The Four Types of Strategic Real Estate Amenities

From Swimming Pools to Pirate Ships, Amenities (Even Crazy Ones) Aren’t Just Perks, but Assets to Enhance Performance

May 9, 2017

Researcher, NBBJ

As competition for tenants, patients, employees and students has intensified, amenities have become an important asset and differentiator across all building types. For example, the total amount of space devoted to amenities in commercial office buildings has risen from 3 percent to 12 percent for high-end tenants, while hospitals and higher education institutions have spent billions to create amenity-rich campuses. Amenities not only draw potential building users, but they also can have a positive impact in terms of asking rates, employee retention [PDF], patient satisfaction and patient outcomes.

While food service has become a baseline amenity in a wide range of facilities, four other amenity types are gaining popularity, namely, those which support fitness & health, access to nature, flexibility & control, and positive distraction.

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Fitness & Health

Gyms are high on the list of employees’ desired amenities, particularly among millennials. In fact, three quarters of European employers already provide fitness facilities, expecting to benefit through reduced healthcare costs and improved productivity. Companies like Chesapeake Energy provide not just gyms but basketball courts and Olympic-sized swimming pools, while even coworking spaces like Brooklyn Boulders Somerville feature major fitness amenities like 22-foot climbing walls.

In healthcare, wellness and fitness centers have evolved from marketing gimmicks into profitable and popular amenities supporting integrated care and population health models. Akron General’s Health & Wellness Center–Green, for example, incorporates a fitness center with outpatient services and emergency department in a sprawling complex, while Florida Hospital is building an 80,000-square-foot wellness center that features indoor farmers’ markets.

 

Access to Nature

Green space is one of the most desired yet underprovided amenities in office buildings, according to surveys of millennials, and has a restorative effect on the weary. Some of the more innovative examples of green space amenities include multi-story glass spheres at Amazon’s new headquarters in Seattle, and a 43,000-square-foot urban farm at Pasona Group’s main offices in Tokyo.

Evidence-based design studies have also demonstrated that patients with a view of nature have less anxiety and pain [PDF], which has helped popularize healing gardens and other green amenities in the healthcare industry. For example, Diakonie-Klinikum Stuttgart has over 150,000 square feet of green space and gardens, while Massachusetts General Hospital’s Lunder Building has an atrium featuring hanging gardens.

 

Flexibility & Control

Employees that have a higher degree of control over where they work, including access to private space and a range of task-appropriate work environments, tend to have a higher degree of workplace engagement. Companies like ViaStat and Thermo Fisher Scientific have actively encouraged employees to modify and redesign their work environments to provide more flexibility and personal control.

Other studies have found that giving patients more personal control and choice reduces stress, an insight hospitals accommodate by creating relaxation rooms and enabling patients to control variables like lighting, sound and temperature. UCSD Jacobs Medical Center’s new facility gives patients iPads which control windows shades, room lights, the thermostat and an Apple TV.

 

Positive Distraction

Game and recreation areas have long been common in the tech industry but are becoming a more widespread phenomenon. These spaces may seem juvenile, but research suggests that helping people feel younger improves productivity. Other workplace amenities like lounges, libraries and terraces can help to create more varied, stimulating environments. Some more unusual examples include a mock pirate ship at Inventionland’s headquarters, and a 65-foot Ferris wheel at Acuity’s main offices.

Hospitals have invested in common spaces like lobbies and lounges to create areas of positive distraction and to reduce stress. At the Minnesota Health Clinics and Surgery Center, waiting spaces have discovery bars where patients can explore research and educational materials via iPads, while Lurie Children’s Hospital has a custom fire truck that kids can play in.

 

Research and anecdotal evidence suggest that amenities which support fitness & health, access to nature, flexibility & control and positive distraction can have tangible benefits. The right type of amenity can be not just a perk but an asset that contributes to the bottom line, whether it’s more engaged employees, better patient outcomes or more desirable properties.

Banner image courtesy of Pixabay.

Infographic © NBBJ.

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It’s Time to Design a Better Experience for Behavioral Health Patients

How to Deliver Better Care While Freeing up Hospital Space

March 28, 2017

Partner, NBBJ

Editor’s Note: A version of this post was previously published in the Puget Sound Business Journal.

