According to Advisory Board’s Annual Health Care CEO Survey, cost control has surpassed revenue growth as healthcare system CEOs’ number one priority.

There are lots of different types of healthcare facilities — from hospitals to clinics to outpatient care centers to rehabilitation centers. So, whether you’re starting a drug rehab center or building a new hospital, you need to all of the costs have been calculated and you know it won’t lose money. At the end of the day, hospitals are large enterprises, whether they are part of a healthcare system with hundreds of hospitals, or a single hospital with hundreds of beds, as reported by Matthew Keahey, national vice president, operations, Medxcel.

Additionally, each hospital can encompass hundreds of employees in both clinical and operational faculties. Even as hospitals and their systems grow larger, 62 percent of surveyed CEOs identify “preparing the enterprise for sustainable cost control” as their top priority.

Keahey explained that while discussing cost control in the physical space of a hospital, the term “investment” may seem counter-intuitive. How does an organization save on costs if it’s investing? This doesn’t necessarily mean a large capital investment, but an investment in the people and processes serving in operational roles that ensure a hospital runs effectively.

According to Keahey, one can prioritize their facilities to enable cost control through appropriate staffing, employee engagement and date measurement.

HC+O News spoke with Keahey recently to expand on this topic.

Q: What are the best possible methods that healthcare facilities can follow to maintain cost control?

Keahey: The short answer is to invest – not with a large capital investment, but in the people and processes that serve in operational roles to ensure a hospital runs effectively. This begins with an audit of current processes and staffing to examine what is working and what isn’t, as well as the long-term effects of changes to those processes.

For example, sometimes the strategies many hospitals adopt to save money can cost them far more in the long run. Many healthcare facilities excel in caring for clinical staff with robust training, support and bonuses, but the same isn’t always true for support or skilled trade staff. It’s common to promote from within, but without the appropriate training, mentoring or leadership ability, this promotion can lead to high turnover, loss of institutional knowledge and a growing reliance on external service contracts that will cost organizations far more than growing in-house capabilities.

Furthermore, by switching to software like OneStream, the management of data, and finance can be taken care of. There are service providers like Holland Parker who can assist in this transformation to OneStream platforms. In the long run, this switch to the digital is going to help in cost control and data analysis of any given business.

Q: What is the benefit of using in-house workers compared to outsourcing?

Keahey: Many hospitals explore the route of FTE reduction to provide immediate cost savings. Within the facilities, these costs are more than often replaced with contracted services, but the long-term expenses can far outweigh the short-term gains. For example, say your facility employs one highly technical or senior-level technician, two mid-level technicians, and one contractor to fill in the gaps. What happens when your senior-level technician retires and leadership decides instead of filling that position, they like the immediate salary savings they are seeing? To take it a step further, they decide to cut costs even more by eliminating a mid-level technician, too.

Facility work must still be completed, but your staff has been reduced by half. Therefore, you outsource with a high-margin service contract. Look carefully – is the contractor’s cost more in the long-run than your in-house technicians? It’s not just the numbers, though. In-house technicians are readily available for repairs and maintenance, but now, turnaround takes longer and is dependent on the contractor’s availability. How do response delays affect patient care and clinicians?

Finally, your on-site technicians have intimate knowledge of your facility, processes, systems, and the building specifics and priorities of internal customers. Those technicians look at your facility with the eyes of an employee owner and develop rapport with others in the facility. Relationships are vital. When eliminating in-house positions, that priceless knowledge and rapport is also eliminated.

Q: How can employers enable employee engagement in the healthcare worker environment?

Keahey: Not with ping pong tables and free snacks, as nice as those are. Associates who feel valued will always do more, consider what’s best for the organization when making decisions, and stick around for the long run.

Don’t guess at what your employees want and need. Ask them. How do they want to grow? How do they want to improve your facility? This will help guide an engaging conversation and allow you to show your commitment to helping them grow in their career, resulting in higher engagement.

As part of your cost control and engagement investment, your facility should commit to reducing waste – not just environmentally, but in processes and assessments. Allow associates to participate in the solutions. Disparate systems, processes and documentation are common symptoms of a decentralized facilities management program. We often see this in organizations where different entities manage different aspects of the facility. Not only are associates operating in different ways under different standards, but it’s also difficult to assess performance accurately or pinpoint metrics at a moment’s notice, which can lead to frustrations and inconsistent feedback. Eliminate confusion and unnecessary work to make getting work done easier.

