Large healthcare organizations that are actively merging with and/or acquiring facilities, as well as building new ground-up facilities for better healthcare offerings, need to consider overall performance objectives and determine ways to optimize their operations. In my last post, I discussed how the centralization of services improved quality and reduced cost for Montefiore Medical Center through a greater standardization of care. Now, I will discuss the benefits of and appropriate times for de-centralization.
De-Centralization and the Conversion of Space
Moses Campus: As healthcare systems perform system-wide services assessments and begin services consolidation efforts, they must re-purpose decanted space. Although Montefiore consolidated all reference lab functions off-site on the Mount Vernon campus, they are maintaining Stat Lab functions within the hospitals. Array collaborated with them on this initiative for the Moses campus, creating a 6,000 SF Rapid Response Lab. This effort comprised performing a master plan to study the work flow of the pathology department, as well as determine the appropriate functional work space for a growing business and changing technology. Once a plan was in place for lab services, Montefiore decided to allocate the space for the Children’s Hospital at Montefiore’s NICU beds.
Centers of Excellence: Decanting space at Moses to provide more space for the children’s hospital contributed to Montefiore’s success in making their Pediatric Notable Center of Excellence even more accommodating for their patients and loved ones. Systems often face the decision to either provide all services at each location, or try to centralize these services to one campus, enabling the entire department to work closely and more effectively.
Westchester Square Campus: Acquired in 2013, Montefiore needed to understand the infrastructure and layout to determine the best path to make this a profitable, well-running facility. After a master planning effort, Array became involved with designing the implementation projects, enabling emergency services and ambulatory surgery to be the first services available on the new campus. This included removing all inpatient functions from this building and moving licensed beds to another facility. Though this worked well, the system still had the community to consider—a community that became accustomed to having their own full-service hospital. The solution was to incorporate a freestanding ED into the Ambulatory Care Center, where staff could assess and stabilize patients who then transferred to another location. Having access to emergency services was important to the residents of this area.
Radiology/Imaging: Montefiore decided to take a de-centralized approach for this service so they could offer multiple locations where patients could choose from the latest technology. Outpatient imaging is an important service line to attract and retain patients, so parity across facilities is paramount to patient satisfaction. Ease of scheduling and quick access to test results also contributes to this being a successful entry point to a particular campus.
It is important that a healthcare system have the proper vision when realigning their service lines or campuses due to additional service lines or acquisitions. While a centralized approach allows for a single location of a specific service line, other service lines—such as radiology, PAT, phlebotomy, etc.—complement a centralized approach. Embracing a de-centralized approach with these service lines will lead to greater convenience for patients, yielding increased patient satisfaction in the ever-changing healthcare market.
Blog written by Jason Lee, former Principal and Studio Director with Array.
