In the past 18 months, the downtown Billings Clinic campus has become the epicenter for construction in the medical corridor as $42.2 million worth of projects have either been started or finished.
Since Jan. 1 of last year, Billings Clinic has fast-tracked 10 major construction projects downtown, some that were stalled five years by the sluggish economy.
“The size of the recession this time really did put some things on hold,” said Dr. Nicholas Wolter, CEO of Billings Clinic. “We ended up doing these projects on a timeline that might have been somewhat different if we had been able to start in 2008.”
The health care industry overall is experiencing huge growth in new construction to accommodate the aging population and increased regulations.
In 1965, the average life expectancy for men was 67, and 73 for women. Today, a 65-year-old man can expect to live to 80, and a 65-year-old woman can expect to live to 84. Aging baby boomers add about 10,000 people a day to the Medicare ranks.
“People are going to need inpatient care, outpatient care and care in rural communities,” Wolter said. “We’re trying to have a balanced investment approach that allows us to have a continuum of care available to the patients that come to see us.”
But for Billings Clinic, it’s more than just keeping pace with the industry; it is about charting new territory, responding to public demand for services and accommodating growth. For much of the past year, the 285-bed Clinic has been at capacity.
Additionally, the expansions, upgrades and additions are designed to help the hospital support its work in keeping patients close to their homes and communities. With 45 percent of the Clinic’s patients living outside Yellowstone County, the hospital has forged formal affiliations with 11 hospitals and clinics in the region.
The construction is also designed to accommodate an industry that is headed into what Wolter calls an “unprecedented time of change.” Industry insiders predict that reimbursement models will change and that efforts will be made to treat more people on an outpatient basis and to keep people out of the hospital.
“As we’re making investments, we really want to be thinking that some of these new facilities will have a 30-to 40-year life or longer,” Wolter said. “We want to be sure we’ve been thoughtful about the need for these things.”
The projects include everything from creating the infrastructure to support the state’s first Internal Medicine Residency program to help fill a void in primary care physicians, to building a new inpatient pediatric unit at the Clinic, the first since the early 1970s.
Also among the projects is a new intensive care unit, an expanded Family Birth Center and an expanded and remodeled neonatal intensive care unit.
“Billings Clinic has always been progressive and capable of responding to the needs of the community,” said Brock Slabach, National Rural Health Association’s membership services senior vice president and a former longtime rural hospital CEO. “It’s important not only for Billings but for the region.”
The millions invested in the health care infrastructure will “pay dividends” with an economic impact in the community, Slabach said. Health care is critical to the community's economic well-being as it is a vital source of jobs. If local health care disappeared, as much as 20 percent of the economy would also disappear.
“If hospitals don’t modernize their facilities, it becomes difficult to recruit and retain specialists, and recruiting specialists in a rural area is always an issue,” Slabach said.
Mitch Goplen, vice president of facility services, has been with the Clinic for nearly three decades and said he has never experienced so much construction in such a short time — all in one concentrated area.
It was all made possible because of the longstanding, trusted relationships Billings Clinic has with the general contractors and architectural and engineering firms that completed the work, Goplen said.
“Working in health care is totally different than working in any other commercial building. You’re dealing with a lot of life safety systems and a lot of specialty systems,” Goplen said. “You’re working on a campus that has a lot of people in it day in and day out. We’re in a 24-hour, seven-day-a-week operation. The contractors must understand how to work in that environment and be cost-effective.”
Throughout the design and construction process, Clinic leaders have been mindful of a growing body of research that demonstrates the benefits of a healing environment and the importance of being surrounded by family.
Among other things, the research shows that specific design changes in health care environments can reduce stress and alleviate the consequences of that stress. These changes can also help reduce medical errors and hospital-acquired infections, while improving staff morale and efficiency.
Take the ICU, for example. Each room features private bathrooms and a designated area with sleeping accommodations and a work space for a patient's family members who want to stay at their loved one’s bedside. Studies show that greater interaction between patient and family promotes healing.
Each room has large exterior windows to maximize daylight and provides views of the Rimrocks and the Deaconess Healing Garden. Research shows that patients who enjoy views of nature heal faster than control groups that look onto blank walls.
The ICU features state-of-the-art technology, including beds that allow caregivers 360-degree access to patients. It also houses a satellite pharmacy.
Other features of the new unit include individual waiting areas, a family consultation area, a kitchenette for family use, a play area for children, a fireplace, and sleeping rooms for physicians. In addition, a room is available for large family meetings, education classes and multidisciplinary team meetings.
The hallmark of the new unit is its patient-centered design that features improved décor, more privacy, reduced environmental stressors, natural surroundings and greater patient control over tasks and information.
“We feel these are the right things to do for patients and their families going forward,” Wolter said. “That’s been very important to us.”
None of it would be possible without charitable giving, an increasingly vital component to the Clinic’s construction. Nearly a quarter of the $42.2 million worth of construction projects was paid for with donations.
“Philanthropy is an increasingly critical component as you look at both facility and technology needs,” Wolter said. “It’s been true for a while and it’s going to be even truer in the future.”