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Dr. Neel Shah, Assistant Professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School, recently wrote an article for Politico about the unfortunate assumption that hospital patients need beds–and not room to walk (…/the-case-against-hospital-beds-0…).

“Currently, very few hospital spaces are designed with the assumption that most of our patients need to walk to be healthier…especially after surgery,” Dr. Shah says in the article.

He adds that even though very, very few patients are admitted for bed rest these days, “When the healthcare industry talks about hospitals, it tends to use the language of facility planners—one in which ‘patients’ and ‘beds’ are equivalent. This is the legacy of a very different era in medicine.The more we know about healing, the more it appears that health care spaces will need a different approach—one that sometimes looks more like a park than a long fluorescent hallway full of beds.”

Which brings us back to Fort Wayne and the repeated conversations about a new hospital. How many “beds” do we need? It appears that the St. Joseph’s replacement will be smaller than its predecessor. And, in Indianapolis, the IU Health combination of Methodist and University Hospitals would, in past decades, have totaled nearly 3000 beds. Together, the two hospitals have but 1200 beds and the upcoming replacement is likely to be smaller–but with more intensive care space and much more capacity for outpatient care. This is the current model. And so:

– If the new St. Joseph’s hospital is 100 beds as announced, greater emphasis will be on ambulatory care.
Parkview’s growth will continue to be a relatively easy expansion of its Randalia facility, already at about 145 beds.

– Watch for growth in clinic facilities including ambulatory surgical centers by IU Health and its competitors.
One would expect growth in skilled nursing facilities to accommodate postoperative and less acutely ill patients transferred from intensive care.

– Coordination will be the next challenge—keeping track of the patients’ records and medications throughout changes in severity of illness and location.

As Dr. Shah stated: “The future demands this shift, as year after year, the costs of care continue to rapidly outstrip the benefits.”