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Changes in health care bring the challenge of leaner facility staffs. That means doing more with less.
At Crozer-Keystone Health System in Pennsylvania, Brian Crimmins, vice president, facilities planning and development at operates with a lean team. There are three facilities directors over the five hospitals and 40 satellite facilities. There is also a director of real estate and a team of five in property managers that report back to Crimmins.
"For the most part, we all wear several different hats," says Anthony Salvatore, director of facilities services at Taylor Hospital and Springfield Hospital. Twenty years ago, there might have been a director each for facilities, environmental services, and safety and security. Not anymore. It's harder because there's more work. But, he concedes, "it's easier in that you can't have a disagreement between three different departments if one person is running the three different departments. There's more directed vision. You see it one way."
As services move out from the centralized hospital campus to smaller, often less complicated, facilities in the community, it creates more moving parts for Crimmins' team to track and dilutes available resources for operations and management. Recently, on a committee related to Joint Commission standards, all of the off-campus sites and who is doing what were put on one spreadsheet, which was an eye-opening experience. "It's no longer one hospital and you know what you have. We've got stuff all over the place now," Crimmins says. And with 40 and growing off-campus sites, the trick is to know who is responsible for what, especially when the Joint Commission or the Department of Health comes calling.
The number of off-campus sites presents a sheer physical logistics challenge. Currently, the set up is that each hospital's director is also responsible for the sites generally in the hospital's geographic area. For example, Salvatore has eight in his zone. "It's a challenge to give them the time and energy they deserve," he says.
When Crimmins looks to the next five to 10 years, he sees a continuation of tuning the health care facilities portfolio to meet the needs of the customers. As inpatient numbers continue to fall at the hospitals, some of the spaces might be converted to outpatient purposes. Some of the smaller ambulatory sites will be consolidated into larger sites, where you can get more critical mass and gain some staffing and operations efficiencies.
"It all goes towards finding the most cost-effective way to deliver the highest quality of care," he says.