A week after the U.S. Supreme Court upheld the Affordable Care Act, I can’t help but wonder how much the decision will impact the projects healthcare facilities across the country are planning, or recently completed.

When I spoke with Andrew Quirk, senior vice president, national director, Skanska USA Building, Healthcare Center of Excellence, after the verdict was handed down (See “A Moment of Clarity”), he made an interesting point that while the environment of uncertainty regarding legislative reform was given some clarity, in the end it was more of a “reaffirmation” of what health systems are already doing.

“[Owners] have somewhat already accepted that reform is coming and they need to change. And they’re all moving toward the outpatient model, which is basically what is required. So their trains have already left the station about a year ago,” Quirk says in the article, adding that even if parts of the law had been shot down, he didn’t anticipate health systems to divert from that path.

Quirk also added that due to that new care delivery model, where throughput and patient satisfaction will be key, the A/E/C community will likely be tasked with becoming more creative in the solutions it offers clients with a focus on return on investment, demonstrated value, and innovation.

I immediately was reminded of a facility tour the editors here at HEALTHCARE DESIGN and Healthcare Building Ideas took just the day before the high court handed down its decision, where all of these factors appeared to have already come into play—an example of health systems heading in the direction Quirk describes.

Cleveland Clinic Richard E. Jacobs Health Center and Ambulatory Surgery Center in Avon, Ohio, includes a four-story family health center that houses 26 specialties and a two-story ambulatory surgery center with an outpatient surgery center, 24-hour freestanding emergency department, and an imaging suite.

It opened in December 2011.

Geoffrey Aiken, AIA, LEED AP, and Michael Ball, AIA, of URS, which served as architect and engineer on the project, led our tour.

Tackling the patient satisfaction component that will be all too essential moving forward, the facility was designed around the patient experience through extensive views of nature and daylighting, ease of navigation, and areas of retreat provided for patients throughout the building.

Waiting rooms are stacked, maintaining modularity on each floor, where reception desks await patients for a variety of specialties rather than diverting them to dozens of different waiting areas. In an effort to maximize throughput, physicians’ offices were designed to hold three doctors per room, allowing more room for exam space.

Along those same lines, another unique component of the project is a focus on how the facility operates to be efficient and Lean. Central nurses’ stations were built with corridors linking them, again with a focus on modularity between floors, and allows for specialties to flex for need by day or permanently.

Because the ambulatory surgery center is anticipated to expand first, followed by a future five-story bed tower, the project had to be carried out with flexibility in mind.

From my perspective, having covered the industry in the wake of healthcare reform, and likely from your own perspectives from either working in or serving the healthcare industry over the past year, these concepts feel like old friends—so familiar in discussions on how future care delivery will be supported.  

In the end, perhaps the impact last week’s decision has on the trajectory of care delivery and how that’s answered in the physical space may be minimal. But it certainly does affirm that we’re on the right track.