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A standing-room only crowd gathered on June 4th at the Healthcare Master Builders forum to hear experts discuss how the sweeping changes in healthcare delivery as well as technological advances are resulting in new development and construction paradigms in the healthcare industry. Hosted by Zetlin & De Chiara LLP, The New York Building Congress, The American Council of Engineering Companies of New York, The Steven L. Newman Real Estate Institute and Real Estate Weekly, the program offered insight into the strategic visions and planning challenges of some the Tri-State area’s most prestigious hospitals and healthcare systems and the critical role that the design, development and construction industries play in supporting these institutions.

Zetlin & De Chiara Partner Loryn P. Riggiola introduced the program noting, “The healthcare industry is changing, and its changes are going to impact the way we design, build and maintain our healthcare institutions today and in the future.” Ms. Riggiola outlined market factors that were driving forces of change, specifically:

• The demands of educated healthcare consumers who can choose from a range of hospitals and treatment options and are pushing for more specialized health centers which is leading hospitals to invest in more ambulatory and outpatient care facilities.
• New financial demands, such as the 30 million new Americans with health insurance due to the Affordable Care Act and the pressure to keep costs down, are forcing hospitals to seek new financing options to achieve growth such as selling bonds, mergers and exploring public private partnerships (P3s).
• Healthcare organizations continue to seek consolidation whether horizontally (hospital –hospital), vertically (hospital-diagnostic center-wellness center) or cross-sector (health plan provider-clinical services).
• Technology issues in the healthcare industry include mobile health, maintaining state-of-the-art clinical care as well as electronic healthcare data and privacy which all impact infrastructure and facilities planning and design.

Next, Zetlin & De Chiara Partner Lina Telese described a number of construction trends that are taking hold in the healthcare industry as a result of market demands, including:

• Adoption of fixed price contract models (e.g. Design-build, Integrated Project Delivery) over traditional Design-bid-Build models
• The necessity of Building Information Modeling (BIM) for all construction projects as well as ongoing facilities management
• A focus on sustainable construction and environmental responsibility
• The emergence of the converged network to service the multi-tiered technology needs of healthcare providers
• Flexible design and construction to accommodate changing needs is the new standard in the healthcare sector.

Following the introduction, four healthcare leaders outlined their institutions’ strategies in light of the shifting industry landscape.

Gary Acord, Vice President of Design + Construction at Memorial Sloan Kettering Cancer Center (MSKCC), discussed MSKCC’s growth plan, focusing on consolidation of existing spaces and the expansion of ambulatory care centers as opposed to in-patient care or pure research facilities. The ambulatory and outpatient centers will be in strategic locations around the Tri-State area according to Mr. Acord who said that regional growth is “the future.” He also discussed the critical importance of extensive resiliency and disaster preparedness measures like those being integrated into the design and construction of MSKCC’s Manhattan development on the East River in response to events like Hurricane Sandy.

Thomas Ahn, Vice President of Real Estate Services at Mount Sinai Hospital, echoed many of Mr. Acord’s points in discussing the strategic goals for the health system following its recent merger with Continuum Health Partners. He outlined Mt. Sinai’s vision for creating a regional network of comprehensive ambulatory care practices that would offer a “one-stop-shop” for low cost, high-quality care. Mr. Ahn said, “We want to be everywhere in the Tri-State area. We want to be on every corner providing communities with access to exceptional primary and tertiary care.”

Following Mr. Ahn’s presentation, Patrick J. Burke, III AIA, Assistant Vice President of Capital Project Management at Columbia University Medical Center, detailed the hospital’s efforts to consolidate disparate practices and create new unified, sustainable and cutting-edge care centers while balancing ongoing capital needs for upgrades and maintenance throughout their existing properties. He discussed the importance of building an integrated project team that truly understands the hospital’s goals for new and renovated facilities. He said, “When we invest in new or renovated spaces we want a very high quality of design and a feeling of timelessness so that these facilities continue to provide an exceptional patient experience and feel fresh for years to come.”

Finally, Sharon Greenberger, Senior Vice President of Facilities and Construction at New York Presbyterian Hospital, provided an overview of the unique challenges facing the hospital when considering space needs particularly because the average age of its existing facilities is 70 years old. Ms. Greenberger discussed NY Presbyterian’s focus on flexible, forward-thinking designs with consistent aesthetics that anticipate the ongoing need for technology and equipment upgrades and those that focus on patient comfort and convenience. She underscored the need for disaster preparedness across all properties with major resiliency and redundancy efforts. Ms. Greenberger also noted, “Many of our renovation and capital projects are phased over years because these are happening in living spaces, like emergency departments, that are constantly in use and must be treated sensitively to preserve the patient experience.”

The third segment of the Healthcare Master Builders program was a roundtable discussion moderated by Michael K. De Chiara, Senior Partner of Zetlin & De Chiara LLP. Mr. Accord, Mr. Ahn, Mr. Burke and Ms. Greenberger were joined by Duncan Hazard, AIA, Founding Partner and Management Principal of Ennead Architects LLP; Dana Panzarino, P.E., Partner and Managing Director of VVA Project Managers & Consultants; and Mitchel W. Simpler, Managing Partner of Jaros, Baum & Bolles, Consulting Engineers.

Mr. De Chiara asked the panel how they are navigating the increasingly rapid technological advances taking place in healthcare while planning, designing and building projects over the course of many years. The panelists agreed that pre-planning, flexibility and an experienced team are keys to facing this challenge.

Ms. Panzarino noted, “It is best practice to bring together a group of all vested parties, including clinical team members, facilities and operations representatives as well as design and construction professionals at the very beginning of the design and planning process to flush out any potential issues.”

When Mr. De Chiara asked about the most significant design and construction changes in the healthcare sector in recent years, Mr. Simpler reiterated the point that “resiliency and redundancy have become major focuses, and sustainable design is not just the norm, it is a necessity.”

Mr. Hazard added, ”Hospitals and ambulatory care centers have become the new civic centers, offering elevated patient-centered experiences and a broader range of amenities and services. It is an exciting time to be working in these areas and addressing the design needs of these institutions going forward.”

For additional information regarding this event, please visit http://healthcaremasterbuilders.com/index.html