"Fable Hospital" Illustrates ROI from Evidence-Based Design

To demonstrate the return on investment on evidence-based design elements, the Center for Health Design in 2004 imagined a hospital that would include key features of recently built or redesigned facilities. Numerous research studies have shown that these design elements reduce costs and increase patients and employee satisfaction.

Fable Hospital, an imagined $240 million replacement hospital with 300 beds, would have the following design innovations, with their projected extra costs:

1. Larger private patient rooms: $4,717,500. These rooms add space for family, staff activities and in-room procedures.
2. Acuity-adaptable rooms: $816,000. Includes technology hook-ups so that patients don't have to be moved as their conditions change.
3. Larger windows: $150,000. To let in more light, the typical three-foot-by-five-foot window in patient rooms is enlarged to five feet by eight feet.
4. Larger double-door bathrooms: $1,509,600. This enables caregivers to more easily assist patients to and from the bathroom.
5. Hand-hygiene: $1,071,000. Hand-washing sink is installed at the doorway of each patient room and alcohol-based hand-rub dispenser is put at the bedside.
6. Decentralized nursing stations: $556,800. Alcoves near beds provide a charting surface and access to information technology.
7. HEPA filters: $270,000. High-efficiency particulate air filters improve filtration of incoming outside air and eliminate recirculated air.
8. Noise-reduction: $430,000. Carpet and special wall and ceiling tiles absorb sound and wireless communications eliminate overhead paging.
9. Additional family & social spaces: $510,000. A family-style great room and family kitchen placed on each patient floor.
10. Health information centers: $95,200. Centers on each floor offer brochures, books, videotapes and Internet access to patients, visitors and staff.
11. Meditation room: $61,200. Quiet spaces for family and staff meditation are located on each patient floor.
12. Staff gym: $342,500. This facility includes exercise equipment, changing rooms, toilets and showers.
13. Artwork: $450,000. This figure represents the additional artwork allowance beyond the typical budget.
14. Healing gardens: $1,050,000. Figure includes meditation garden, strolling garden, pond, outdoor meeting area, outdoor dining and children's playground.

TOTAL EXTRA COSTS: $12 million added to the construction budget.

Also based on studies, the center came up with the following projected savings and revenue due to the new features in the hospital's first year of operation:

1. Reduction in patient falls: $2,452,800 savings.
2. Reduction in patient transfers: $3,893,200 savings.
3. Reduction in nosocomial infections: $80,640 savings.
4. Reduction in drug costs: $1,216,666 savings.
5. Reduction in nursing turnover: $164,000 savings.
6. Increased market share: $2,108,100 increased revenue.
7. Increased philanthropy: $1,500,000 increased revenue.

TOTAL REVENUE & SAVINGS: $11,475,406 in the first year of operation.

Source: Center for Health Design