Sustainability is Key to the Health System of the Future

By Jonathan Anschutz

Two principles guide Palomar Pomerado’s building project – reducing environmental impact, and creating better healing and workplace environments.

Editor’s Note: Healthcare facilities that were built during the Hill-Burton years (1945-1975) are aging, and market demands are changing. That’s why IDNs are building again. Contracting executives are often called on to help with the plans, and to furnish and supply these new facilities. In this regular feature, JHC gives its readers a heads-up on construction trends in the industry, and how they might affect you.

Healthcare systems across the United States are embarking upon construction projects to replace aging facilities, or expand and upgrade existing ones. One such health system is Palomar Pomerado Health (PPH), which in 2004 began an expansion/renovation project to create “the health system of the future.” At the center of the project is a new hospital designed to be sustainable and flexible enough to meet the future needs of the healthcare industry.

The project calls for the construction of Palomar Medical Center West (the “hospital of the future”) in Escondido, Calif.; redevelopment of the current Palomar Medical Center campus in Escondido for specialty inpatient, outpatient, and wellness services; expansion of Pomerado Hospital in Poway, Calif.; and the development of outpatient satellite centers strategically located throughout the system’s 800 square-mile service area.

Architects focused on sustainability as the project’s central concept, reflecting Palomar Pomerado’s belief that sustainable facilities create the best healing environments. As such, their designs focus on two main principles: reducing environmental impact and creating better healing and workplace environments.

In order to reduce the new medical center’s environmental impact, Palomar Pomerado sought to decrease resource consumption and waste generation. Designs for the new hospital call for environmentally friendly features, such as a special cooling system, automated light controls, and landscaped roofs that deflect sunlight rather than absorb it. In addition, project designers hope to use natural materials whenever possible in the building’s construction, reduce water consumption, and increase recycling. At press time, IDN executives were also considering installing a solar energy system on top of a new parking structure, and were seeking an industry partner for the project.

Healing environment
As part of their effort to create improved healing and workplace environments, designers took into consideration the physical, emotional, and spiritual needs of patients, families, and staff members. Designs call for construction of so-called “same-handed rooms,” which use the same room orientation throughout. For example, key room elements, such as beds and medical equipment, are located along the same wall in each room. (Typically, adjacent hospital rooms are built as mirror images of the other in order to share utilities such as plumbing and wiring.) Evidence suggests same-handed rooms – while more expensive to construct because they do not share utilities – encourage consistency of patient care practices, reduce staff errors, and minimize staff reaction time in high-stress situations. The new hospital design also features natural elements, such as terraces, balconies, rooftop gardens and interior courtyards, to give patients, families, and staff access to nature and daylight – which is believed to enhance patient healing, reduce stress, and improve clinical and operational outcomes.

Another important feature of the sustainable-design concept is the acuity-adaptable patient room. These rooms are equipped with medical technology needed for a wide range of health conditions. They can then be adapted to the patient’s condition, eliminating the need to transfer him or her between departments. Not only do such rooms reduce the stress of being moved from room to room, but they also reduce the chance of infection and medical errors. In addition, Palomar Pomerado officials believe that staying in one room provides patients with a comfortable, familiar, and stable environment, which will help them recuperate faster. Palomar Medical Center West will have 192 acuity-adaptable rooms.

All healthcare facilities construction projects experience cost overruns. Palomar Pomerado CEO Michael Covert reported in June that the project’s costs ballooned 53 percent to $1.15 billion. As a result, Covert proposed delaying several aspects of the project. Covert hopes that the delays will allow the IDN to pay down existing debt and free up money for the project. He added that eliminating debt will put Palomar Pomerado in a better position to borrow money in the future to finish the project. In the meantime, the IDN is investigating contracting with a third party developer to build a central plant and medical support building at Palomar Medical Center West. “The hospital of the future” is set to open by 2011.

Jonathan Anschutz is industry analyst for U.S. Lifeline, Carlisle, Pa., a provider of intelligence for the supply chain, including Major Accounts Exchange (The MAX). He may be reached at (717) 243-3293.