Heathcare Overview
by K. Robert Wendel

Bad food and small rooms are out in new hospitals, with owners concentrating more on the patient and family experience to attract new customers in an increasingly competitive health- care market.

Along with those basic changes, many facilities are also gearing up to handle the mass casualties if there ever is a bio- terror or terrorist attack.

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According to McGraw-Hill Construction Information Group, more than $2.25 billion in new hospital work is in planning in Arizona, Nevada and New Mexico since March 2003. Another $982 million in work is currently under bid or under way in the three states.

Outpatient clinics, labs and convalescent homes, along with medical office buildings, accounted for another $5.5 billion in current construction.

"We see continuous increases in hospital construction," said Bill Welch, president of the Nevada Hospital Association. "Every 12 or 18 months, one to two new hospitals open or existing facilities go through major renovation and expansion, and I don't see that changing in the foreseeable future."

The pace of hospital construction isn't the only thing that continues to grow. Hospital rooms are also getting larger, moving from an average of 150 sq. ft. to more than 400 sq. ft in some new hospitals. One of the more recent trends is construction of private rooms.

"There's a move towards more private patient rooms, and to my understanding, it reduces liability, but is more expensive," said Tom Thliveris of the Arizona State Department of Health Services Licensing Division. "Another change is hand- washing sinks, and infection- control issues are much more important."

The larger rooms also offer space for relatives to spend the night, and some hospitals are starting to offer room service.

"Instead of forcing the patient, family, friend or even a physician to go to the cafeteria, they can order room service," said Jeff Nelson, Banner Health public relations director. "We have guaranteed delivery within 45 minutes, 24- hours a day."

With new medical technology developing at a rapid rate, hospital owners said design flexibility is a key issue when planning a hospital. Today's modern, efficient magnetic resonance technology could be replaced with tomorrow's technology de jour, but if the hospital's design is inflexible, that technology cannot be easily incorporated.

"Hospitals are subject to the most rapid changes in medical technology," said Nick Devenney, principal of Phoenix-based Devenney Group LTD Architects. "They are developing a lot of machines called "heavy iron," and these pieces of equipment are highly sensitive to one another. They have to be separated or screened, so the design of a hospital becomes very technical, but it still must remain flexible."

Terror Concerns at Facilities

Hospitals are also gearing up for an unpredictable future. At the new Scottsdale Osborn Emergency Department, a new helipad can handle up to three normal life-flight helicopters, or one U.S. military UH-60 Sikorsky Blackhawk, a 16-ton aircraft. The E.R. department is also designed so that in the event of a bio- terror attack, victims could be contained in the E.R. without contaminating the rest of the hospital.

At Banner Estrella in west Phoenix, contractors are building a community center at the edge of the hospital campus that doubles as a triage center in the event of a bio- terror attack. The center features space so the families of emergency responders can take shelter nearby, lessening the worries of emergency personal.

Health Construction Robust

After spending much of the 1990s in a contraction mode, health-care facilities owners are cracking open their wallets in a big way, focusing on new general hospitals and medical office buildings. Clinical and nursing home construction also appears to be bouncing back after a two-year slide.

In Nevada, the largest project by far is the planned Nevada Medical Specialty Center in Las Vegas, a private, $700 million, multi-phase project that features a non-profit children's hospital, a cardiovascular hospital, rehabilitation hospital and a behavior health center. Developed by Houston-based Genesis Healthcare International, an initial phase will see the construction of an 800-bed hospital and medical facility.

A construction date, contractor or architect has not been determined.

In Arizona, plans are calling for a $250 million, six-story addition to St. Joseph's Medical Center in Phoenix, with Kitchell Contractors recently breaking ground.

Kitchell also recently broke ground on the 200-bed San Martine Hospital in Las Vegas.
Construction cost is an estimated $75 million.

Kitchell and McCarthy Cos. both have work in western Arizona. Kitchell is performing $20 million in renovation work the Yuma Regional Medical Center. McCarthy Cos. are in planning for a $58 million addition to the medical center in Yuma, with plans calling for a new critical-care tower, emergency room additions and a medical office building.

Bids are out on a $120 million women and children's center at the University of New Mexico in Albuquerque. Designed by DCSW of Albuquerque, the estimated 450,000- sq.- ft. project is expected to break ground in late summer or early fall.

Texas firms Austin Commercial and PCL, along with a joint venture between J.E. Dunn and local contractor Jaynes and Okland Construction, are in all in the running for the project.

There are several hospital projects in the $50 million range. On the West side of Phoenix, Banner Health and contractor DPR Construction are building a $92 million, three- story, 452,000-sq.-ft. hospital.

Banner Health canceled a Gilbert hospital, valued at $50 million, but is remodeling its Banner Good Samaritan in downtown Phoenix.

In Gilbert, a campus for Catholic Healthcare West, estimated at $50 million, is planned.

Kitchell also won the contract for an estimated $75 million renovation and expansion of a children's hospital in Clark County, Nevada.

In Albuquerque, McCarthy is nearly finished on the $35 million renovation and expansion of the Presbyterian Hospital.

"Right now, there is a bed shortage, but it's hard to say where we will be in two years when those beds (in new projects) open up," said Professor Bradford Kirkman-Liff, a professor in at Arizona State University's W.P. Carey School of Business. "That's the nature of a having a free market for health care.

"When you have a shortage, so many people jump in and build facilities, then you end up with a surplus. I don't see a potential for over capacity, but obviously, it is always a risk."

>Healthcare Overview
>Specialty Hospitals
>Carson-Tahoe Regional Medical Center
>Albuquerque Presbyterian Hospital
>Banner Estrella Medical Center
>Scottsdale Osborn Medical Center