CREJ

July 2021 — Health Care & Senior Housing Quarterly — Page 11 www.crej.com HEALTH CARE — OUTLOOK now are offering financial incentives for skilled workers to relocate. Not everyone should or can live in larger cities, and not everyone wants to deal with the traffic and crowding in urban areas. Therefore, rural health facilities must remain vital and current to care for rural Americans just as we aim to serve urban and suburban Americans. Ensuring the viability of rural health involves multiple aspects, including recruitment and retention of clinical staff in addition to increased financial support through Medicare/Medicaid and insurance reimbursements. The physical environment also is a vital component, but it can be the most dif- ficult to acquire. It necessitates gain- ing community buy-in, engaging the public and providing the community with amenities that further enrich lives. n Educating the community to get buy- in. The community may not under- stand the need for a new health care facility. After all, a house or small commercial property is still useable after 40 or 50 years, so why should a hospital building be any different? The difference is the evolution of health care treatment methods, practices and technology. • The HVAC/air quality and technol- ogy required for modern facilities to provide adequate ventilation (such as air changes per hour in procedure rooms) cannot be attained in older buildings. • Treatment spaces like operating rooms are undersized for modern pro- cedures (e.g., total hip replacement), efficient workflow and the necessary supporting equipment. • Building height, structural bay size and building envelope insulation (or lack thereof) hamper efforts to renovate internally. Interior upgrades usually cost more than building new facilities. • Health care practice continues to move away from spending multiple nights in the hospital and toward out- patient and home care. Older facilities are designed around a more passive model of health focusing on inpatient care. • Facilities built before the mid-1990s do not comply with the Americans with Disabilities Act, a major piece of civil rights legislation that has posi- tively impacted health care design. Facility leadership and staff must make their case for major capital proj- ects to the community early and often to build support for funding new con- struction. The facility staff can make that case as well as, if not better than, facts and figures. Personal testimonies from nurses and maintenance staff give the community a face to relate to when listening to the daily struggle of not being able to perform a job to the best of their ability because the physi- cal environment holds them back. n Engaging the community in the design process. A hospital can engage the community as part of a process that only begins with buy-in. An open house event that includes tours of how the hospital is currently function- ing (or not) can viscerally illustrate the need for a new building.When the time for planning and design comes, make the facility’s user groups as big as possible. Create a com- munity/patient user group to review built physical mock-ups of some of the spaces and let folks tour it. Let staff “play with” furniture and finish materials. Including the community in a physical and tactile way allows them to have more of a stake and feel that their voices and concerns are being heard. It decreases perceptions that the project and design are being forced on them because they are part of the process from the beginning. n Redefining health care facilities as community amenities. The hospital as a “sick place” is an artifact of 20th cen- tury health care. Hospitals are working to shed the perception that they are buildings for only sick people, when in fact they are becoming centers of wellness. (Note how many people avoided emergency departments dur- ing the pandemic for fear of contract- ing COVID-19 at a hospital.) Residents may be more likely to support a major renovation or replacement project if the facility includes amenities and services for the community that pro- mote health and wellness. A relatively simple version of this is to provide memberships to a gym that includes physical therapy and cardiac rehab services. Patients can continue to work out regularly in a space in which they previously received medical care, and the gym is monitored by actual health care professionals who can help users with their form or even provide sug- gestions on training for general health or for a specific event, like a commu- nity-sponsored 5K run. Some facilities may partner with an entity such as the YMCA to expand offerings and help manage the nonmedical aspects of a wellness gym. An indoor pool provides an excellent place for physi- cal therapy as well as water aerobics classes and a fun afternoon outing for children after school or during school breaks. These may seem like lofty goals, yet multiple (potentially more achievable) amenities can be offered: • A walking track with exercise sta- tions can be located easily on a larger campus for a new facility. • Meeting space such as conference rooms available to the community provide event spaces for family or organizational gatherings (which can be supported through catering from the hospital dietary services). • Hospital dietary services provide a healthy and affordable dining-out option in rural communities; this service can expand into nutritional/ health educational sessions and even allow for a demonstration kitchen to provide a “how-to” for healthy cooking and choices. • A strongWi-Fi signal allows resi- dents with insufficient internet service to use it from dietary spaces or even from the parking lot for a telehealth appointment they may not want to conduct in the facility. (Concerns like “Which of my neighbors will see me in the clinic?” can be a challenge for people seeking care in these commu- nities.) • Hospitals can serve as a gathering place in the wake of a natural disaster and can even provide shelter; hospi- tals must withstand harsher meteo- rological and seismic conditions than any other building type, and in some communities, they can be a safe place in the event of a tornado. As a nation we have an urgent need to revitalize rural health and support our rural neighbors. Health care can no longer be considered a privilege, especially in the wake of the 2020 pandemic. Health care is a right for all Americans to main- tain a positive society and economy. Sometimes, the people we need to convince are in the community a health care facility serves. And make no mistake, it is worth the effort for all of us. s vwilliams@pagethink.com Continued from Page 1