The Parking Conundrum

Posted on February 9, 2011


At some point or another, a hospital, regardless of size, will run into a parking squeeze.  I have seen it at the critical access hospital (CAH) level, at community hospitals, and well-known regional medical centers. The scale of the problem is relative to the institution, but parking is still an issue—even at suburban and rural hospitals.

Almost every hospital seeks growth and this is a byproduct of growth.  Much like a building expansion requires dedicated infrastructure like HVAC and storage, a building expansion carries with it additional parking needs. And it can sneak up on you. Adding an MOB in the parking lot of an existing hospital not only consumes existing parking spots; the MOB requires additional spots of its own. Growing outpatient services, often an evolution over time, can exacerbate parking needs.

At large mega-healthcare facilities that are essentially one structure, and even smaller community hospitals, structured parking makes sense on so many levels.  It stacks what is essentially an eyesore; it allows a hospital to contain 200, 300, 400, even 500% more cars on the same plot of land; it protects cars from the elements, and it provides more security more easily for arguably less maintenance. Some fringe benefits include:   valuable real estate freed up, shorter walks for visitors, and a potential income stream, if so desired.

However, most hospitals do not charge for parking because that would be mercenary.  Even for-profit systems I have visited that have parking decks do not charge. Another issue:  benefactors and foundations do not give money for structured parking.  No one wants to put their name on a parking facility—not even a handsome and sustainably-designed deck—at least not yet.

Unfortunately, there are not many ways around parking problems. Hospitals can organize shuttles from nearby housing complexes and community centers.  They can hire a parking service to manage it for them. Other hospitals may want to work with their municipality to connect to public transportation. Many hospitals tucked into neighborhoods buy up adjacent lots (often houses) and raze them to feed the parking need. The most extreme solution is to abandon a current location in favor of a new campus where visibility is greater, land is plentiful and a population has better access.

Still, a land-locked campus or a campus with a natural feature like a steep hill or stream may not have a choice than to invest in a parking deck. Keep in mind, the ideal site plan is not necessarily a building floating in a sea of parking; I think that typology has been the design out of default for malls and hospitals alike. I am convinced there is a better solution, a more savvy approach out there. I think hospitals of the future will consider a planned precinct that mixes a hospital with related healthcare buildings that are more “9-5”, like a biotech park, research lab, clinic or MOB.

Some suggestions:

  • Build parking under a new wing or addition
  • Incorporate a little bit of the parking solution somehow into each project so it does not become a project on its own
  • Share the cost and use of a parking structure with a neighbor (office building, museum, church, housing or retail complex); this works better financially and especially if the neighbor has very uneven demands for the spots, like only needing the parking on weekends or for major events
  • Avoid “silver bullet” solutions; the best option may be a combined effort of four or five incremental improvements
  • Educate your local zoning, permit or municipal planning official to understand your situation; they may know of something on the table from another business or land owner which could help you out 
  • Task your facility’s master plan team for creative solutions (satellite parking, village concept,…who knows)

Whatever the decision, know that parking decks are not immune to change. Access and circulation patterns at your campus change. Existing utility mains may limit development and parking. If possible, design for excess capacity, much like shell space for future build out; the initial cost is incremental compared to expanding it later as a separate project. And much like hospitals, vertical expansion is a nice concept but when the building is in use, it is not easy or cheap to do.

Structured parking is neither a badge of honor nor a scarlet letter. Be thoughtful and the right solution will present itself for your facility.