Are 'bedless' hospitals the wave of the future?

Technology is helping make the shift possible, experts say

More providers are building "bedless" hospitals in response to changing patient preferences and reimbursement practices, David Royse reports for Modern Healthcare.

Tenet Healthcare's Detroit Medical Center (DMC) expects to open Children's Hospital of Michigan Specialty Center (CHMSC) in February. The $44 million, 63,000-square-foot center has much of what you would expect in a hospital, with an ED, ORs, and specialty facilities for cardiology, neurology, and oncology—but no inpatient beds.

A shift in the industry

It's exemplary of a trend to build advanced outpatient centers that offer a combination of imaging, telehealth, surgery, and short-term observation care, Royse writes. These facilities, experts say, allow providers to move care into a lower-cost outpatient settings and provide the convenience that many patients want.

Outpatient center wants to offer surgeries that require overnight stays

Paul Strohm, director of global health care practice at design and architecture firm HOK, says his company is increasingly designing smaller, more efficient, and flexible facilities. "There are way fewer big projects," he says.

John Kouletsis, VP of facilities planning and design for Kaiser Permanente, says the shift reflects a different approach to care that deemphasizes the hospital. He says technology and a focus on convenience are accelerating the pace of change.

Patient experience

For instance, Kaiser is increasingly emphasizing telehealth and ambulatory facilities located near where patients work and live.

Tenet poised to become America's largest ambulatory surgery provider

And experts say that moving lower-risk surgeries into outpatient centers can improve wait times. Montefiore Medical Center in New York is using that strategy with it new $152 million, 280,000-square-foot "bedless" hospital.

"You don't want to have a healthy person that needs a small procedure next to a person who needs major neurosurgery," explains Susan Solometo, Montefiore's VP of clinical services at the surgery-care center. "If you're following one of those big cases, chances are that case might run over."

Ron Henry, chief facilities engineering and construction officer at DMC, notes that ambulatory centers can improve the patient experience in other ways as well. For instance, he says traveling to a large hospital can be anxiety-provoking—especially for children.

Plus, bedless hospitals often have flexible designs that can respond to shifting patient demands. For instance, CHMSC is built out of modules that can be modified to provide new services as the market evolves further. "This building is definitely designed for future expansion," Henry says (Royse, Modern Healthcare, 9/12).


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