Hospitals go upscale to make patients feel better
By Jay MacDonald • Bankrate.com

When Hippocrates, the father of modern medicine, established the first medical center overlooking the Aegean Sea on the Greek island of Kos around 400 B.C., he had little science and few tools with which to actually heal the sick. But his philosophy was way ahead of its time: Surround patients with ample reason to live and many will opt to do so.

Fast forward to your last visit to a hospital. Was there anything about that experience that even remotely improved your mood? Probably not.

But there soon will be.

A quiet revolution is taking place behind all the doom-and-gloom headlines about health care today. Increasingly, hospitals are transforming themselves into warmer, cozier places that have more in common with upscale hotels than with the dreary, impersonal wards of old.

Life-affirming colors, flat screen TVs and artwork are brightening up those refrigerator-white hospital walls. Room service is replacing sub-par cafeteria food. Bedside Internet access is becoming standard. Even those drafty hospital gowns may soon be gone with the wind.

In addition, many major medical centers also offer patients the chance to upgrade to luxury suites. Well-heeled patients are willing to pay whatever it costs for the same four-star treatment they receive at a Four Seasons or Ritz-Carlton hotel.

And the price for such pampering can be steep. Anything above your health insurance's "usual and reasonable" coverage limits will come out of your pocket. If your policy pays $500 a day for a private room, but your medical center charges $1,500 for a top-notch suite, you have to come up with the extra daily grand; if you're only allowed insurance reimbursement for a semiprivate room capped at $200 a day, the hospital will collect the excess $1,300-per-day directly from you.

The boomer health-care revolution
Why the upgrade in patient accommodations? Hospitals are preparing to battle for the richest patient base in history: the baby boomers.

Just look at the changes the peace-and-love generation has already made to American hospitals, according to Randy Carter, vice president of Planetree, a nonprofit organization that advocates patient-centered health care.

"Prior to the 1970s, the birthing experience was vastly different. When the boomers came in contact with that, it changed pretty radically. Our belief system, that people couldn't be in the sterile environment of the birthing room and couldn't handle that experience, all of a sudden changed. Now it's the norm," he says.

"When boomers' parents became impacted by the need for hospice care, hospice was certainly changed. It doesn't take a rocket scientist to see that those same changes are coming to other areas of health care as soon as they come into contact with this generation."

Case in point: The impending demise of the semiprivate room.

"Single rooms have become the industry norm. Almost everything being built now is single rooms," says Mike Romano of Modern Healthcare magazine. "It's a matter of the baby boomers aging. People have more choice now of where they go for their care, and they want to go to a single."

Dennis Brimhall, president and CEO of Denver's new University of Colorado Hospital, which has nothing but private rooms, says it's a move that's long overdue.

"There is something fundamentally wrong with being sick, one of life's most private and difficult moments, and yet you're going to share that with someone in a semiprivate room. We don't go to hotels and share rooms. People just aren't going to put up with it anymore, and they shouldn't. They absolutely shouldn't."

Brimhall points out that a number of factors have aligned to bring about a revolution in the look, feel and configuration of today's hospitals, including:

• Infrastructure: Many hospitals built in the '50s and '60s are woefully inadequate to serve today's medical needs. Due to advances in medical technology, it actually costs 30 percent more to remodel existing hospitals than to build new ones, Brimhall says.
• Patient privacy: Federal legislation such as the Health Insurance Portability and Accountability Act (HIPAA) make it difficult to consult with a patient in a semiprivate room.
• Medical technology: Many ailments that once warranted a hospital stay are now treated at home or on an outpatient basis. Brimhall estimates that the University of Colorado Hospital treats 23 outpatients for every one inpatient. Bottom line: If you're in a hospital today, you're pretty sick.
• Infection control: New contagious diseases such as SARS has hospitals acutely aware of the liability involved with semiprivate rooms.
• Operational efficiencies: Private rooms may seem to cut the number of beds (and hence revenue), but they in fact make it easier to place and treat patients without gender, infection control and dying patient issues.
• Patient choice: The consumer generation that raised the bar on hotel accommodations is about to do the same thing to acute care facilities.

"In the old days when hospitals were run by charitable organizations, they weren't places to get better, they were basically places to die," Brimhall says. "They were not focused on the patient experience because the patient was never the driver; the provider was the driver.

"Health care, I think, has been hurt by its fundamental premise because it is designed from the provider out, not from the patient back. That's contrary to what we do in any other part of our society."

Mint-on-the-pillow approach
Brimhall's new facility was designed with the patient's experience in mind, from the Mediterranean-inspired design to the new dignified patient gowns. Patients order their meals from a room service menu, check e-mail with a bedside keyboard patched into their flat-screen TV and can be tested and treated in complete privacy.

The new perspective opened his eyes to just how insidious the old mindset was.

"Most hospitals build the front door on the street and all the signage and traffic flow all go up that front door, including the information desk. Then they build a parking structure in the back and 50 percent of all the people come into the hospital through the back door, against the way-finding. That's how dumb we are," he chuckles.

Brimhall says it's not enough to cater to patients by providing amenities; hospital staffs must also learn to deliver intangibles such as privacy, dignity and respect. Some hospitals now put their orderlies through hospitality training at the Disney Institute and even high-end hoteliers such as Ritz-Carlton to teach them the first rule of the new reality: The customer comes first.

"It's little things like teaching your staff to never go into a room without knocking. That is not your room, it's their room; they're paying for it. Nobody in a hotel would ever just barge in without knocking," he says.

"Before, we said none of the hospitality issues matter, the only thing that matters here is health care. Well, that's a little bit like telling an airline passenger, 'Look, it's only important that the engines are maintained properly. It doesn't matter what you sit in or how we treat you or if we lose your luggage.'"

Kaveh Safari, chief medical officer for Solucient, an Evanston, Ill.-based health care database and information company, says new patient-friendly hospitals such as Northwestern University Medical Center in Chicago are raising the bar on the places we try to avoid.

"They made their whole hospital an upscale hospital because their market segment was insured upper-middle-class and upper-class clientele from the Gold Coast north. They built that as their standard hospital. Now some would describe that as going for the hoteling aspect, but they were not charging outside of the normal insurance payment strategy. The patient's cost out of pocket was whatever their insurance would have covered," he says.

Randy Carter says the seeds planted by Planetree may finally be bearing fruit, thanks in large part to the higher expectations of today's patients.

"What we will see in the future is a greater emphasis on personalizing care to the individual and their particular needs. For one thing, the boomers are probably going to demand that kind of experience as they come into the health care environment in a different way. Hospitals will be radically different than the hospitals of today. They will be fully integrated models of living, more like malls or food stores. You won't have to check your life at the door."

Somewhere Hippocrates is smiling.