Saturday, August 22, 2009

Impact of Recession Easing on Hospitals

From a story on Reuters, 19 Aug 2009:

Thomson Reuters Study Finds Impact of Recession Easing on U.S. Hospitals

Total Margins, Liquidity Increase Significantly From Third Quarter of 2008; 30 Percent of Hospitals Remain Unprofitable

Ann Arbor, MI - August 19, 2009 - The median profit margin of U.S. hospitals increased from 0.17 percent in the third quarter of 2008 to 3.1 percent in the first quarter of 2009, according to an analysis of hospital finances published today by Thomson Reuters.

The recovery has been broad-based, with all classes of hospitals - small, medium and large community hospitals, teaching hospitals and major teaching hospitals - showing positive median margins.

The study tracks two dozen key financial indicators, using proprietary and public data to dissect the balance sheets of more than 400 hospitals nationwide. It evaluates trends in revenue and profit, employment levels, closures, inpatient volume, days cash on hand, and charity expenses to gauge the fiscal health of the nation's hospitals.

Following are the key findings of the analysis:

Total Margins Increase: Hospitals' median total margins were near zero the last time this analysis was conducted, which captured data through Q3 2008. In Q1 2009, all classes of hospitals had positive operating margins, reaching an average of 3.1 percent.
30 Percent of Hospitals Still in the Red: In Q1 2009, 30 percent of hospitals had negative profit margins. This is an improvement from Q3 2008, when 50 percent of hospitals were operating in the red.

Liquidity Holding Steady: Amidst fears of a hospital credit crunch, it appears that hospitals' "median days cash on hand" is holding steady. On average, hospitals had 90 days cash on hand in Q1 2009, a decline from the highs seen in early 2007, but an increase from Q3 2008.
Running at 90 Percent Capacity: In Q1 2009, more than 90 percent of licensed beds were in operation in a typical hospital. This number has held relatively steady since 2005.

Labor Costs Down: Hospitals have cut labor costs by approximately 3 percent year-over-year through Q1 2009, while non-labor-related expenses have decreased by approximately 2 percent year-over-year.
"The financial situation has improved dramatically for U.S. hospitals," said Gary Pickens, chief research officer for the Healthcare & Science business of Thomson Reuters and lead author of the study. "When we published our first analysis of hospital economic health in the fall of 2008, hospitals were facing unprecedented economic stress and staring down a real crisis. Through a combination of aggressive cost controls and overall improvement in the economy, we're beginning to see a recovery, but it will be critical to watch these metrics to make sure that recovery is sustainable.

For more information, go to www.thomsonreuters.com

For Hospital Design see, http://bernarch.com/healthcare-design-hospitals/

Sunday, August 9, 2009

New Cardiology Business Website Features Equipment, Products & Services

Cardiology Business (http://www.cardiologybusiness.com/) is a new website that has been developed to assist cardiology administrators and cardiologists in creating state-of-the-art facilities for their cardiology department, cardiology clinic and/or cardiology office.

The site features extensive resources for cardiology equipment, cardiology software, cardiology products and cardiology services.

This cardiology website also features articles by cardiology consultants, such as well-known cardiology architect, William N. Bernstein, AIA, principal of the healthcare architecture firm of Bernstein and Associates, Architects.

For Cardiology Design see,  http://bernarch.com/healthcare-design-cardiology/

Additional topics on Cardiology Business include: Cardiology Planning and Facility Design Services, Facility Construction Services, Cardiology Project Management Services, Cardiology Products, Cardiology Equipment, Cardiology Suite Furniture, and Cardiology Software.
Cardiology Business
CardiologyBusiness.com
59 W 19, NY, NY 10011
P: 212.463.0800
F: 212.463.9898

Sunday, August 2, 2009

Pharmacy Design Website Established

For Immediate Release (08/01/09)

Pharmacy Design Website Features Latest Information for the Hospital Pharmacy and Clinical Pharmacy.

Looking to design a pharmacy, purchase pharmacy equipment, or hire a pharmacy architect? Then you may be interested in a new pharmacy website which focuses on the all of the components that go into designing, building and maintaining a state-of-the-art pharmacy.

An important component of today’s pharmacy is pharmacy automation. This is one area that Pharmacy Design (www.pharmacydesign.org) features, including the latest pharmacy equipment and pharmacy machines.

Another area of focus is trends in pharmacy architecture, pharmacy layout design, and pharmacy interior design. As an example, a recent article published on the site, written by well-known pharmacy designer William N. Bernstein, AIA --- of the prominent pharmacy design group Bernstein & Associates, Architects --- explores how design for pharmacy can contribute to the efficiency and success of the pharmacy operation.

An additional area of focus is USP 797 design.

