Of all the various issues that can plague the development community, none is so crucial to the general population as healthcare. Ensuring our medical facilities are adequate and up-to-date is one of the most pressing items. In this month’s panel event, hundreds of architects, engineers, and more, filed into the California Club to hear from a group of panelists at the forefront of the medical facility planning and development processes. In one of our most heavily attended events, panelists discussed how the various issues in the healthcare industry will affect development, Southern California, and the nation as a whole.

Sarah Meeker Jensen, AIA, LEED AP, President of Jensen + Partners began the program by introducing the 4 panelists who work in different domains of healthcare development. Jean Mah, FAIA, FACHA, LEED AP of Perkins + Will, who is a principal and healthcare planner, has been recognized for her innovative style. The second panelist, Andrew K. Moey, AIA, is an assistant deputy director at Los Angeles County Public Works. Projects he has worked on include the renovation and master-planning of UCLA Harbor Medical Center, which is currently in development stages. Our final panelist, who was quite a rarity, was George Tingwald, MD, AIA, ACHA of Stanford Healthcare. Dr. Tingwald was able to provide unique perspectives due to his experience as both a physician and an architect, which also serve him exceptionally well in creating medical facility master plans.

Sustainability in Medical Facilities

Our panel discussion touched on many topics which pertain to sustainability, both of individual medical facilities as well as the state of the healthcare industry itself.

“Hospitals are the most challenging building type to make sustainable, but they also present some of the biggest opportunities for designers,” said Jean Mah. “The potential benefits to people and the environment are so high.”

All panelists had their own concerns regarding the sustainability of our current healthcare facility model. This is especially important to California – both northern and southern – whose metro areas face increasingly limited quantities of space. San Jose, was noted specifically as having a notable access problem with over 350,000 individuals being turned away from hospitals in 2018 alone. Other issues relate to the resiliency of structures. It is estimated that between 20% and 40% of California hospitals may be forced in to closure in the near future due to the inability to fund seismic retrofitting renovations, which are mandated by state law. While these regulations have the best intentions, they can often hamper development efforts. This can be especially precarious in the arena of structures which provide essential services, hospitals being among them.

Current Successes, Failures and Looming Crises

While the panelists delivered mostly sobering information during the discussion, not everything was laden with bad news. For instance, some of successes that were noted by panelists centered around certain progress made in the realm of behavioral health.

“Healthcare in Los Angeles has developed to place a large emphasis on behavioral healthcare,” said Andrew K. Moey. “However, for it to be truly successful on a long-term basis, healthcare professionals must adapt a model in which behavioral health is fully integrated into mainstream medical care,” he continued.

Other panelists agreed that while progress has been made, there is still abundant room for improvement. Issues surrounding behavioral health are especially pertinent in Southern California, a region notorious for being rife with homeless individuals, many of whom are suffering from mental illness, addiction, and other behavioral health issues.

“These problems affect many areas of society, we need to move into a model of behavioral health that removes those who are suffering from the vicious cycle they are caught up in,” said Moey of the current shortcomings.

Wellness, a popular concept which has taken the healthcare landscape by storm in the last decade was noted by panelists as largely being a failure. This concept is perhaps better suited towards retail environments in the form of a service provided, not necessarily healthcare. Looming crises include the current statistics of nurses and physicians.

“Around 50% of nurses and doctors are over the age of 50,” said Tingwald. “This is especially going to affect the baby boomer generation, who are the next generation to advance into the upper stages of aging.”

Panelists all agreed that while development efforts are crucial in the future of the healthcare landscape, the medical profession must also reconsider how doctors and nurses are trained. In addition to training, medical professionals must continue to work with members of the development community to provide both the best care for patients, as well as the best working environment for hospital staff.