Emergency technologies affect planning and design

Real Estate Weekly, Dec 8, 2004 by James Case

The healthcare field is in the midst of a technological transformation. In an effort to improve patient outcomes, enhance patient safety, increase market share, decrease operating costs and boost profitability, hospitals and private medical groups are investing in new medical and information technology at an often frantic pace.

Today's "must-have" and emerging technologies are affecting the planning and design of new facilities and renovations of existing facilities.

In particular, accommodating new medical technologies is leading to increased floor area and floor-to-floor heights in new facilities and revised layouts in traditional hospital spaces, such as the operating rooms and the emergency department and improved infrastructure for telecommunications, electrical and mechanical systems.

The "must-haves" in today's competitive hospitals include:

Noninvasive technologies. New technologies for minimally invasive or noninvasive medical procedures--in particular, imaging and surgery--are "must-haves" for hospitals that can afford the equipment and the specialized training often required to implement it. As a result, many hospitals are converting traditional operating rooms into minimally invasive surgery or laparoscopic surgery rooms, typically involving an almost total renovation of the room.

Increasing numbers of PCs and portable equipment. Hospital rooms from the Intensive Care Unit to the Emergency Department to inpatient units are becoming crammed by the use of more equipment, including PCs and mobile equipment such as ultrasound units.

As a result, these rooms must be enlarged, and conduit and junction boxes for a variety of cabling needs, telecommunications ports and power outlets must be installed to accommodate this technology.

Picture archiving and communication systems (PACs). Digital transmission and storage of diagnostic images is becoming the norm for new or upgraded hospital facilities. Computer workstations with PACs capability are being requested not only in central reading rooms, but also throughout the hospital, providing doctors with convenient access to diagnostic image reading.

This has increased the need for space to house computer workstations.

Automated medication dispensing machines. Widely used today, automated medication dispensing machines can reduce the size requirements for medication storage and prep rooms at nursing stations.

Air handling systems designed to support control of infectious respiratory diseases. Health care building codes have been upgraded to enhance control of infectious respiratory diseases. Higher floor-to-floor heights are now employed in new construction to accommodate larger ductwork and other air handling equipment needed to provide the increased air flow, air change rates, fresh air intake and filtration that is typically required by the newer standards.

Emerging Trends

A number of emerging technologies are likely to become "must-haves" within the next three to five years ...

Pressurized treatment and inpatient rooms. With increasing concern about infectious diseases, some hospitals are installing air handling systems that enable designated Emergency Department treatment rooms and inpatient rooms to be switched from positive to negative pressure as needed for certain patient conditions.

Electronic medical records. Approximately 15 percent of hospitals and 5 percent of private physicians have already installed computerized electronic medical records technology for patient records as a vehicle for streamlining hospital operations, increasing accuracy and reducing medical errors.

Bedside Registration. Hospitals are expanding the capabilities of their electronic medical records systems with portable patient registration devices.

Especially in Emergency Departments, bedside registration and "electronic dashboards" will replace the waiting room registration counter and the old white marker board.

Wireless communications. In the future, much of the telecommunications load in the hospital setting may be taken over by wireless technology, assuming that the industry improves reliability and data security to assure patient privacy.

Accommodating new medical technologies today and planning for their implementation in the future requires foresight and flexibility.

New construction, renovations and additions should be planned with maximum flexibility to allow for the implementation of new technology.

Expansion, redesign, or adaptive reuse of existing spaces must incorporate allowances for new equipment and increased capacity in mechanical, electrical and IT systems.