For Pharmacy Design see,  http://bernarch.com/healthcare-design-pharmacy/

For further information about pharmacies design, visit the pharmacy design website:
Pharmacy Design at www.pharmacydesign.org.

Wednesday, July 1, 2009

Architecture Firm Spins Off Equipment Planning Services into New Firm

For Immediate Release (07/01/09)

Bernstein & Associates, Architects is pleased to announce that it has established a new equipment planning firm to serve its existing hospital, healthcare and laboratory clients. The firm has a history of over nineteen years of equipment planning expertise.

The new company --- Equipment Planning, Inc. --- is dedicated to providing quality equipment planning services to a wide range of facilities around the country. We serve a variety of clients, from large to small, public to private, medical to non-medical. The company prides itself on its ability to combine the best business and design practices available today and on its talented and diverse staff. Having had years of experience in equipment planning and project management, we can guide your facility through the process of re-evaluation and re-installation of equipment, making the job easier and the outcome better.

Catering to Your Needs

Equipment Planning, Inc. is prepared to cover any and all of your equipment planning needs. Our services include, but are not limited to, equipment and facility assessment, budgeting, schematic design, drafting of construction documents, assistance procuring and installing equipment, and planning for improved workflow. We can work with you from beginning to end of a project, or we can help just where you need it most; we can manage and oversee the entire equipment planning process, or we can work as consultants to facilitate it.

A Unique Perspective

As a firm dedicated to seeing the big picture, Equipment Planning, Inc. does not just seek to satisfy its customers: we seek to exceed their expectations. Our knowledge and expertise stretch far beyond equipment planning, so we can help you both meet the necessary expectations and improve your facilities in the process. Better spaces can mean better workflow, so we will do everything we can to acquire and install better equipment as well as design and retool the spaces to meet your ever-changing needs.

Practice Makes Perfect

Without experience, we wouldn’t be able to provide you with the comprehensive services that are available today. Our experience allows us to provide you with some of the most knowledgeable and resourceful techniques available today.

Cost Savings

Equipment Planning, Inc. also seeks to minimize costs and save you money. We benefit from having happy clients, so one of our most important goals is not only to help you acquire the best equipment at the cheapest prices, but to keep your operational costs to a minimum. Our experience with project management and design for improved workflow qualify us to recommend cutting-edge technologies and design options that will save you money in the long-term.

An Objective Approach

Unlike many equipment planning services, Equipment Planning, Inc. seeks only to benefit our clients: Equipment Planning, Inc. team members do not have ties to equipment manufacturers, vendors, or contractors. We do not accept gifts, not even lunch, from these suppliers, which allows us to provide absolute objectivity when selecting equipment and installation services. Our only goal is to make each project as simple and inexpensive as possible for the client.

The president of the company, William N. Bernstein, LEED®AP, AIA, is a well known healthcare and laboratory architect. He was educated at the Yale University School of Architecture, where he received a Master of Architecture. He is a member of the American Institute of Architects, American College of Healthcare Architects, Construction Specification Institute and Project Management Institute. He is one of the few architects in the United States to receive the American Hospital Association Construction Management Certificate. He has written many articles on hospital and healthcare design and construction, and his healthcare and lab projects have won numerous awards and been published widely.

For further information about equipment planning services for your company or institution, please contact:

William N. Bernstein, LEED®AP, AIA –
President
Equipment Planning, Inc.
59 West 19th St. - 6A, NY, NY 10011
P: 212-463-0800
F: 212-463-9898
E: info@EquipmentPlanning.org
W: www.EquipmentPlanning.org

Monday, June 29, 2009

What to Do Today to Maximize Your ARRA Funding

What to Do Today to Maximize Your ARRA Funding
Ian Janer and William N. Bernstein, LEED®AP, AIA
June 25th, 2009

Overview of ARRA: Opportunities and Challenges

The American Recovery & Reinvestment Act of 2009 (ARRA) has been instituted under President Obama to encourage economic stimulus. For healthcare providers, the bill seeks to encourage advancement and development by providing incentives for converting from paper records to EMRs (electronic medical records) and for better patient care through improvements in data infrastructure. In order for hospitals and other healthcare providers to maximize their ARRA funding and ultimately cut costs, it is essential that they begin the process of upgrading their systems now to reach the first deadline at the end of 2010.
Another important motivator in adapting these technologies is the nature of the diminishing incentive rates. Every year the incentives will decrease for those facilities still attempting to get up to par with their peers, and any facility that has not adapted EMR by 2015 will begin to see penalties taken out of their Medicare refunds. With the deadline approaching so soon, healthcare providers that haven’t already adopted EMR must act now to see the necessary improvements.

