New York has long faced challenges with hospital bed allocation, a problem that was starkly highlighted during the COVID-19 pandemic. According to a recent podcast, The pathway to closing hospitals in New York , featuring Mark Ustin, a New York State Regulatory & Government Relations, Partner/Attorney at Farrell Fritz, P.C. in Albany, NY, Ustin discusses the long-held dilemma with New York struggling to allocate hospital beds and healthcare resources across the state, especially as COVID put a spotlight to these issues.
Ustin shared that historically, “there’s been a mismatch between healthcare supply and population changes, especially in upstate New York. We need a system that can adjust more easily to population shifts.”
One of those solutions is to explore options that embrace flexibility as a priority when considering the quick responses needed from COVID outbreaks. As Ustin said, “The ‘surge and flex’ system has been a good example of how hospitals can quickly ramp up capacity and staffing. Modular capacity is another approach we need to explore, allowing us to scale up and down as needed without the burden of maintaining empty beds.”
According to the Science Direct Journal, Hospital surge capacity preparedness in disasters and emergencies: a systematic review , they analyzed New York statewide in a cross-sectional study comprising 242 hospitals. Based on their findings, “they suggested extending existing space and preparing new spaces for the treatment of disaster victims, as well as developing a collaboration with other facilities to transfer patients quickly when needed. In addition, prior knowledge of the hospital's existing capacity, including human resources and equipment, is essential. Several studies have assessed the role of reverse triage in creating better hospital surge capacity by freeing beds for disaster victims needing immediate medical attention.”
In addition to flexibility and data collection, Ustin emphasized the importance of community feedback: “It’s just as important to get feedback from the communities and patients themselves to make sure we’re not missing something vital,” Ustin said.
Laura Poltronieri AIA, Regional Leader of Healthcare, Northeast, HOK agrees with this approach when describing the role that the community should play in the decision-making process regarding hospital closures or expansions: “It is through the thoughtful and strategic combination of community involvement and outcomes data which should inform these strategic decisions,” Poltronieri said.
A White Paper by USC Schaeffer, The Evolving Role of Hospitals and Health Systems in Community Health and Emergency Preparedness cites the significance of communities on healthcare systems: “Hospitals play a critical and central role in healthcare delivery in the U.S. and its communities, accounting for about 1 in 3 healthcare dollars spent in the U.S. Hospitals not only provide essential maternity and emergency services, but are also often a significant local employer.” They suggest improving community health by encouraging hospitals and the entire U.S. healthcare system to coordinate with nonclinical social service agencies that address social determinants of health, such as housing and food insecurity, often without dedicated reimbursement.
Ustin described the significance of hospitals is that it provides jobs in communities, noting that job losses can be a real issue when services are reduced or closed. Poltronieri describes the work that HOK is doing to address the current health needs of the population in light of recent calls for hospital closures: “HOK is currently undertaking a health care research initiative which is looking at health outcomes in three different cities across the United States: New York City, Austin and San Francisco. Each city, and each community within the city has its own unique health care resources and challenges. Like all cities in the US, the quality of the health care across NYC various greatly by community. In NYC for instance average life expectancy varies from 76 to 87.7 years depending on which community district you live in. We surmise that this variation probably has a lot to do with lifestyle issues and access to primary and preventative care and is not directly tied to hospital care.”
When looking ahead at the future of healthcare facilities, New York should invest in adaptable options like hybrid facilities and urgent care centers to better serve its population and address current gaps. Ustin recommends that hospitals “keep the focus on quality of care while balancing financial needs,” as there are questions about how private sector investment might affect the quality of care on the capital side. Poltronieri encourages “additional primary and preventative health care programs need to be expanded and integrated into communities in new ways including in elementary and secondary schools, through community organizations and other trusted institutions.”
Addressing New York's healthcare facility challenges requires a multifaceted approach that includes flexible infrastructure, community involvement and strategic investment in hybrid and urgent care centers.
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