Q: When speaking about data measurement – what exact information are you trying to gain out of your data collection?

Keahey: Data makes everyone’s jobs easier, if you know where you want to go and what you’re looking for along the way. Like using a GPS to route you to a new location, your first step is to be crystal-clear on your destination, as well as where you stand right now. Evaluate the current state of your workflow, staff and resources, then set achievable goals for your team to work towards that align with the organization’s goals. Establish milestones and reporting processes to show progress.

The data measured will be different for every facility, but no matter what you’re measuring, the benchmarks and milestones collected will paint a clear picture of if your facility is moving in the right direction, or if it needs adjustments throughout the process.

Q: Any additional insights to share?

Keahey: Being committed to the development of staff is crucial to success. As a leader, helping our associates to accomplish more should be our focus, whether it be formal education, training, job shadowing, cross training or certification. Motivated and engaged staff produce quality work and save money for the organization. Additionally, when associates grow personally, they will advance to be our future leaders. Investing in your staff is always money well spent.

The post Q&A: Prioritizing Cost Control in Healthcare Facilities appeared first on HCO News.

INDIANAPOLIS — Hospitals are commonly regarded as a safe place among patients and caregivers, where services never cease, and staff is continuously effective — but what happens when disaster strikes? Hospitals are needed to operate under standard-to-severe conditions, maintaining quality care and protection for patients, visitors and associates alike in the event of a natural disaster.

According to Scott Cormier, vice president of emergency management, environment of care, and safety at Medxcel, weather-related catastrophes are responsible for nearly 500 deaths and $15 billion in damages. In his recent publication, Cormier focuses on tornadoes in particular, which typically occur during the months of spring and summer. As hospitals stand as a crucial asset in the response and recovery of a community following a disaster, it’s imperative that these facilities are prepared and protected. Cormier explained how a hospital can prepare and protect during the event of a tornado by following three separate steps. These steps comprise implementing a comprehensive emergency management plan, developing communication infrastructure and following the plan.

In 2017, the Centers for Medicare and Medicaid Services updated emergency management requirements for 17 providers and suppliers of healthcare including hospitals, long term care, home health, and outpatient services. Through this, Medicare and Medicaid providers are required to create comprehensive emergency management plans in place that account for their patients, associates, and communities for all natural, man-made and technological disasters.

If a facility is determined unsafe, the hospital must work with local emergency management and public safety agencies, as well as contracted partners, to evacuate the facility.

There are three methods of evacuation: horizontal (moving patients from one side of a building to another that is safer), vertical (evacuating a floor of the hospital to another floor), and total (evacuating the entire facility.  Each department should have a specific evacuation plan that considers the type of patient being evacuated, such as a newborn, critical care patient, or patients attached to specialized equipment. The Hospital Command Center coordinates the evacuation, connecting patients with transport assets and open beds at other facilities, while patients are transported from their rooms to a staging area, and those patients that require rapid transportation are evacuated first, while making sure to provide the patient’s chart for any specialized medications so they can continue care.

Tornado safety features include special windows to withstand flying debris, underground wiring to prevent power outages, and a reinforced roof. For existing structures, the facility team should create safe zones characterized as windowless, reinforced rooms placed throughout the facility where staff, visitors, and patients can shelter during a tornado. The Federal Emergency Management Agency (FEMA) has a grant program called the Hazard Mitigation Grant Program, in which healthcare facilities can partner with local and state governments to apply for safe room grants.

Cormier urges hospitals to create a plan that reinforces areas to make the building safer, stating it should be a part of a multi-year capital improvement program. Further protections include investing in warning equipment like weather alert systems, and subscribing to a private meteorological service that has the exact coordinates of hospitals to receive specific forecasts and warnings based upon those locations, which is more accurate than the general warnings broadcasted in the media. It is also vital to train staff on how to react during a tornado watch and warning, which includes preparation of patients and visitors, keeping emergency equipment accessible in all areas of the facility, and having a checklist to quickly determine if the building is safe to stay after the tornado passes. Finally, confirming memorandums of understanding (MOU’s) for staffing, transportation and evacuation sites are up to date.

“Since tornadoes appear with little warning, unlike hurricanes, there is little that can be done when a tornado warning is issued. Natural disasters are one of the top hazards a healthcare facility will face, so it makes sense that they invest in preparation, response, and recovery supplies and equipment,” said Cormier. “If you are in a tornado risk area, it’s important you understand your facility, your vulnerabilities, and where safe areas are located in the building.”

