HCA – formerly HCA-The Healthcare Company – is the one of the largest, for-profit hospital operators in the United States. Published reports show HCA owns nearly 180 acute care, general, and psychiatric hospitals; and 78 freestanding ambulatory surgery centers located primarily in the Sunbelt in the United States, as well as a few holdings in Switzerland and the United Kingdom. The company’s annual report shows medical facilities square footage to be 41.9 million. Numbers provided by HCA in the Buildings’ questionnaire say the company has more than 300 buildings in its system, totaling 66 million square feet. Besides health facilities, these include a five-building, 828,000-square-foot headquarters complex in Nashville and service centers throughout HCA’s market areas. The dollar volume of spending in 2003 for capital expenditures is estimated to be around $1 billion with new construction of about 1.4 million square feet and modernization projects equaling more than 800,000 square feet. During the design of every facility, HCA requires the inclusion of a plan for future expansion of several key clinical areas: the emergency department, imaging department, operating suite, and critical care and medical-surgical patient rooms.
[Editors’ Note: While state codes and American Institute of Architects guidelines set minimums, the facilities professionals at HCA have developed their own design standards to go above those requirements. At the same time, these professionals take a very aggressive – and forward-thinking – stance in long-term decisions regarding building components and systems (making appropriate determinations on initial vs. life-cycle costs), wisely conscious that value engineering claims may have little to do with value or with engineering. By building mock-ups for new spaces – and involving physicians, nurses, and staff in testing – surprising insight and cost efficiencies on the viability and functionality of future planned spaces have resulted.]