Big-box takes big pressure off hospital

MINNESOTA OUTPATIENT CLINIC CREATES CONVENIENT, PRIVATE ENVIRONMENT

By Jessica Griffith

 

John Brandt received a “tough mission” in 2003.

The senior business development director of HealthPartners, a Minnesota health system, was asked to remove 100,000 outpatient visits a year from heavily congested Regions Hospital in downtown St. Paul, Minn., the state’s capital.

Initially, the plan was to remove just outpatient diagnostic imaging, such as MRIs and ultrasounds.

“Imaging was taking up space and parking, and we had to decongest the Regions campus,” Mr. Brandt says.

At first, HealthPartners, the parent company of Regions Hospital and HealthPartners Medical Group, decided to build an outpatient clinic. The project, however, quickly morphed from an imaging center to a full-service healthcare complex.

Instead of building a traditional medical office building (MOB), HealthPartners opted for the latest evolution: a big-box style, integrated clinic designed to make medical visits as convenient and private for patients as possible.

A request for proposals led the HealthPartners team to Frauenshuh Cos., a Bloomington, Minn.-based developer with about a dozen big-box healthcare facilities on its resume.

“This met HealthPartners’ requirements for the delivery of healthcare,” says Richard Wicka, principal with Frauenshuh Healthcare Real Estate Solutions. “It is an outpatient facility conveniently located in the community, and it meets patient needs in terms of the variety and accessibility of healthcare.”

HealthPartners also viewed the clinic as a way to change its image from a former county hospital to that of a sophisticated healthcare provider.

“It was an excuse to change the way we delivered care,” Mr. Brandt says.

Customer convenience

Frauenshuh and HealthPartners considered about 25 potential sites for the project, settling on a 5-acre piece of land in the Phalen Corridor, a redevelopment zone on the east side of the city.

The St. Paul Port Authority, which serves as an economic development agency for the region, already had cleaned up the former railroad and junkyard. Mr. Brandt says the land was virtually free because HealthPartners met a requirement of creating living-wage jobs.

HealthPartners broke ground on the 128,000 square foot building in August 2004, and the facility opened to patients in October. That first day, physicians at the HealthPartners Specialty Center saw 750 patients, a figure that now ranges from 750 to 825 patients per day.

A shuttle bus travels the mile from Regions Hospital to the clinic every 15 minutes. When patients arrive, they are greeted not by a directory but by a concierge at the front desk, who directs them to the appropriate floor.

The lobby resembles that of an upscale shopping center, with a waterfall, armchairs and a coffee counter that sells drinks and snacks.

“We weren’t necessarily going for a particular look, but we wanted a to create a certain feel, a welcoming environment,” Mr. Wicka says.

“The old clinics were not patient-friendly,” Mr. Brandt adds. “Most of these services were located in the intestines of Regions Hospital and it took almost as long to park and find your doctor as it did for your appointment.”

Diagnostic imaging remains a core mission of the clinic and 15,000 square feet, or half the first floor, houses what Mr. Brandt calls the largest diagnostic center in the Twin Cities outside of a hospital. Much of the remaining first floor is taken up with a large physical rehab center. Upper floors house more than a dozen practices, including internal medicine, dermatology, orthopedics, neurology and rheumatology. An 8,000 square foot basement contains conference and meeting rooms.

Mr. Brandt estimates the project cost $20 million to $25 million, including equipment. HealthPartners paid for it with existing capital and tax-exempt bonds.

Easy navigation

Unlike a traditional MOB, the HealthPartners clinic does not have hallways. The first-floor lobby features clearly marked doors for the imaging and rehab practices, and the elevator bays on the upper floors open into waiting rooms for the various medical offices.

Wayfinding is simplified with a color-coding system that matches signs with chairs and other furnishings in the waiting areas.

Privacy is paramount, as required both by HIPAA (Health Insurance Portability and Accountability Act) regulations and patient concerns. Each medical practice has checkout stations so patients do not have to stand in waiting rooms to make follow-up appointments. Doctors have quiet stations that replace the old custom of dictating patient information in hallways or other potentially public areas.

Patient comfort is illustrated through design details such as wider chairs in the bariatric surgery waiting room and bi-level counters at the reception desk, so both walking and wheelchair-using patients can reach to write. A paperless medical records system means patients who require care from multiple providers do not have to repeatedly fill out forms.

Free parking is another amenity; both patients and staff had to pay for parking at the hospital.

“We have a patient-centered culture that reinforces respect for patients,” says Terri Draxten, surgical specialties manager for HealthPartners’ specialty clinics.

Big box again

A second, 128,000 square foot clinic is under construction just to the east of the specialty center. Although HealthPartners will occupy more than half of the building, this development is a joint venture between Frauenshuh Cos. and the St. Paul Port Authority. HealthPartners will lease space for surgical suites, endoscopy procedures and other services, and the nearby Gillette Children’s Specialty Healthcare will lease about one and one-half floors.

“With the two buildings, we will have eliminated 160,000 visits a year (from Regions Hospital),” Mr. Brandt says. “It clears the clutter.”

The second building also will add 600 parking spaces to the 530 currently available at the first clinic.

Mr. Wicka says the project will cost about $30 million, not including medical and surgical equipment. HealthPartners chose to use off-balance-sheet financing for the second building to keep capital available for other uses, he says.

“Rather than tie up dollars with bricks and mortar, they can leave their capital for equipment, new technology, doctor recruitment and other programs,” Mr. Wicka says. q

Jessica Griffith is a business writer specializing in commercial real estate.

HealthPartners Specialty Center

ST. PAUL, MINN.

STATS

• 128,000 square foot building, four stories plus basement

• 5-acre site

PLAYERS

• Owner: HealthPartners

• Developer: Frauenshuh Cos., Bloomington, Minn.

• Architect: Pope Associates, St. Paul, Minn.

• General Contractor: Kraus-Anderson Construction, Minneapolis