Building boom on the prairie

There’s been a fairly significant hospital building boom out here on the Minnesota prairie over the past decade. I didn’t realize how extensive it was until I started collecting information last month for the West Central Tribune’s annual Focus section. Since 2000, virtually every hospital within a 50- to 60-mile radius has undertaken some kind of strategic or capital project. If you add up all the construction projects, they total somewhere around $150 million – and there are probably several I’ve missed.

Hospital and clinic building projects can sometimes be accompanied by ambivalence from the public. People might wonder: Do we really need this? Why is it so fancy? Is it going to drive up the cost of health care? Can’t we just get by with what we have?

To be sure, these are valid questions. The hospital industry in the U.S. has invested millions in bricks and mortar in recent years. It hasn’t always been clear whether all this construction is entirely for the benefit of patients or whether it’s aimed at enhancing marketability, particularly in communities where there’s competition.

From what I’ve seen of the health care projects in this region of Minnesota, however, the investment looks well-justified.

Most of the smaller critical access hospitals were built in the 1950s with federal Hill-Burton money and were beginning to show their age. Some had hardly been altered since the day they opened their doors. If you think back to how health care has changed over half a century, it becomes pretty clear that these hospitals won’t survive if they don’t keep up.

Some of the demands are practical – for instance, the need to accommodate technology that hadn’t even been envisioned 50 years ago. Others are a little harder to measure. If a facility isn’t up to date, how well is it going to be able to attract health care professionals who want to work there? Do patients want to come to an aging hospital or clinic, or will they decide to go somewhere else? Like it or not, amenities do matter, especially when they’re conspicuously absent.

The bigger issue at stake is whether the small rural hospitals can remain viable. If they can’t stay current, they’re risking not only their own future but the entire fabric of local health care services.

I was around when Rice Memorial Hospital started planning its four-year, $52 million building expansion and renovation more than 10 years ago. I remember the patient rooms in the west wing and how cramped they were. I remember how dark the lobby was. I remember the thick walls in the original 1937 wing and their utter resistance to anything so modern as fiber optic wiring.

If you’re really an old-timer, you might recall that at one time the CT scanner was housed in a room at the end of the radiology wing. For an imaging study, you had to don your gown in the locker area, then traipse back through the waiting room and down the hall for your scan – not very dignified or private (although it was a step up from the mobile services of the 1980s and early 1990s that required patients to go out into the parking lot to reach the trailer where the mobile scanner was housed.) The patient rooms in the old intensive care unit were so small, they barely accommodated ventilators, monitors and all the other high-tech equipment that’s now required.

That’s just my experience, albeit limited, as a former patient/visitor. Imagine what it’s like to be an employee in an older facility, trying to provide good patient care in an environment that constantly limits what you’re able to do. Imagine trying to adapt and plan for the future in a building whose structure you’ve outgrown.

All of this is to say that hospitals can’t afford to sit still when it comes to investing in their physical plant. So if I had to pick a word to describe the construction philosophy of the region’s hospitals, it would probably be “wise.”

None of these projects were lavish or overly ambitious. They met basic community needs. They took future needs into account. And they were undertaken at a time when the cost of construction and renovation was still within financial reach.

Have they raised the cost of care? If you visit the Minnesota Hospital Association’s hospital price check site, it’s pretty clear that charges for inpatient and outpatient procedures at local hospitals hover right around the median. There’s a case to be made, of course, that hospital construction around the state is helping to drive up the total overall cost of health care. But local prices do not appear to have been pushed beyond the norm as a result of the regional building boom.

The region’s hospital boards and hospital officials could have chosen not to take the risk inherent in financing a construction project. They could have made do with what they had. Ultimately, though, I don’t think this would have made them good stewards of local health care resources. There was a chance here to be smart and forward-thinking, and they seized it. And in the long haul, I suspect the region’s health care infrastructure will be better off because of it.

Image: Kirk Stensrud, CEO of Glacial Ridge Health System, outside the new entrance of the hospital and clinic in Glenwood. The $10 million project was completed a year ago. West Central Tribune photo by Tom Cherveny.

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