Healthcare Design - March 2020 - 32

In Focus

2/5

consider how these factors are integrated. Rather, the traditional master planning approach aligns strategy and finance as a precursor to determining the specifications for a facilities roadmap, later executing on
the strategy with capital expenditure. Analyzing these two perspectives
before addressing facilities and operations is
a mistake. Facilities necessarily tie back into
BECAUSE STRATEGY IS
finance as budgets and project realities interface-and this is where architects risk failing
RARELY REVISITED ONCE
their clients.
ESTABLISHED, BUILDINGS
Strategy is particularly problematic, as it's
rarely revisited once established. The result
MAY OPEN IN ENTIRELY
is that buildings-constructed long after straNEW REALITIES.
tegic decisions inspired their programs-may
open in entirely new realities. Conditions
such as shifting reimbursements, encroaching competitors, or mergers and acquisitions could each have a direct impact on the longevity
or usefulness of a new program. Architects (as a result of carrying out
the wishes of health systems) have been responsible for buildings with
purposes that have shifted and no longer align with market realities,
requiring changes soon after their opening. In this traditional master
planning paradigm, operations and the need to adapt to new systems of
care are essentially left out of the equation.
What if master planners led an approach that brought the conversations
and experts driving the inputs of finance, operations, strategy, and facilities together? Architects are trained to challenge conventional thinking
and tasked every day with leading the coordination of multiple groups with
siloed expertise to align and integrate those skill sets in a way that derives a
comprehensive end product. If they could help drive these conversations
to happen in parallel during master planning, so all factors are considered
as they push and pull one another, could it derive a more holistic solution?
PUT TO THE TEST

The team at Array Architects has been testing the hypothesis that early
integration would drive more value and applying it in practice to several
master planning engagements. Here are some notable findings:
1. 	 All current-state baselines can be established at the same time.
Existing conditions, including budgets, marketplace, real estate, care
models, etc., represent a context, or baseline, for decision-making and
projecting viable strategies. Master planning shouldn't just be about
receiving strategy and financial goals, and then providing phased
capital expenditures for facilities as a means of conveying that strategy. By exploring current-state baselines at the same time (including
those in strategy, finance, operations, and facilities) instead of determining two as precursor to the rest (as is typical), master planners can
perform much more sophisticated analyses and determine how operational and facility-based considerations alter strategy.
2. 	 An integrated approach doesn't necessitate working within a
single organization. It's necessary to have a "conductor" (possibly the
architect/master planner) driving collaboration between all parties.
This conductor should be well-suited to coordinate external consultants, including strategy advisers, financial consultants, the facilities
team, and operations specialists, to orchestrate a collaborative master
planning engagement. Unlike the traditional approach, where health
systems assume they should work out the primary strategy drivers or
perform a financial analysis before engaging the master planning team,
an integrated approach is a coordinated, concurrent exploration of all

32

MARCH 2020

HCDMAGAZINE.COM

drivers in the equation. It's not necessary to
have all perspectives evaluated under one
roof, but an ongoing conversation among all
parties must occur so that decisions and information cycle through, providing influence
and comparison across the perspectives. For
example, macro approaches to operations
have a direct impact on capacity, throughput,
and need, which would influence decisions
around facilities.
3. 	 An integrated approach takes the same
amount of time as a traditional one.
Working out primary strategy and financial
drivers concurrently with operations and
facilities helps health systems integrate
those considerations early on to produce
more rapid analyses and, in turn, a more
holistic and fruitful master plan. Fortunately, an integrated approach takes the
same amount of time, too, yielding a result
that's better informed and tested.
CASE STUDY

