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There’s no cure-all for the health care industry’s needs, but, fortunately for leaders in design and construction, they are at least growing pains.
Commercial Observer’s Design and Construction Healthcare Forum kicked off Tuesday morning at CUNY Graduate Center in Midtown with some of the industry’s biggest names discussing the problems and solutions that are changing the way medical facilities are being built.
Mount Sinai Health System’s Douglas Carney and Shawmut Design & Construction’s Jay Quackenbush, the moderator, opened the show with a keynote: “The Rejuvenation of the National Healthcare Real Estate Market.”
“The key to institutional predictive modeling is to be hand in glove with your strategy people and to do what we’re in the middle of right now at Mount Sinai, which is a comprehensive master plan,” Carney said. “We have about 30 workstreams that are looking at everything that drives our demand for facilities.”
The next panel, “Modernization and Expansion of the Healthcare Market on Long Island,” saw Catholic Health’s Christine Flaherty, architecture and engineering firm EwingCole’s Sophie Buttiens, Hospital for Special Surgery’s Michael Rawlings, engineering consultancy Vanasse Hangen Brustlin’s Raffaela Dunne and Association of Medical Facility Professionals’ Andrew Weinberg, who moderated, talking about the changing needs of facilities beyond New York City’s limits.
Panelists talked a lot about how to compete by bringing a mix of different services under the same roof so patients can have both convenience and a choice of options when seeking care.
“Consumers expect to be in control and feel confident on the level of care and the location where they’re receiving that care,” Buttiens said. “What we continue to see is a push, especially on Long Island, for consolidating those physician practices. You’re not building six or seven smaller practices, but you’re really combining them into one holistic care setting. So you can go and see your doctor and you can perhaps get an X-ray and schedule a surgery all within the same building.”
“The Importance of Close Team Coordination During Preconstruction” was the next panel with Scott Habjan of E4H Environments for Health Architecture, Bill Allan of Consigli Construction, Ray Prucha of engineering firm BR+A, David Faren of New York-Presbyterian Hospital and moderator Ryan LaBarbera of building consultancy turner & townsend.
Said coordination is built on trust to some extent by understanding the needs of clients, according to both Prucha and Allan. But, ultimately, preconstruction saves time in case the client backs out after the planning and architectural process is done, including cost assessments. After all, the preconstruction phase is about answering the question of whether or not to build.
“Is it a complete failure when the decision is made at the end of the day by the client that ‘It’s not good for me to build this’?” Allan said. “That, to me, that’s money well spent.”
On the panel titled “The Future of Off-Campus Healthcare Facilities & Enhancing the Patient Experience,” moderated by Dana Kfir of safety analytics firm Otoos, speakers attested that regional facilities provide services closer to where patients are while providing work-life balance to physicians.
Panelists included Antonio Cabrera of Hunter Roberts Construction Group, David Kontra of Children’s Hospital of Philadelphia, Mariyana Pampova of Memorial Sloan Kettering Cancer Center and Elizabeth Sullivan of Northwell Health.
“I think we all see that retail has died. There’s a lot of empty office spaces, and I think that there’s going to be a lot more conversion for health care,” Sullivan said. “I think that we’re going to be seeing a shift to that, and it’s smarter to make use of spaces available, sustainable.”
Blima Ehrentreu of The Designers Group moderated a fireside chat, “The Development of Ambulatory Care Institutions for the Broader Market” with Columbia University Irving Medical Center’s Patrick Burke, Memorial Sloan Kettering’s Roger McClean and turner construction Company’s Jason Tavarez.
“When it comes to long term treatment and cancer care, it’s almost like a second home [for the patient], chemo therapy program is time consuming. It’s daily in some cases, and we realized the importance of that,” Tavarez said. “I think on the real estate side there’s a lot more that you can do with some of these regional locations… We made that decision to kind of give ourselves more [space] in these regional areas and be closer to our patients.”
“The Power of Digital Twins and Modern Tech in Healthcare,” moderated by Jack Conway of HVAC company Gil-Bar, was composed of Jonathan Cogswell of Northwell Health, Melissa Kiefer of Hospital for Special Surgery and Mahmoud Shouman of engineering firm JB&B. A digital twin can help administrators make decisions about the utilization of a space.
It can do this in surprising ways.
“A digital twin can predict when a piece of equipment is about to fail, or when it needs maintenance, and, by doing that, sort of prevents having to have appointments canceled or emergency repairs,” Shouman said. “You have this unified, holistic view of your building. So, instead of having an operator juggling multiple software for the lighting and security, you have this unified dashboard. It’s almost like my chart sort of centralizes all of your different patient data on a single software because it’s like having my chart for your building.”
Christina Champness of construction company Lendlease moderated a fireside with Oscar Gonzalez of NYC Health + Hospitals in a segment titled “Multi-Phased New and Occupied Renovation Projects.”
Gonzalez said it isn’t always as simple as building new from the ground up. At times, renovations have to happen in a series of waves that create as little disruption to patient services as possible, even if NYC Health + Hospitals facilities are still operating.
The government health system currently has $7 billion in the pipeline for 350 different projects, but red tape in accessing funds and infrastructure upgrades to cut greenhouse gas emissions just isn’t in the cards.
“Unfortunately, New York City is very dense so there’s only so much we can do. Geothermal and windmills just aren’t really an option for us,” Gonzalez said. “Often we have to go back to [city officials] and ask for additional money, which is a problem because we start a project, everybody is gung-ho, we’ve got the consultants on board … and then the project gets put on hold.”
Last, Plaza Construction’s Thomas D’Ercole moderated the discussion “Rethinking the Planning Process: Design Strategies of the Future” with Memorial Sloan Kettering Cancer Center’s Suzen Heeley, St. Peter’s Health Partners’ Udo Ammon and Jefferson Hospital’s Clayton Mitchell.
With the medical industry facing staff shortages, the discourse on the panel revolved around how built-in technology can take the load off nurses overburdened by tasks as simple as closing the blinds in a patient’s room.
But the construction side also has its staffing shortages in the form of planners.
“Planning is a function that I don’t think is focused on as much in an academic environment, and so planning will typically come from architects who have that kind of acumen, but I also think that it’s an expertise that requires time and intentional development,” Mitchell said. “It requires us to do a lot of coaching. … It’s just another level of expertise that a person will need beyond just the technical, the political skills, the communication skills, and also a little bit about resource allocation.”
Mark Hallum can be reached at mhallum@commercialobserver.com.
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