Having battled through trials presented by the Covid-19 pandemic, hospitals are now facing a new set of challenges. Demand for care is still surging, the cost of providing these services is rising at an alarming rate, and a globally aging population combined with an increase in long-term age-related diseases means that bed space is at a premium. Pressure has subsequently fallen on the estates team to help reduce building operational costs so funding can be channelled into patient care. Technology innovations such as CAFM, BIM, AI and IoT are helping, but estates teams should also look at the foundations of their site: what space they have and how much it is costing. Having a more accurate understanding of the estate’s space and how it is used can positively influence all other estates costs, be more sustainable and potentially improve clinical efficiency.
The Changing Face of Space
Many hospitals are sprawling estates, often built decades ago; extended and repurposed in line with demand. With new departments bolted on to old, this organic growth poses difficulties in patient wayfinding and means that space is easily underused or not fit for purpose. Which are the busiest departments and do they have the most consultation rooms? Is the waiting area for a clinic too big? Could room be made for therapeutic green spaces? And with space at a premium, it cannot be wasted.
Compliance and Management
Government compliance measures and regulation have become increasingly more stringent as they look to improve patient safety at the same time as reducing costs. In the UK FMs must return Premises Assurance Model (PAM) and Estates Returns Information Collection (ERIC) data, which comprise details of running costs and space usage across the estate. Targets include reducing carbon emissions to net zero by 2040, and dedicating less than 35% of the building to non-clinical space.
Aged care in Australia has also undergone stricter regulation following the Royal Commission into aged care quality and safety. Many residential care homes have closed due to non-compliance, and others have been taken over by larger providers due, in part, to difficulties meeting the standards. Not only must the care homes offer ‘homely’ living conditions with safety as a priority, but also outdoor space plays a big role in resident wellbeing and must be managed appropriately.
The increasing demands from statutory bodies and internal decision makers for accurate and detailed data means that space management software is now an essential tool for healthcare organisations. For indoor space, it can show the size of the total estate, a breakdown of how much space is dedicated to different functions, and model layout scenarios to deliver better use of space. For outdoors, there are numerous assets to be managed such as lighting, seating, visitor parking – even trees – and points of interest such as infrastructure access points (manhole covers etc). All these assets can be positioned on digital site plans and assigned maintenance schedules to ensure safe, functional and well-maintained space. Having this information digitally means it’s accurate and available for the whole team, negating the need to remeasure areas or go out and find assets. And it can save hours, if not days, when completing mandatory reporting.
Modern Space Strategies
In Germany, smaller community hospitals are being closed and patients are directed to larger hubs to save the government money. In the UK meanwhile, some services are being offered remotely through ‘virtual wards’, where care is delivered either via home visit or video call to patients monitored with wearable technology. This allows them to avoid trips to hospitals or be discharged faster, freeing up bed and outpatient clinic space for other patients, or enabling the space to be repurposed. Virtual working remains the norm for a substantial portion of the administrative workforce following the pandemic, further increasing the potential for available space and the value of its management.
Space is now more likely to be rented out to make a profit: in the ERIC report for 2022/23, NHS trusts reported a total of 9% more commercial retail space than the previous year. Not only does this provide amenities for hospital users, the money made (and the cost of utilities saved) can be reinvested into patient care.
Space isn’t Set in Stone
Increasing pressure is being placed on estates teams to save money, meet targets and improve safety – all whilst keeping the building running smoothly. Reviewing how the space is used should be the first step for every organisation. Without accurate space data, it is more challenging to make informed decisions about space allocation. Space management software helps teams harness the data, visualise it, report on it, trial any number of new layouts to find the version that works best for their estate, and even plan how to make the required moves. With the potential for such efficiency savings and patient experience improvements, can estates teams afford not to invest in their space?For more information on our space management software, QFM Space, watch a short demo video or contact us to speak to an advisor.