This article first appeared on March 24, 2009 on HHN Magazine's online site.
Delivering Health Care the Retail Way
By Paula CrowleyHealth care organizations succeed by treating outpatients like consumers.
Paula CrowleyA successful ambulatory health care facility must offer more than just a pretty space. Today’s knowledgeable health care consumers demand high-quality providers who offer excellent care and state-of-the-art technology. But in a competitive market, a provider must also recognize that health care consumers value what all consumers value: convenience and customer service.
Providers have redefined the way they deliver ambulatory services. They rely on the fundamental principles of a profitable retail center: location, access, visibility, convenience and customer service. Like successful retailers, these health care providers are laying the groundwork for patient satisfaction and loyalty by creating a positive experience.
In the retail model of health care, a positive experience begins when consumers have access to a range of carefully integrated outpatient services and independent physicians in a single well-designed facility—not unlike one-stop shopping. Along with the conventional clinical and diagnostic functions, an outpatient facility may include complementary services, such as a spa, café, boutique or fitness center.
Patient-friendly indoor public spaces ideally include a gracious entrance lobby with a one-stop reception and registration desk, spacious shared waiting areas furnished with a variety of comfortable seating arrangements, and health information resources. Use of natural materials, such as stone and wood, abundant natural lighting, and water features create a calming environment.
Textbook Cases
The following projects have been designed to create an atmosphere of hospitality, service and comfort, eliminating the confusing, institutional feeling of many health care facilities.
The Health & Wellness Center. Doylestown Hospital needed to appeal directly to health care consumers, market its physicians to the community, and increase patient loyalty. So it developed The Health & Wellness Center in a prime commercial area of Warrington, Pa., which is in Bucks County, one of the fastest-growing suburban markets on the East Coast.
Since the 120,000-square-foot outpatient facility opened in 2001, The Health & Wellness Center has been recognized for its carefully coordinated delivery of ambulatory health care services in a pleasing, customer-friendly environment. First-year revenues exceeded projections by seven times. Moreover, the center has consistently delivered high Press Ganey scores for patient satisfaction, averaging 91 percent over the first five years of operation, and 79 percent of the facility’s users are repeat visitors.
The center includes a full range of physician specialties and outpatient services: cardiology, family medicine, gastroenterology, endocrinology, ob-gyn, pediatric dentistry, orthodontics, cosmetic surgery, physical therapy, and orthopedics and sports medicine. The center also features a 34,000-square-foot medically based fitness center with an associated retail boutique, spa, café and health design center. By merchandizing, or co-locating, similar services (such as orthopedics and physical therapy), The Health & Wellness Center benefits from reduced operating costs. Departments share back-office support space and equipment, which eliminates duplicate costs.
As a result of merchandizing services, the center is designed to be open and easy to navigate. Cardiac rehab, medical fitness, orthopedics and physical therapy facilities are located on the same floor and share waiting space. Consumers accustomed to shopping malls find this grouping of similar products and services intuitive and nonthreatening. Indoor public spaces feature a variety of comfortable seating arrangements, natural light and a water feature (see figure 1), as well as access to patient information and other resources. And, although the project is highly visible from the main highway, it is softened by six healing gardens that surround the building façade.
Capital Health System. Wanting to rebrand its image as a health care provider “beyond the city limits,” Capital Health System—with two campuses in downtown Trenton, N.J.—developed a 72,000-square-foot outpatient campus in Hamilton, a nearby growing suburban community. Opened in 2005, the campus has a shared waiting area with water features, an abundance of natural light, a bistro and a variety of seating options that allow the customers to select where they feel most comfortable waiting (see figure 2).
This new project has not only allowed the health system to increase its outpatient revenues by offering a variety of diagnostic services in an integrated suburban setting, but it has also enabled the health system to compete directly with suburban hospitals in the area.
Capital Health System’s outpatient campus comprises two buildings: a 46,000-square-foot ambulatory care facility and a 26,000-square-foot medical facility with a four-OR surgery center, diagnostic and general imaging, women’s imaging, pediatrics, ophthalmology, general surgery, family practice, endocrinology, gastroenterology, cardiology, ob-gyn, the Center for Sleep Medicine and the CHS Institute for Neurosciences.
This design creates a comfortable environment that promotes healing through close associations with the natural world. In one building, an open floor plan leads patients past water features to a café and outdoor terrace overlooking unspoiled wetlands. In the other building, patients can select from a variety of waiting areas, taking advantage of a cozy fireplace or a sunlit, vaulted atrium, all surrounded by an extensive art collection.
Centers of Excellence
The retail model has also been applied with great success to special centers of excellence. For example, in August 2006, Good Shepherd Rehabilitation Hospital completed and opened the Health & Technology Center, a 64,000-square-foot, state-of-the-art outpatient center for its campus in Allentown, Pa. From design through programming, the Good Shepherd Health & Technology Center gained recognition as a cutting-edge prototype for outpatient rehabilitation. All of Good Shepherd’s outpatient services have been carefully organized under one roof, sharing a campus that also offers inpatient care, long-term care and independent living.
The introduction to the project is at the front door with a retail destination—including Rehability, a 2,000-square-foot retail store selling durable medical equipment and daily living aids for the disabled (figure 3), and a health resource center providing health education. This area is connected to a technology center that demonstrates and sells the latest in adaptive technologies to a disabled population.
Ownership Options
An experienced health care developer will integrate the concepts outlined above, and working with a health care real estate developer will enable a hospital or health system to select the most advantageous ownership structure for its project. In some cases, the health care organization may choose to assign the risk to the developer as owner, and to lease space in the project. Or, the organization may opt to purchase the project during its lease term at previously established prices.
If a health care provider prefers to share in project ownership, it may be advantageous to form a partnership or other similar arrangement for that purpose; physician tenants might also be included as project owners. If the provider prefers to assume the development risk, furnishing the capital and owning the project, it may nevertheless wish to retain the developer on a fee basis for planning, development and construction management services.
In a competitive market, health care organizations succeed when they treat outpatients like consumers. Location, visibility, easy access, hospitality and familiarity are essential considerations. In the cases of Doylestown Hospital, Capital Health System and Good Shepherd Rehabilitation Hospital, delivering health care the retail way—that is, applying solid retail principles to the delivery of ambulatory services—has proven to be a wise decision.
Paula Crowley is the chief executive officer and a founder of Anchor Health Properties in Wilmington, Del.
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Figure 1: Atrium Waterfall at The Health & Wellness Center,
Doylestown Hospital, Warrington, Pa.
Figure 2: Shared Waiting Area at Capital Health System,
Hamilton, N.J.
Figure 3: Retail Store, Rehability, in the Good Shepherd Rehabilitation
Hospital Health & Technology Center, Allentown, Pa.
This article first appeared on March 24, 2009 on HHN Magazine's online site.