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LOS ANGELES — Innovative and contemporary hospital designs have succeeded to not only guarantee patient satisfaction, but to also reduce costs and improve patient outcomes. Research has shown that hospitals featuring new designs and amenities increase patient satisfaction significantly. Even one study, conducted by Professor Dana Goldman and Associate Professor (Research) John A. Romley at the Schaeffer Center for Health Policy and Economics at the University of Southern California, showed that amenities are a larger factor in driving traffic to hospitals than clinical quality. As a result, amenity-filled hospitals with modern design features are attracting more patients, which benefits the hospital’s top line.

Interior Design has placed Perkins+Will the No. 2 firm on its annual Top 100 Giants list—moving themselves up one spot from the 2016 rankings, and two spots from the 2015 rankings. The recognition is based on overall interior design revenues across all project types. The firm holds its No. 1 position for healthcare interior design on the Top 10 Giants by Sector rankings. It also took the No. 2 ranking for “Most Admired Firm”—up one spot from 2016, according to a statement. 

Jennifer Riddle Curley, AIA, NCARB, LEED AP, project associate and Stephanie Domek, IIDA, LEED AP ID+C, interior project designer of Perkins+Will spoke with HC+O news to discuss efficient design strategies and the benefits of quality interior design in healthcare facilities. 

Q: What are the biggest trends you’ve seen affecting hospital interior design?  

Domek: Off the top of my head, three trends:

A Consumer Experience.  Creating a more amenity and hospitality rich program to improve the patient and their family’s experience within the healthcare environment.

Designing for the Evolving Workplace.  Improving the quality and functional space for multidisciplinary caregiver teams to create successful teaming performance and benefits for staff retention.

Technology.  The rate of advancement and adoption of technologies, leveraging technology to engage better with patients and staff collaboration, as well as planning for the unknown. 

Q: How have you incorporated these techniques into designs you’ve worked on recently? 

Domek: Design strategies to address these trends include visioning sessions early in the process to identify the community qualities the hospital wants to emphasize and how the hospital wants the patient experience to feel.  Additionally, a deeper dive into current workplace strategies are now being regularly discussed to help the facility understand the variety of workspace typologies available for today’s teams.  I recently had a conversation that involved acknowledging that a laptop does not need to sit on a desk all day.  Healthcare organizations are at different places on the journey to redesigning new ways of how they do work and how interior design can improve their workflow goals.  

Q: How do these design trends affect the patient/user experience? 

Domek: As hospitals understand the patient as a consumer concept, the patient experience is directly affected in a positive way by coming to expect a higher level of service, easier forms of communication, and spaces designed with improved comfort, acoustics, lighting, and overall quality. Indirectly, patient experience is affected by progressive workplace strategies employed in facilities that aid team-based collaboration and allows staff to choose where they can do their best work. (ie. open touchdown, a quiet enclave, a social setting, or respite room.)

Curley: By improving the caregiver experience, it creates an environment where caregivers can concentrate on the job. Additionally, the improvements in the workplace environment can positively impact a facilities ability to recruit and retain talent.

Q:  How are these trends in line with general interior design trends across all building types? 

Domek: With the arrival of the Well Building Institute and Fitwell, healthy human-centered design aligns with evidence-based design in healthcare by bringing important features like daylighting, clean air, and comfort measures to the workplace.  The concept of wellness has permeated all building types. 

Q: How will interior design continue to advance healthcare today and into the future? 

Interior design directly affects the quality of the healthcare environment and can influence the way patients, families, and staff feel and experience the physical space.  The more we, as designers, can find synergies between current practices in adjacent markets like corporate commercial, education, and hospitality, the more healthcare design can create connections within the community as a destination for wellness. 

Q: What kind of feedback have you received from healthcare professionals on specific design techniques that interact well with their practice?  

Curley: Our academic medical center clients are requesting that we create true partnerships in the design process with their multi-disciplinary teams. We have been engaging with our client teams to execute week long 3P Kaizen events in lieu of the traditional hour-long user meetings that typically occur on a periodic basis. In the 3P Kaizen event, a diverse set of key stakeholders are brought together for an intense collaboration with the project team. These sessions require a substantial amount preparation to be successful, but the results are a broad consensus built around a design solution within a matter of days.

