As healthcare organizations seek new ways to provide care, microhospitals are offering a new model with distinct advantages for both providers and patients.
Microhospitals are 24/7, small-scale inpatient facilities, roughly 15,000 to 50,000 square feet, with between five and 15 inpatient beds for observation and short stay use. In some cases these facilities can reach 50 beds based on market demand. While microhospitals can treat some high-acuity needs when necessary, most are located within 20 miles of a full-service hospital to ensure a seamless transfer process when warranted.
Urgent care clinics have become popular in recent years, but they are limited in terms of the services they can provide. On the other hand, microhospitals can offer a full set of services typically found in large hospitals, including ER, pharmacy, lab, radiology and even surgery. They offer greater accessibility and convenience for many consumers and cost-effective market growth opportunities for providers. They also enable healthcare services to reach some traditionally underserved areas. Although the cost varies depending on the number and type of ancillary services offered, building a microhospital costs between $7 million and $35 million.
This new type of care facility is appearing primarily in large urban and suburban metro areas across the southern as well as mid-western parts of the United States, including Texas, Ohio, Colorado, Nevada, Michigan, and Arizona, but the idea is growing in popularity and beginning to spread to areas including Indianapolis, California, and Las Vegas.
Here's a closer look at some of the benefits:
Greater Efficiency
In traditional hospital design there are some inherent inefficiencies. Services are typically far from one another, requiring transporting patients across a great distance, for example from the emergency department to diagnostics. The smaller footprint of microhospitals, in which every resource is closely available, offers an overall easier, more accessible and highly convenient experience for both patients and clinicians.
Highly Flexible
Many of the design concepts in microhospitals are actually beneficial for regular-sized hospitals as well. Spaces are designed to be multi-functional and offer greater flexibility. As the average daily census, acuity, and specific needs of patients in any hospital setting fluctuates, flexibility in how spaces can be used can avoid bottlenecks and wasted space and staffing. In microhospitals, patient rooms are often built to beyond minimum guidelines for multiple uses and can thereby be cross-utilized. For example, a facility in Ohio has an inpatient bed unit contiguous to the emergency department. The beds can be used as they are needed at the time, with the option of opening up secondary units, offering greater flexibility in terms of both space and staffing. The central location of the nurses' station can ease transitions, and the nursing staff on duty are trained to handle the full variety of patient conditions.
Rapid Deployment
In addition to greater efficiencies in clinical treatment, there is often a streamlined approval process for microhospitals. With a goal of getting a project underway in 90 days, we are often able to identify and test fit a piece of property rapidly. We can usually identify all of the issues — including zoning, parking analyses, drainage testing, and floor area ratio analysis — within three to four business days to determine if it is a viable site. The whole journey is what we would normally do for traditional hospitals, but on an expedited timeline.
Better Access to Care
Rural communities are thrilled to get more local access to healthcare and generally welcome these smaller facilities with open arms. Unlike behemoth hospitals in urban medical areas, the impact of traffic is a much less significant obstacle. Emergent traffic and associated noise are common community concerns in hospital construction, but these are greatly reduced by the smaller footprint of a microhospital. Furthermore, microhospitals are often designed to bring added resources to a community, such as integrating bicycle trails into the hospital site, offering outdoor dining spaces or a rooftop terrace open to the public, and making other appealing quality of life improvements to the area. Communities demand and warrant hospitality and the consumer factor drives amenities.
Common misconceptions
A common misconception about microhospitals is that they offer only limited services. Many actually offer the full range of medical resources, including primary care, specialties, diagnostics, and surgical capabilities, as well as amenities such as high-quality food service. The initial experience of finding all that you need in large hospitals is vastly different than that in a microhospital setting. The smaller, more intimate atmosphere provides positive experiences for both patients as well as clinical staff. Often consumers boomerang back after initial visits, appreciating the greater accessibility and intimacy of the care setting as well as the highly modern facilities and equipment. Convenience and confidence create a point of care response right-sized to a smaller catchment area and not normally seen in healthcare limited by larger real estate demand.
In terms of the level of clinical experience they offer, medical staff has privileges at multiple facilities, so the quality of physicians is the same. Furthermore, clinicians enjoy the opportunity to manage the majority of their case load in these smaller settings, getting closer to the reason they went into medicine in the first place: caring for patients and families.
Both consumers and physicians demand and expect greater convenience and access to medical care, and healthcare providers must find innovative and sustainable ways to deliver. Microhospitals offer a high-quality, viable and cost-effective alternative to traditional mammoth hospitals and dense medical cities. We expect to see this trend to grow in the coming years.
Rod Booze is a Partner with Environments for Health (E4H), an architecture firm exclusively focused on the healthcare industry, is a design leader in the newly-emerging field of microhospital facility construction. To date, E4H has designed 12 microhospitals, or 24% of the 50 microhospitals built in the United States to date, and an additional 6 small, boutique hospitals.
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