The Realities of Meaningful Use

The government has allotted $77B dollars for medical incentives, and the largest payments will be made to hospitals and practices that are up to the standards of “meaningful use” by the end of 2010. While the term “meaningful use” generally means clear improvements in workflow and patient care thanks to the adoption of EMR, the official definition is still being determined by the CCHIT (Certification Commission for HIT). However, there are a few digital technologies that are expected to be necessary to prove “meaningful use.” Among other systems, hospitals should have PACS (picture archiving and communication systems), CDSS (clinical decision support systems), and, most importantly, CPOE (computerized physician order entry) systems installed throughout their facilities. These electronic methods are essential to the type of patient care improvements that are expected to come out of the ARRA.

Gap Assessment

To be able to make the switch over to digital, medical professionals should go through their workflow and search for gaps: do nurses have to go back and forth between the patients’ rooms and nurses’ stations to enter data? One of the purposes of EMR is to minimize physical workflow constraints, so this would be one area to improve. Another area to investigate is whether the information technologies are available throughout the facility or just in one department: it’s essential that the entire facility be up to standards to receive ARRA funding. What if the IT system goes down? All healthcare providers should have system redundancies (backup computers, servers, workstations, etc.) in case something happens to part of the system – a hospital should never be in a situation where all of radiology is on a single server that could crash without having a backup. The last area to investigate before preparing for the transition is staff readiness: it is important that the doctors, nurses, administrators, and other staff members are behind the transition and prepared to proceed smoothly. The best way to ensure this is through offering monetary incentives and paid training.

Qualified EMR Systems

In order to reach the standards set by CCHIT, which will be announced in about 6 months, facilities should try to start work now, even before the final requirements have been laid out. The main goal should be to reach what is considered by Dr. Richard Howe, vice president of Healthcare Informatics Associates, to be the minimum required to see a large difference in patient care: fully-operational CPOE. Because this is what enables doctors to interact with patients’ files and records digitally, this is one of the most important aspects of a good EMR system. Without CPOE, it’s impossible for any hospital to advance to full digitization and difficult for any hospital to see any significant improvements in patient care.

Evaluating the IT Infrastructure

It’s important that hospitals looking to update to enable CPOE first evaluate their current systems to see if they will be able to support CPOE and other basic digital technologies. In some cases, facilities may need to go through the expensive, time-consuming, but ultimately rewarding process of replacing their old computer systems with modernized ones and starting from scratch. Another option, for hospitals that have EMR systems that are relatively up-to-date but not quite up to par, is to simply refurbish what they already have. This may not be possible or even preferable in many cases, however, because new technologies can mean large changes in workflow and user-interface that could be more easily negotiated with an entirely modern system.

Measuring the Investment

Healthcare providers should make sure not to see this transition as an obligatory inconvenience, but as a way to both improve patient care and cut costs. EMR significantly increases accountability and reduces error, which can save lives and eliminate mistakes that cost money. The investment in a good EMR network is well worth it. To put together a more specific cost-benefit analysis, there are calculators online that hospitals and practices can use to approximate their ARRA stimulus packages, which can be found at the CMS (Centers for Medicare and Medicaid Services) or HIMSS (Healthcare Information and Management Systems Society) websites. Healthcare providers must then estimate how far they are from their goal and how large the investment to reach that goal will be, and they must not forget to include the significant operational cost of training in that estimate.

Action Steps to Take Today

Although the task of switching to digital records may be daunting, there is no time like the present to get started. The first thing that providers seeking to get ARRA checks by the end of 2010 should do is set their “meaningful use” goals: see what systems (PACS, CPOE, CDSS, etc.) can be installed now, and what can follow immediately after. Next, facilities should check on their existing IT infrastructures to see if they can carry the transition and whether they have redundancies or, on the negative side, disparate systems/networks. Hospitals and practices should also immediately eliminate any non-standard procedures, including shortcuts taken by staff to save time. Any procedures that aren’t industry best practices can lead to inconsistencies, which will interfere with the switch to digital. Basically, facilities should be filling in the gaps now to prepare for the transition.

For Healthcare Design News see, http://bernarch.com/healthcare-design-news/

For further information on ARRA, contact healthcare and hospital architecture firm:

William N. Bernstein, LEED®AP, AIA
Principal
Bernstein & Assoc. Architects - PLLC
59 West 19th Street - 6A, New York, NY 10011
T: 212.463.8200
C: 917.747.2924
F: 212.463.9898
E: wb@bernarch.com
W: www.bernarch.com
NEW YORK - HARTFORD - PRINCETON

Friday, June 26, 2009

Architect Initiates New Hospital-Oriented Twitter Account

For Immediate Release (06/26/09)

Bernstein & Associates, Architects is pleased that the firm principal, well-known healthcare and hospital architect --- William N. Bernstein, LEED®AP, AIA --- has initiated a new Twitter account with news about hospital and healthcare subjects.