Array was engaged by a health system in the
Northeast to quantify the obsolescence of an
existing hospital campus and help define the
system's future through a revised inpatient and
ambulatory strategy and site selection assessment. Through a multiperspective approach, the
team uncovered critical information, including
a sociodemographic shift occurring within the
client's market and unsustainable operational
costs at key facilities, that showed the health
system needed a holistic and system-wide solution. Array then integrated strategic advisers,
architects, and data analysts to simultaneously
evaluate program scenarios, the system's current state, real estate assets, demographics, and
strategic goals.
By evaluating these components in unison, the
team was able to forgo a solution that addressed
only one problem in favor of tackling foundational issues at a macro level, identifying the
need for a redistribution of care resources and a
new facility in an alternate location. Moreover,
the team was able to determine this need using a
process that demonstrated how it would lead to
a higher return on investment. Lastly, our team
helped the client develop alternate options to
redeploy, repurpose, or reinvent its existing hospital using third-party investor, hospital, and
township resources-options now being considered as a way to help the existing facility continue to serve an important community function.
Once the decision was made to move forward
with a new facility, the team defined care mod-


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Healthcare Design - March 2020

Table of Contents for the Digital Edition of Healthcare Design - March 2020

Healthcare Design - March 2020
Editorial
Show Talk
Fuel for Change
Hospital Hotspots
Listen Up, Quiet Down
Special Report: Introduction
Special Report: Elevate & Evolve
Special Report: Support Network
Planning and Design
Product Spotlight
The Center
Supplement to Healthcare Design
Face Time
Healthcare Design - March 2020 - Healthcare Design - March 2020
Healthcare Design - March 2020 - Cover2
Healthcare Design - March 2020 - 1
Healthcare Design - March 2020 - 2
Healthcare Design - March 2020 - 3
Healthcare Design - March 2020 - 4
Healthcare Design - March 2020 - 5
Healthcare Design - March 2020 - 6
Healthcare Design - March 2020 - 7
Healthcare Design - March 2020 - 8
Healthcare Design - March 2020 - Editorial
Healthcare Design - March 2020 - Show Talk
Healthcare Design - March 2020 - 11
Healthcare Design - March 2020 - 12
Healthcare Design - March 2020 - Fuel for Change
Healthcare Design - March 2020 - 14
Healthcare Design - March 2020 - 15
Healthcare Design - March 2020 - Hospital Hotspots
Healthcare Design - March 2020 - Listen Up, Quiet Down
Healthcare Design - March 2020 - Special Report: Introduction
Healthcare Design - March 2020 - 19
Healthcare Design - March 2020 - Special Report: Elevate & Evolve
Healthcare Design - March 2020 - 21
Healthcare Design - March 2020 - 22
Healthcare Design - March 2020 - 23
Healthcare Design - March 2020 - 24
Healthcare Design - March 2020 - 25
Healthcare Design - March 2020 - Special Report: Support Network
Healthcare Design - March 2020 - 27
Healthcare Design - March 2020 - 28
Healthcare Design - March 2020 - 29
Healthcare Design - March 2020 - 30
Healthcare Design - March 2020 - Planning and Design
Healthcare Design - March 2020 - 32
Healthcare Design - March 2020 - 33
Healthcare Design - March 2020 - Product Spotlight
Healthcare Design - March 2020 - 35
Healthcare Design - March 2020 - 36
Healthcare Design - March 2020 - 37
Healthcare Design - March 2020 - The Center
Healthcare Design - March 2020 - 39
Healthcare Design - March 2020 - 40
Healthcare Design - March 2020 - Supplement to Healthcare Design
Healthcare Design - March 2020 - 42
Healthcare Design - March 2020 - 43
Healthcare Design - March 2020 - 44
Healthcare Design - March 2020 - 45
Healthcare Design - March 2020 - 46
Healthcare Design - March 2020 - 47
Healthcare Design - March 2020 - 48
Healthcare Design - March 2020 - 49
Healthcare Design - March 2020 - 50
Healthcare Design - March 2020 - 51
Healthcare Design - March 2020 - 52
Healthcare Design - March 2020 - 53
Healthcare Design - March 2020 - 54
Healthcare Design - March 2020 - 55
Healthcare Design - March 2020 - Face Time
Healthcare Design - March 2020 - Cover3
Healthcare Design - March 2020 - Cover4
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