The post Perkins+Will Explains the Benefits of Interior Design in the Medical World appeared first on HCO News.

That is why, Jim Perry, chief technical officer of New York-based Cerami & Associates, addresses the problem of noise pollution within healthcare facilities by using the Lunder Building in Boston as a case study.

His webinar, “The Importance of Acoustics on Patient Care: A Case Study on The Lunder Building,” offers real answers to this pressing healthcare challenge. Perry has created a discourse covering different methods to cut vibration levels, reduce major noise sources such as HVAC systems, improve the sound-isolating performance of doors and even addressing intrusive noise from the outside. Using the Lunder Building’s 535,000-square-foot, 150-bed mid-rise hospital tower as an example, Perry can address the impact of building acoustics on both caregivers and patients.

HC+O News spoke with Perry to get the inside scoop on why the Lunder Building is such a prime example of how to reduce noise pollution in healthcare facilities.

Q: For those unaware of this issue, what is “noise pollution,” and why is it being addressed in healthcare facilities? What constitutes an “acoustically healthy” environment?

Perry: In healthcare facilities, high noise levels can be a detriment to patients and staff in different ways. Limiting the noise impacts on patients is critical to promote resting, which has a direct correlation to healing, the ultimate goal. In regard to the staff, high noise levels contributes to higher stress levels and increases the possibility of mistakes being made in all aspects of their job.

Q: What are some of the key design features of the Lunder Building that mitigate or prevent noise pollution? When did the project of this new design begin?

Perry: There were many aspects of the planning of the space that were utilized to reduce the noise impacts on the patients, distributed nursing stations, minimizing proximity of back of house spaces and doors to patient rooms, location and types of alarms and notification systems all aimed at reducing the noise impacts on the patients. The design for this began with NBBJ utilizing these planning methods before 2006.

Q: What are the biggest challenges in designing a healthier noise environment? How can other facilities work towards implementing these designs, and are there any future plans for extending this to other healthcare facilities? 

Perry: The biggest challenge is that the noise levels are due to not only the built environment, but also the staff behavior and operations, so there are multiple avenues that need to be addressed in order to achieve a better environment. This requires a change in typical behavior from the staff, which is not always possible.

According to a statement, Perry has 17 years of experience providing acoustical and vibration consulting for varying project types. Perry has gained special expertise in areas of mechanical system design and vibration control, especially in the design of large scale developments, residences, and healthcare facilities. Perry has appeared as an expert witness at Community Board hearings in both New York and New Jersey, offering testimony on noise transmission, with regard to noise codes, residential impact issues, and other acoustical and vibration issues. He is fully conversant with all aspects of architectural acoustics, mechanical systems, noise and vibration control and environmental impact assessment.

The post Boston’s Lunder Building Exemplifies Noise-Level Reduction Solutions appeared first on HCO News.

The health care industry is growing fast as America’s older population ages and younger generations reach record numbers. Hospitals are expanding at a rapid pace to meet the new demand for health care services; however, during this process, it is important to not lose site of important facility programs, including pest management.

While renovations bring great changes, the process can often disrupt normal services, pausing normal sanitation schedules, interrupting maintenance routings, and increasing traffic and visitors. One unhealthy side effect can be that pest control services get shelved. However, renovations tend to be when pests pose the largest threat to health care facilities. When outdoor habitats are disrupted for new construction or pest control routines are abandoned during upgrades, it can lead to problems. Mice, rats and other rodents can scurry inside if their outdoor homes are disturbed. So, if you do come across any rodents on your property, you should call a professional pest control service, or manage the situation yourself by using something like a pellet pistol (if you find them in your garden), to ensure that they don’t interfere with your lives. These aren’t the only pests that can disappear if you don’t catch them quick enough though. Cockroaches and other insects also can take root if moisture seeps into foundations. And termites can run the show if construction debris isn’t discarded properly. Termites are everywhere and any waste will certainly attract them. The only way to remove them is to have a professional come and perform Termite Control in Phoenix, LA, or wherever you may be.

Patients can leave negative reviews or complain to auditors if pests are found, and rightly so. Everyone expects a high level of sanitation and cleanliness at hospitals, doctors’ offices and clinics.