The United States faces a mental health crisis, with 26% of people nationwide suffering from psychological illness or addiction. When these patients are at their most vulnerable, our communities’ emergency departments (EDs) are used as dumping grounds and holding areas due to the shortage of appropriate resources.

While any treatment is better than none, EDs are often unequipped to treat these specific patients, especially in smaller cities that are challenged by less capacity and staffing or by fewer specialized facilities. Treatment in the ED often comes with loud noises, bright lights, chaos and seclusion — which can aggravate and trigger complications for a behavioral health patient. EDs are also an expensive treatment option, increasing the cost of care for the patient and the public.

The trend of patients seeking care in EDs instead of psychiatric institutions is not new. In 1963 Congress passed the Community Mental Health Centers Act to deinstitutionalize the mentally ill. The goal was to stop “quarantining” the mentally ill and provide voluntary humane treatment. Unfortunately, this act has not been successful; the deinstitutionalization movement has been called the trans-institutional movement, with patients instead filling EDs, jails, prisons, and homeless shelters.

A Healthy Path Forward

Luckily, healthcare organizations are working with partners in their communities to overcome these challenges. For example, Kaiser Permanente and MultiCare are actively participating in programs to provide appropriate treatment for behavioral health patients — from better training of emergency responders, to preventive health measures, to better funding models.

Another solution is to redesign our treatment facilities. In Portland, Oregon, is Unity Health, envisioned by the Randall Charitable Trust. Together with a series of healthcare institutions, the trust remodeled a shuttered hospital into an inpatient behavioral health hospital with a psychiatric emergency services department. Several architectural firms came together to design appropriate spaces for care and treatment, not just stabilization until a patient is “good enough” to be released.

For example, at Unity, the typical ED exam room allows patients to dim, brighten or turn off lighting completely. While a seemingly benign solution, there is conclusive evidence on the power light has to hinder or support healing, especially with those suffering from anxiety attacks.

The project also focuses on reducing noise. When sound becomes too acute in healthcare settings, it can raise stress levels, boost blood pressure levels and require additional medication. These side effects work against providers as they seek to support their patients. The new design focuses on creating quieter spaces — using sound-absorbing materials, sliding doors and acoustical tiles to decrease noise levels.

In addition, behavioral health patients often react to each other’s outbursts, so the design relies on patient monitoring for safety. Not only does this allow for patient privacy, it also prevents patients from being put in windowless, isolated rooms.

A Call to Action

Despite the best efforts of the Affordable Care Act, the cost to treat behavioral health patients is skyrocketing. To counter the cost impact, we need to create programs for understanding, rehabilitation and prevention to ensure behavioral health patients find wellness and stay well. Studies show that for every 10% increase in mental health spending, the prison population is reduced by 1.5%. It’s clearly better to spend our resources on creating a well-balanced environment — through programs, assistance and facility design — than incarceration.

While the nation grapples with the uncertainty of healthcare under a new administration, we can take steps now to ensure patients suffering from behavioral health issues are given the tools and resources necessary to lead healthier, happier lives.

Image courtesy of Pexels.

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Hospitals Play a Key Role in Building Pathways Out of Poverty

How Healthcare Providers Can Give Back to Their Neighborhoods, and Benefit from It

February 28, 2017

Planner / Architect, NBBJ

Editor’s Note: A version of this post was originally published by Next City.

As jobs in many low income neighborhoods have migrated to suburbs (or overseas), so have retailers and newer housing for those well-off enough to pull up roots and move out. Not so for the large hospitals that have substantial capital investments in existing buildings and, in many cases, social investments in existing communities. Public hospitals in particular tend to find themselves embedded in some of the most distressed communities in America.

As a planner working with many stressed cities in the “Rust Belt,” I frequently find local hospitals are the last and most committed economic anchors, but also the ones most impacted by economic decline in urban cores. City governments are searching for ways to leverage the economic benefits of these anchor institutions (hospital jobs certainly, but also subcontracting and services) for the benefit of the larger community. And some forward-thinking governments, along with aligned organizations and foundations, are now advancing policies and programs to do so.

