision-making group
serves as a forum for frank brainstorming, problem-solving, and budgetary
decisions that infuses positive momentum throughout the life of the project.
With this spirit of cooperation, the user receives the best possible
product.
Medical
clients have become very sophisticated over the years in design and
construction. Not only do they act as partners in the decision making, they
frequently bring client-purchased materials and equipment to the table to be
incorporated into a project. As a member of a design-build team, they meet with
the principals at least weekly to identify issues and determine details. What
type of patient bed should be purchased? As the construction industry moves
from the Uniform Building Code to the International Building Code, what are the
differences, and which should be incorporated? What are respective
jurisdictions? Is the institution public or private? Does it receive federal
funding? What kind of roof? Which modality should be housed on which level?
These issues, and all the rest on a sizeable list of items, are addressed by
everyone, allowing development of a singular prioritized work plan that favors
the client and user groups.
Most health care conscious contractors are getting smarter,
too. Value engineering and securing mutual decisions in advance of breaking
ground reduce funding for the project, a resource that can be transferred to
upgrade other aspects.
ears ago, for example, the industry norm dictated that the
client define equipment needs during initial design phases. The ensuing design
and bidding phases could continue for two more years before construction
commenced. When the facility was completed and it was time to set equipment
into cookie-cutter spaces, the latest equipment carried new dimensions. It was
already time to remodel. With design-build methods, clients and users have the
luxury of more time to make final decisions. "Floating" space designs go even
further to offer flexibility throughout the reasonable useful life of a
building.
Actively
involving user groups from the very first day is a good rule. From pharmacists
to food service managers to medical staff to the patients themselves, talking
regularly with those who will work and reside within the environment produces a
wiser perception on the part of team members as to what defines a successful
outcome. In general, contractors are responding well to this brand of input
from users and patient groups. Again, it's part of the ongoing education of the
construction industry.
Increasingly, hospitals are giving the nod to private rooms
over semi-private. The movement is toward giving patients more privacy,
conducting better infection control, and eliminating the sometimes difficult
job of pairing patients with compatible illnesses. The trend in architecture
and landscaping is to create a more soothing, homelike environment where the
emphasis is on wellness and healing to offset the more austere and clinical
treatment elements. Daylighting is incorporated wherever architecturally
possible, as is lush groundscaping. Inside, well-designed spaces with clear
signage enable patients to circulate in localized areas for all their needs,
including admissions, examinations, and treatments rather than requiring them
to maneuver through the stressful maze of florescent-lit corridors and
elevators.
What
are the immediate physical plant hurdles for health care? Medical equipment,
with its heat and light sensitivities, power requirements, and space needs is
advancing at a dizzy pace matching that of computer technology. Treatments are
changing and so are the spaces in which they are performed. Telecommunications
and video conferencing allow for greater interface between physicians and
researchers, so let's take advantage of that, too. Medical record-keeping will
be digitally stored rather than filed. As this process is perfected, medical
space assigned to film and file storage will be freed for other uses. More
examination rooms, office space, or cozy lounges may take up the space.
Contractors need to be fully aware of these possibilities and
more.
As a health
care administrator, provider or patient, if you are presented with a chance to
add your perspective to a medical construction project, get into the mix.
Competent contractors encourage your input, and it's your chance to take
advantage of it. In fact, rapid progress happens only with open conversation,
an understanding of the common goal, and a pull in the same direction. Design
and construction professionals have a burdensome duty to anticipate heath care
trends, but hand in hand with the health care industry, everyone learns, and
all benefit. It's happening. There is a conceptual change afoot as well as a
philosophical one in the medical community, and facility construction should
support both. We could do with the most flexible and aesthetically-pleasing
solutions for space best suited to improve the health of our family, friends,
and community populations. Changes are coming quickly, and the construction
industry is doing its best to mirror the advancing medical field. If not at the
speed of light, progress is surely happening at the speed of
life.
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