Achieving cost-effective building design

Hospital leadership have a number of options at their disposal to help reduce hospital building costs

With the average cost of a new hospital ranging from $1.5 million to $2 million per bed, it is increasingly important to executive leadership to achieve the most cost-effective building design possible. Even small decisions can add up to either big savings or bigger costs, depending on the level of consideration they are given in the design process.

According to Fred Campobasso, managing director, Navigant Healthcare Real Estate, some of the major trends that impact hospital design and construction continue to be underpinned by the overarching goals of reducing costs, optimizing clinical outcomes and enhancing the patient experience. 

“There is increased emphasis on operational planning integrated with facility planning with the goal of ‘smarter’ real estate/facilities assets and building less facility with increased throughput/efficiencies,” said Campobasso. 

Campobasso said he believes “the intersection of retail and healthcare will steadily increase in order to maximize accessibility, reduce costs and improve the patient experience.”

It is often beneficial to bring a contractor into the design process early on to find potential cost savings, said J. Exley Hill, president, American Health Facilities Development.



“Some of the ideas that the architect might have in mind for the design can be tested with a contractor who can offer some construction cost inputs that may affect the approach to the design or the kind of finishes or structure or various other aspects of the building that would come into play,” Hill said.

Hill said construction choices are sometimes driven by geographic limitations or demands. For example, he said, “building a steel structure in one part of the country may be less expensive than building a concrete structure depending on the availability of contractors in that area and what a city tends to go toward.”

In addition, Hill said, green building practices should be given careful consideration at the outset. “You might create a higher first cost for the project to a degree, but you may have longer term operating savings, so that’s where your cost benefit ratio comes into play.”

An integrated project delivery approach – a highly collaborative team working together to achieve a common set of project goals – can also be successful in reducing costs and saving time.

Another trend that is continuing to gain ground is building information modeling (BIM), a 3D modeling process, which is typically in place from concept design through construction and is designed to reduce construction costs, enhance schedules and improve quality. 

Campobasso said deploying performance-based contracting, which he described as the ability to earn “up” incentives for meeting or exceeding measurable project goals and earn “down”/risk sharing for underperforming against measurable project goals, is also proving to help reduce project costs and improve overall project outcomes.

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