For example, in Cleveland, the nonprofit development organization University Circle, Inc. has been cooperating with the city’s many world-renowned hospitals to enhance the surrounding neighborhoods. One such initiative, Greater Circle Living, is an employer-assisted housing program created to encourage eligible employees to live closer to their jobs, thus strengthening the local housing market and reducing traffic congestion on regional roadways. Another example, Next Step, encourages large institutions to focus their spending on local green businesses to supply cleaning services, food preparation or laundry. This not only advances green agendas but also bolsters local, and frequently minority-owned, enterprises and local employment in the services sector. Through programs such as these, local communities see direct benefits from the regional anchor institutions in their midst.

So how can regional healthcare institutions — that are struggling to provide quality care and attract new insured patients — benefit from these types of efforts and develop their own?

 

Think Local

By a biological analogy, a healthy organism thrives in a healthy environment. Under new accountable healthcare mandates, hospitals no longer necessarily profit from serving unhealthy populations as they may once have. Many local hospitals want to improve their positioning, marketing and general appearance for insured patients, but they also need to address the general health of the local populations which suffer from the highest preventable disease rates. Urban hospitals across the country treat residents in communities where nearly half the population is either uninsured or on Medicare. Treating population health issues and their causes is now more important than ever to reduce healthcare costs.

In the past, responses to poor local conditions may have led hospitals to clear blight in their vicinity, or to turn their backs on negative conditions in an effort to screen the problems and present a brighter face to their regional customers. Security frequently took the form of a siege mentality: fencing or large parking lots that separated troubled neighborhoods from secure zones within the campus. This approach did not do much to reverse neighborhood decline or negative impacts on the anchor institution, nor did it improve health outcomes of local residents.

 

Practice What You Preach

As in Cleveland, The Aultman Health Foundation (an integrated health system with two hospitals, a health plan and a college) in Canton, OH, is demonstrative of a more comprehensive approach to health. Aultman (and one other hospital, Mercy Medical Center) remains within the city limits, serving the city’s reduced urban population of 70,000 as well as the growing metropolitan-area population of 400,000. Employees and patients seeking specialized medical care must travel from far-flung suburbs and hamlets to one of Canton’s most distressed inner-city neighborhoods. While the neighborhood is arguably less blighted than the surroundings of other famous urban hospitals, the contrast is striking for patients and employees, and local conditions do not support healthy lifestyles for nearby residents.

The health district could eventually involve the entire neighborhood of 40 square blocks where, for example, existing residents would have access to a much-needed wellness (fitness) center, outpatient clinic, quality daycare and healthier food options. Local residents will share these resources with hospital staff, nursing students, patients and patients’ families. Nursing students, medical residents and staff will find housing in the immediate neighborhood in renovated homes or in new apartments. Redesigned roadways will reduce accidents and provide safer pedestrian crossings for kids and the elderly. Parks and tree-lined streets will encourage residents and patients to get outside in a safer neighborhood.

 

Be the Convener

As one might expect, some healthcare institutions are cautious about exercising skill sets beyond providing healthcare. They were rarely organized, or willing, to take on community blight or mixed-use development projects. But they are good at team-building. And this “Health District Strategy” takes many players — healthcare institutions, governments, foundations, private enterprises, even architects and planners — to succeed.

Aultman Health Foundation, by working with the City of Canton and their comprehensive plan, has begun to develop a comprehensive strategy for neighborhood transformation that involves an expanded group of stakeholders, city and state governments and the private development sector. At this point Aultman has convened city government, the Ohio Department of Transportation, the Canton Community Development Corporation, a local foundation and a private real estate developer to create a blueprint for a health district called “Aultman Health Village.” From fixing blighted houses to rebuilding roadways and adding needed retail and services, each of these players are addressing specific coordinated actions that are essential for success.

Aultman Health Foundation and Cleveland provide examples for other progressive healthcare institutions to follow. Anchor institutions can take a look at their surrounding communities to find win-win opportunities. One needn’t be a world-class center of medicine like the Cleveland Clinic to make a difference in one’s own community. Rather than retreat from each other in fear, institutions and communities can actively engage to reverse decline and surround the hospitals with the goods, services and housing that will heal both.

Photo courtesy of Pexels.

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