Dollars and sense: Planning for a new hospital

The hospital’s 1998 construction plans called for completely replacing the hospital with a new building on vacant land east of the Family Birth Center. Our patient services would then be on the north side of Oak Street, with parking on the south side.

As you would do if you dusted off an old plan to buy or build a house, we recently set out to reevaluate what we needed in a new hospital, where it should be located, and how much it would cost, before we moved forward.

What we need in a new hospital

We asked many questions—How many beds will we need in the next several decades? How will hospital services be provided in the future?—and learned the following.

• Imaging and other technology will continue to be an important component of healthcare, requiring more space for equipment and changes in room configurations.
• We knew we wanted to bring several of our outlying services, such as psychiatry and rehabilitation, onto the Winter Street campus to make hospital support services more readily available and to reduce transportation costs. This decision, along with local population growth, calls for us to ensure an adequate number of beds on the Winter Street campus.
• Healthcare construction costs continue to escalate, and the cost of many building components, such as concrete and steel, is skyrocketing.

With this up-to-date information we determined that completely replacing the hospital in a single building project would cost in excess of $500 million, an amount we can’t afford. So we decided to build in phases. We will begin phase 1 now and plan phase 2 sometime after phase 1 is completed.

Location options

Then we tackled the location question. Since we can only replace part of the hospital now, where should the new building be located?

A team of architects, engineers, and other facility consultants evaluated our options for a new hospital location. The nine options they identified ranged from doing nothing now (and preserving cash to fund future building projects) to purchasing new property and building from scratch.

Comparing the options

The two best options were the vacant land east of the Family Birth Center or the site of the current patient and visitor parking structure.

An important consideration in our decision was the distance between the new building and the Winter Street hospital because we will need to continue using the structurally sound parts of the Winter Street facility. The distance from the vacant lot is about 1/3 of a mile, passing through two other buildings. The parking-structure site is right across the street from the Winter Street hospital.

Making the decision

Patient safety of utmost importance.
Either of the two options would require that we transport patients further than we do today. How would that affect patient safety?

If we selected the vacant-lot option, we would need to travel long distances through multiple buildings to move patients from surgery to a hospital bed, which could put the patient in danger if an emergency occurred during transport.

We concluded that we can provide better patient safety by building at the site of the parking structure because the travel distance is shorter.

Financially responsible decision
Cost was another major consideration. In terms of initial construction costs, it would be cheaper to build on vacant land. However, the new hospital will last for decades—we needed to consider not only the initial cost but the additional costs we would incur over time to operate the hospital in two separate locations.

The additional distance from the Winter Street hospital to the vacant lot would add to the cost of care because more staff would be needed for transport, and more monitoring equipment would be needed, which in turn would require more staff to maintain the equipment, and on and on.

Even when considering the cost of demolition of the parking structure and providing free shuttle and valet services during construction, the additional operating costs at the parking-structure site will be $9 million less over ten years than if we were to build on the vacant lot.

Patient safety and ongoing costs dictated that we select the site of the current patient and visitor parking structure, across the street from the Winter Street hospital. That is where we will build the new patient tower shown on the front page of this special supplement.