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PubMed2004

Debating project sustainability.

Three Construction Industry Environmental Forum workshops, held in Edinburgh, London and Manchester towards the end of last year, focused on a range of key issues concerning the delivery of appropriate sustainability performance in PFI projects.

Facility Design and Construction↗
PubMed2004

Capital optimization: linking investment with strategic intent.

With operating margins showing some improvement in 2003, Y2K being a distant memory, and many critical capital investment decisions delayed as long as possible, hospitals have been on a relative spending spree, building new facilities, renovating operating rooms and inpatient units, and investing in new medical and information technologies. However, with pressure on both cost and revenue expected to continue, if not increase, this spending spree may be short-lived, and hospitals must improve their capital planning efforts; align them with their mission, vision, and strategies; and ensure that capital is available when unplanned or even expected needs arise. This article explores some of the challenges that hospitals face in their capital planning efforts and, more importantly, suggests the necessity for hospitals to integrate capital and strategic planning. Capital planning must be driven by an organization's strategies; however, we also argue that an organization's ability to execute its strategies is highly dependent on the existence of a cohesive capital prioritization and planning process. In this article, we explore a number of issues critical to developing a comprehensive capital plan, including estimating capital costs, evaluating and designing strategies to contend with risk, saving for the proverbial "rainy day," and recognizing the role and value of philanthropy, while challenging some conventional thinking of hospital executives with respect to investment, growth, and planning.

Capital Expenditures↗
PubMed1992

Reform debate must address appropriate capital incentives.

In the broad debate over health care reform, the issue of how to regulate hospital capital spending is being touched on lightly. Many options exist--from incentives built into a national payment mechanism to market-driven plans.

Capital Expenditures↗