Most of us interact with health systems only as patients, and therefore see them primarily as healing havens. True as that is, they're also businesses, and have to compete for market share like any other business.
That competition is pushing hospitals and health systems to be more efficient in their services while, at the same time, more patient-focused by making services convenient, says Brian Crimmins, vice president, facilities planning and development at Crozer-Keystone Health System in Pennsylvania.
"The days when hospitals just sat back and said, 'When you're sick, come here' are over," Crimmins says.
At a time when facility managers continue to grapple with doing more with less, creating progress in the health care delivery model becomes a challenge for any health organization.
Even more so in a health system like Crozer-Keystone, which has some hospitals in economically disadvantaged areas, Crimmins says, and so has a less robust payor mix than other systems in the state.
Crozer-Keystone is the dominant health care provider in Delaware County, just to the west of Philadelphia. Anchored by five main hospital complexes in a roughly 30-mile circuit, the system also has an ever-growing number of satellite facilities throughout the county, including more than 600,000 square feet of physician office space.
The push for innovation and efficiency in health care delivery models at Crozer-Keystone is systemic, from the medical staff's efforts at infection control to the way patient medical records are handled. And, with Crimmins at the helm, the system's facilities have played a big role.
The current moment in health care is one of transition, from the hospital in-patient model to an ambulatory out-patient model.
"The hospital will become the place where only the sickest of the sick will end up because of the intensity of the services they'll need," Crimmins says.
As little as 10 years ago, the idea was that a hospital presided over its geographic area like a shepherd over its local flock. Today, the move to outpatient services opens up the geographic playing field to nearby competitors who can fairly easily open ambulatory sites in a hospital's historic market. The move towards ambulatory services also gives other factors, like aesthetics, greater weight. "You have many more patients showing up at your front door who aren't deathly sick and just want you to make them better," Crimmins says. "They're coming in and they're leaving. And they want it to be a pleasant experience."
This all comes together to give potential patients — or health care consumers, as they're increasingly being thought of — what they want: choice, convenience and a competitive market that is hustling for their business. This gives health systems a major challenge, as they now have to constantly struggle to maintain market share.
At Crozer-Keystone, there's a two-pronged approach from the facilities side aimed at capturing that market share. The first is increasing the number of private rooms. As the care model has shifted to outpatient care, fewer in-patient beds are needed to serve the population in hospitals. While that at first seems like a bad trend, there is actually a silver lining: It allows Crimmins' team to retrofit the hospitals towards a goal of all private rooms. From the facilities perspective, the square footage isn't changing, so there is no efficiency gained, Crimmins says, but it improves patient satisfaction, creates lower densities on the unit and is helpful for infection control.
Brian Crimmins Uses Facilities to Help Crozer-Keystone Health System Increase Market Share
Health Care Facilities Strategy: Ambulatory Care at Crozer-Keystone
Health Care Facilities Management Team Runs Lean at Crozer-Keystone
Tips for Facility Service Contracts for Large Health Care Organizations
Brian Crimmins on the Evolution of Crozer-Keystone Health System