Because pests carry harmful pathogens and the potential to ruin a hospital’s reputation, it’s essential to take a proactive approach to pest control before, during and after renovations. By taking preventive measures and working directly with a pest management professional, with measures like reading through a guide to how to get rid of spiders at pestsmartcontrol or calling them directly before a renovation or expansion, facility owners and operators can ensure a patients’ stay is healthy, and also keep on top of a construction timeline and budget.

Phase I: Planning for Pests Before Renovation

Being proactive about a pest management strategy from the start has long-term benefits. Managing pest control issues during construction typically falls on the contractor, who should create an integrated pest management (IPM) program. Effective IPM practices aim to limit pests’ access to the resources they need to survive and reproduce, typically food, warmth, shelter and water.

IPM is most effective when a property is evaluated beforehand to determine which pests already are located around the property, how large their populations are and in which season they are most prevalent. For example, this information could affect a decision to start a construction project in the driest part of the year if mosquitoes and flies are a problem in a particular area. This may prevent entry from swarms of mosquitoes or flies that could occur if the construction started during wet or humid months.

Materials also have the potential to be problems or – when chosen wisely – solutions. When sourcing building materials, choose those that have the potential to deter pests, such as concrete, fiber-cement siding or non-cellulose insulation. Facility owners also need to inspect all incoming materials for signs of pests, as sometimes they hitch a ride onto the construction site with the new materials. Things to look for include droppings, chewed surfaces, or even dead rodents or insects.

A pest management provider can work with the contractor to treat for termites and other insects as walls and foundations are poured and installed. Owners (or hired contractors) will also want to carefully inspect walls and foundations for cracks that rodents and ants could use as an entry point into the structure, and may ven want to read through sites that ran a recent post about how to ensure the beds are kept clean and safe for use. Newly emptied rooms can be treated with a growth-regulating product to prevent insect pests from breeding before construction begins. New carpets also can be pre-treated for pests before installation.

Additionally, facility owners and maintenance personnel must be proactive about maintaining a clean and clutter-free construction site from the beginning of a renovation. After all, a single leftover lunch could cause a full-fledged infestation of roaches, ants or flies.

Phase II: Implementing Best Practices During Renovation

During renovations, it’s important to grade a property properly so that water drains away from the foundation. Standing water is particularly attractive to mosquitoes, and moist, disturbed soils can be the perfect hiding grounds for termites. While grading the property, place baits around the perimeter to prevent termites before they find a way inside the facility.

Any new landscaping installed during a renovation should be kept trimmed and placed at least 2 feet away from buildings to reduce rodents’ accessibility to upper levels and building roofs. Pests will be further deterred from entering the property by installing LED lights (as some studies have shown are less attractive to flying insects than traditional lighting).

During renovations, it’s important to revisit the most common methods that pests use to enter the property. For instance, entry doors (loading docks, front or back entrances, garage doors, etc.) should remain closed as much as possible to reduce entry of rodents or pests with wings, like birds and flying insects. Double sliding doors are recommended at major entrances to create an additional barrier. If windows must be left open, they should be properly screened. Any utility openings should also be closed off.

For frequently used entrances, air curtains (which are fans mounted against the doorway) and plastic strips help to prevent pests from getting in and conditioned air from getting out. These are often a good idea to install at loading docks or supply areas. Steel or copper mesh can be used to seal walls so that rodents can’t gnaw through to the building’s wires and electrical systems.

At the end of each workday, it’s important that construction crews cover all building materials to protect against the elements, especially rain. No one wants to find fungus, larvae or full-grown pests hiding in wet building materials.

Phase III: Maintaining Pest Management After Renovation

Even when a renovation is complete, pest management is not. Work with a pest management professional to update an IPM program based on new additions to the hospital or clinic. Certain areas of a health care facility need special attention and certainly any new food service areas will need to have a strong pest management plan in place.

Education is the key to long-term prevention of pests following renovation. Health care staff – particularly those who work with food, laundry or patients – should be trained on prevention and inspection techniques. After all, they are on the front lines of pest threats, and they should be encouraged to report and log any pest sightings.

As health care providers, it’s essential to be proactive about pests as renovations occur. By maintaining effective pest management practices before, during and after renovation, a health care facility can provide high-quality care to patients and continue to be a place where health and wellness can thrive.

Tim Husen, Ph.D., BCE is a technical services manager at national pest control company Orkin LLC. A board-certified entomologist specializing in urban entomology, he has more than a decade of experience in the industry. For more information, email thusen@rollins.com or visit www.orkincommercial.com.

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