Whatever the consequences from federal healthcare legislation and the struggling economy, for-profit systems are sending the message to competitors: go big or risk being marginalized. Last December, Community Health Systems (CHS) made an unsolicited proposal to purchase another large, for-profit healthcare provider, Tenet Healthcare. Tenet shareholders rejected the offer, so CHS more recently sweetened the offer to merge. A… [Read more…]
April 27, 2011
As sustainable design becomes truly mainstream, which I define as adopted into required building code, initiatives for those who want to lead will become more aggressive. Sustainable design leaders asked what the ultimate goal is for their buildings may answer: net-zero, or buildings having a neutral energy impact on their environment. More specifically, a net-zero building creates… [Read more…]
April 25, 2011
One core sales tenet is to establish yourself in the eyes of the client as a consultant, rather than a vendor. A vendor sells a product (commodity); a consultant provides creative input on the product (value). Product rep’s come by our firm all the time for ‘lunch-and-learns’, so I see a lot of different products and hear… [Read more…]
April 22, 2011
A couple articles I read recently in online journals, and one of the general sessions at last month’s 2011 PDC Healthcare Summit offered some difficult-to-stomach suggestions for today’s hospital CEO in regard to hospital expansion. Some of the nuggets: Hospital scale + integration = survival How big is big enough? Too integrated creates conflict of interest… [Read more…]
April 20, 2011
At times I have marveled at how much power one person can have on a healthcare project, specifically, one administrator. Even in the most democratic hospitals and systems, an executive such as the Chief Nursing Officer can trigger a project re-design. Sometimes it is ego, sometimes it is the belief additional input will benefit the project, but an… [Read more…]
April 18, 2011
CM-at Risk (CM) was developed as the first major improvement over Design-Bid-Build (DBB); CM generally provided greater cost and quality control, while also delivering a project faster. CM-at Risk and Design-Build (DB) have a lot in common; yet CM is more accepted as a project delivery method, mainly because it is more familiar. I cannot… [Read more…]
April 15, 2011
For five minutes, let’s forget that you write requests for proposals (RFPs) ‘because that’s the way we’ve always done it.’ My immediate answer to that is: healthcare, as it has always been done, is unsustainable. Everyone from doctors to the President want to blow it up with a stick of dynamite. It follows then that… [Read more…]
April 13, 2011
I enjoy learning the details about a topic which confirm my suspicions about a certain subject; I take comfort in learning that I am not crazy. Lately, we have been working on a lot of central plants and I am not sure if this is a sign of the times or luck. What has caught my… [Read more…]
April 11, 2011
Two weeks ago a trailer parked in an open lot adjacent to Jacksonville’s Prime Osborn Convention Center. On its side was painted, quite broadly: “Salvation * Healing * Holy Ghost Revivals” and the namesake carrying out this special service. I laughed out loud. I saw the trailer the next morning on my commute and thought: who is… [Read more…]
April 8, 2011
I asked one of our healthcare plumbing engineers about some design ideas he encountered at the American Society of Plumbing Engineers (ASPE) Convention and Plumbing Expo last November. He said sustainability in medical gas design is something that has been getting a lot of attention and offered some considerations for healthcare owners, facilities, maintenance and… [Read more…]
April 29, 2011
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