July 26--COLUMBIA -- If the complimentary, fruit-infused water inside the front door of Palmetto Health's brand-new Baptist Parkridge hospital fails to remind patients and their visitors of a spa, then they should turn around.
Across the lobby, there's the actual spa. Or at least there will be once it's finished this fall.
South Carolina's newest hospital in northwest Columbia officially opened in mid-March -- just in time to serve as the stunning, if unconventional, backdrop for a few prom pictures. This $120.6 million gleaming glass complex offers the latest example of a national trend that's already hit the Lowcountry. New hospitals resemble four-star hotels.
At Baptist Parkridge, there's more than just the in-house spa. The design incorporates plenty of sunlight, water-and-rock fountains, soft curves and earth-toned upholstery. Lavender, thought to promote relaxation, is placed on patients' pillows at night. Cafeteria staff wear chefs jackets and fix made-to-order meals with fresh, local ingredients. The hospital entrance, complete with rocking chairs, is called "the front porch." Instead of a waiting room, there's "the family room."
"What we call things matters," said Sarah Kirby, the hospital's acute care executive.
Kirby said these touches aren't just superior to yesterday's dingy decor and standard-issue hospital meals -- they actually improve patient care. The community seems to love it, too. Six thousand residents attended the hospital's open house this spring to see the building for themselves. But some economists question the extent to which all this luxury really influences health and, more importantly, how much it's costing the health care system.
"There's an interesting debate here," said John Romley, an economist at the University of Southern California. "First of all, naturally, everyone is concerned about costs. That is a very legitimate concern. There is a question here of what's the value of this to patients. If patients care about it, should we respect that preference to some degree?"
'A paradigm shift'
No new hospitals are now under construction in South Carolina, although three more have been planned for the Lowcountry.
While Roper St. Francis and Trident Health continue fighting a legal battle to determine which system, if not both, should be allowed to build a hospital in Berkeley County, Medical University Hospital is moving forward with the largest of the three proposals. Its new women's and children's hospital may eventually cost $350 million.
The project, if built, will look a lot like MUSC's Ashley River Tower, which opened in 2008, and mimics "the comfort and style of a fine hotel," according to the hospital's website. Amenities include concierge service, private rooms and valet parking.
"It is a market. Patients can go elsewhere. We want them to feel welcome and want them to feel comfortable," said MUSC lobbyist Mark Sweatman.
MUSC isn't the only local hospital taking cues from the hospitality industry. East Cooper Medical Center offers new parents a steak dinner during their hospital stay and flat screen TVs in their private rooms. At the Roper St. Francis Mount Pleasant Hospital, "you get the feeling you're about to check into a health spa or swanky hotel," a recent blog post on hospital system's website bragged.
"There's a growing body of evidence that does indicate that the built environment influences health status indicators and health outcomes," said David Allison, director of graduate studies for Clemson University's Architecture + Health program.
Some design elements, including sunlight, natural views and soothing colors, can improve blood pressure, reduce heart rates and shorten hospital stays, he said.
"When you come into a hospital setting, typically . that's white walls and long hallways and it just feels -- it can be intimidating and uncomfortable," said Kirby, the Baptist Parkridge executive. "We've done a lot of research to show lighting makes a difference. The colors we choose make a difference. What can we do to make sure it's not an intimidating environment? There's no place like home, but what can we do to make it feel warm and welcoming?"
It's a paradigm shift, she explained. Hospitals typically focus on treating illness, performing surgeries and triaging emergencies. Baptist Parkridge looks different than older hospitals because "this is a healing environment."
"We're focused on health and wellness," she said. "When would you have ever thought about waking up and saying to a girlfriend, 'Hey, let's go grab a cup of coffee and go walk on the walking trail and they have this really cool class about journaling and stress management and let's go to the spa!' on a hospital campus?"
'Bells and whistles'
Many experts believe designing a beautiful hospital is also better for business.
"Hospitals want to increase the percentage of patients that have good health insurance. That helps in their overall balance sheet," Allison said. "(Patients) have the choice. They're more informed consumers and so hospitals are competing to capture those patients."
Medicare now partially reimburses hospitals based on patient satisfaction surveys, which include questions ranging from "How often did nurses treat you with courtesy and respect?" to "Would you recommend this hospital to your friends and family?" Even the cleanliness of the hospital bathrooms is taken into account.
"It was all a first-class experience," said Chapin resident Jeff Warren, who spent two nights in intensive care at Baptist Parkridge last month after a copperhead snake bit his leg in a dark woodshed. "The food was excellent. I was able to order off of a menu the food that I wanted . I was impressed."
Warren, 62, who is insured, has not received a bill yet and doesn't know how much he will owe. This was his first trip to the new hospital, about a 30-minute drive from his home.
While the facility is targeted to serve communities in northwest Columbia, including Irmo, Harbison, Chapin and Dutch Fork, research shows some patients are willing to drive past one hospital if they perceive another is more attractive.
Romley, the University of Southern California economist, studied how some Medicare patients with pneumonia chose hospitals in Los Angeles.
"We found quality of care matters -- not surprisingly -- but that amenities were a bigger driver of where people ended up receiving their care," he said.
That's not really surprising, either. Amenities are often more obvious to patients than quality of care. It can be tricky, for example, to figure out how well doctors at a given hospital perform in the operating room, and much easier to notice that its lobby was recently upgraded or that new whirlpool tubs were installed in the labor and delivery rooms.
It also makes sense that patients choose nicer, newer hospitals because they're not responsible for the full bill. Private health insurance companies or the Medicare and Medicaid programs usually pick up most the tab.
"Here, the government is on the hook for it and patients aren't paying full out of pocket for these bells and whistles. The fact that patients enjoy this stuff -- should that weigh in the balance?" Romley asked.
"This is happening throughout the country," but it's still hard to move beyond anecdotal evidence to support either argument, he said. "The truth probably lies somewhere in between."
'The right people'
This hospital trend isn't unique to South Carolina, Allison said.
Palomar Health'sPomerado Hospital in Northern San Diego and Dublin Methodist Hospital in Columbus, Ohio are two facilities that have embraced design as a driver of patient satisfaction, he said.
The Henry Ford West Bloomfield Hospital in West Bloomfield, Mich. even hired a former Ritz-Carlton executive as its CEO. The hospital includes a hair salon, a wellness shop and around-the-clock room service.
"The surface decor of the hospital contributes a very small percentage of the initial cost," Allison said. "The reality is the hospital operates 24/7, 365 days a year. Outside of say, airports, it's the most utilized building that the public ever engages . the physical building of the hospital is a tiny fraction of the life cycle cost over the life of that building."
During a recent tour of Baptist Parkridge, Kirby quickly pointed out its unique physical features -- the Magnolia Boutique for new moms, easy-to-access charging stations for guests, even cleaning supplies that were specifically chosen to keep that notorious hospital smell at bay. Still, she said, amenities only matter so much.
"We've had people come from all over to look and say, 'Hey! This hospital looks like a performing arts center! I mean, the walls, the stone, the water features -- it's beautiful!' And it is and you can have a beautiful place and it's wonderful and that lasts about 30 days," she said. "It's the magic that happens inside. It's the people."
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