Making history

Given the rapid rate of change in health care delivery technologies and processes, it's not surprising that many health care organizations have found it something of a mixed blessing to own historically significant facilities.

In Health Facilities Management's hometown of Chicago, for instance, we've seen intense discussions among preservationists, community groups, building owners and government entities over the fate of notable structures ranging from 35 to more than 100 years old.

While the often-insurmountable financial and technical obstacles of bringing such facilities up to spec in many cases leads to an understandable decision to start over, circumstances and ingenuity can sometimes result in other outcomes.

For instance, HFM has chronicled any number of iconic facilities such as Bellevue Hospital Center in New York City and Community Hospital of the Monterey (Calif.) Peninsula that have been partially repurposed or appended to meet future health care challenges.

In a broader sense, every hospital of every age will need to tackle these issues as post-reform change continues to accelerate and facilities constructed during the last building boom feel the same shifts as their 100-year-old antecedents.

Though the historical and cultural baggage will not be as heavy for the suburban community hospital off the highway as for the architectural gem in the center of town, the same issues of flow, space programming, flexibility, technology and mechanical-electrical-plumbing backbone will determine whether the facility should be improved, adapted or discarded to meet emerging patient profiles.

Because, in the final analysis, health care delivery is more about making history than reliving it.