This hospital Twitter account can be found at: www.twitter.com/hospitals

The Twitter account will focus on the many aspects of specialized design and construction required by hospitals and healthcare facilities, as they improve their aging hospital infrastructure and/or add new programs and technologies to stay up to date with the fast moving world of the healthcare marketplace.

Mr. Bernstein is well equipped to author this Twitter account. He was educated at the Yale University School of Architecture, where he received a Master of Architecture. He is a member of the American Institute of Architects, American College of Healthcare Architects, Construction Specification Institute and Project Management Institute. He is one of the few architects in the United States to receive the American Hospital Association Construction Management Certificate. He has written many articles on hospital and healthcare design and construction, and his healthcare and lab projects have won numerous awards and been published widely.

In addition, Mr. Bernstein is a principal of a healthcare and laboratory architecture firm --- Bernstein & Associates, Architects (www.bernarch.com).

About Bernstein & Associates, Architects: Founded in 1990, this company is an award-winning architectural firm specializing in healthcare and laboratories.

For Hospital Design see, http://bernarch.com/healthcare-design-hospitals/

For more information about hospital and lab design and construction, please contact:

William N. Bernstein, AIA
Principal
Bernstein & Associates, Architects
59 West 19th Street - 6A New York, NY 10011
T: 212.463.8200
F: 212.463.9898
E: info@bernarch.com
W: www.bernarch.com

Thursday, June 11, 2009

New Article To Be Published on Trends in Radiology Design and Operations

For Immediate Release (06/10/09)

New Article to Be Published on Trends in Radiology Design and Operations

Bernstein & Associates, Architects is pleased to announce the upcoming publication of an article on recent trends in radiology design and radiology planning.

The article will be published in the July 2009 edition of Hospital Newspaper.

The article discusses the latest trends in radiology design and radiology planning, including the following issues:

- The fields of radiology and design for radiology have undergone numerous changes due to groundbreaking advances in technology,
- Development of digital imaging and PACS (picture archiving and communication systems)
- Rethinking the radiology environment from the point of view of patients, radiologist and staff, with the general goals of radiology facilities which increase patient and staff comfort, patient privacy, staff safety, and greater efficiency, speed, and through-put in the radiology workflow..
- Significant increases in worker productivity and improvements in the radiology workflow
- Eliminating film developing facilities, and also eliminating --- or at least drastically reducing --- the need for physical storage of hard copy films.
- Increases in legibility and reliability of scans
- Quicker responsiveness to patients.
- Reading room design.
- Ergonometrics for the new digital reading room
- Contemporary reading room must allow for future adaptability.
- Making the radiologists’ reading stations more comfortable, easier to use, and allowing for more control over the environment. Some more specific reading room design initiatives are listed below:
- Limiting Distractions
- Climate Control
- Seating and Positioning Adjustability
- Lighting specifications
- Unification of Systems
- Advances in scanning technologies. Among the most significant: 3.0T MRI’s are the upcoming standard in MRI design, multi-slice CT’s are the same for cat scan design, and digital mammography in the latest in mammography design.
- Mobile scanning equipment, such as portable CT
- Improvements in patient’s experience
- Philips “Ambient Experience”
- Relative growth of private practice radiology over academic, hospital-based radiology
- Opportunities for further development and improvement in the design of radiology facilities
- Patient comfort within the scanning machines s
- Advantages to separating healthy outpatients from very sick inpatients
- Separating women into a women’s center vs. co-mingling male and female throughout
- How the equipment will be changed out in future vs. concern exclusively with initial equipment access to space
- Green design --- eco-friendly design that is good for the environment as well as the patient --- is working its way through the healthcare environment, including the radiology department.
- Increased use of interventional radiology and surgical codes

The above article was written by the Ian Janer and William N. Bernstein, LEED®AP, AIA, of the well-known healthcare and hospital design firm of Bernstein & Associates, Architects. The firm’s principle, Mr. Bernstein, is a well-known architect and radiology consultant in radiology department planning and design. Mr. Bernstein is a graduate of the Yale University School of Architecture, who has specialized in healthcare design and construction for over 30 years.

About Bernstein & Associates, Architects: Founded in 1990, this company is an award-winning architectural firm and specializing in the design and planning of radiology departments. The firm takes pride in providing the highest level of healthcare and hospital design work, with additional expertise in sustainable healthcare facilities, energy saving measures for hospitals, cost reduction strategies for hospitals, hospital safety and patient safety.

For Radiology Design see, http://bernarch.com/healthcare-design-radiology/ 

For more information about radiology department planning, design and construction, please contact:
William N. Bernstein, LEED®AP, AIA
Principal - Bernstein & Associates, Architects - PLLC
59 West 19th Street - 6A New York, NY 10011
Office: 212.463.8200 - Fax: 212.463.9898
Email: info@bernarch.com
www.bernarch.com