Hospital Construction

I'm going to delve into a topic I know very little about. I've visited over 20 hospitals in the last few months for interviews and I've noted an interesting trend: hospitals seem to be indefinitely under construction. Whether it is seismic earthquake safety retrofitting or revamping old operating rooms or adding a new ICU tower or constructing an outpatient facility, hospitals always seem to be upgrading. On some of the hospital tours I went on, buildings have been haphazardly constructed and connected such that a fifth floor in one building connects to a third floor in another which, after ascending half a flight of stairs, leads to the seventh floor of a garage.

I sometimes wonder: is it better to simply upgrade hospitals, as if tacking on or repairing things as needs arise, or is it better to tear an old hospital down and build a completely new one? Obviously, tearing down an old hospital has a lot of problems. Many hospitals simply cannot close; patients are constantly being admitted and discharged, and some patients have been there for months or years. Communities have grown accustomed to and dependent on hospitals, and it's simply not okay to temporarily close a hospital in order to build a new one. Furthermore, the cost of building a completely new hospital is extravagant while constructing one tower at a time is economically feasible. Some hospitals combine the two by building a new facility in piecemeal, allowing patients to be shifted around and controlling costs.

However, I sometimes wonder whether in the long term, it is better to build completely new facilities. Newer hospitals can save money in the long run if they are built with energy efficient principles, designed to manage waste effectively, and constructed in an environmentally friendly manner. They can deliver better care with individual patient rooms, larger ICUs and ORs, better lighting, and more family friendly areas. Indeed, simple patient rooms can be more homey and welcoming rather than sterile and isolating. New hospitals can definitely have better elevator design, more efficient transportation of patients, and better wireless internet access. Perhaps even more innovative technologies can be used such as solar panels for energy production or better isolation systems (especially with diseases like H1N1). Even basic things like the ward structure can be examined - are they really necessary?