Patients want private rooms, and hospitals are accommodating them
When she had a heart attack last spring, Ann Galdos rushed to Massachusetts General Hospital, where doctors worked quickly to open up her blocked coronary artery.
But when she settled in that night to begin her recovery, there was no rest to be found: The other patient in her shared hospital room was coughing, gagging, and moaning for hours. Galdos paced the hallways to find some peace.
“It was impossible for me to sleep,” said Galdos, 71.
Even at Mass. General, one of the most prestigious hospitals in the country, most patients share rooms. The experience can be disruptive and stressful, and can increase the risk of catching infections.
Now the hospital is joining other medical centers across the country in building new private rooms to give patients and caregivers more space and privacy. Mass. General is seeking approval to build two connected towers with 450 spacious private rooms, at a cost of more than $1 billion. Across the city, Beth Israel Deaconess Medical Center is constructing 158 new single rooms, while Boston Children’s Hospital plans to convert all of its doubles into private rooms in the coming years.
These projects reflect a growing sentiment that patient comfort is becoming an essential part of the hospital business.
“People’s expectations have changed,” said Dr. Peter Slavin, president of Mass. General, which has 38 percent of its beds in private rooms. “Being in a double room in this day and age is not something people welcome.”
Several factors are driving hospitals to build more private rooms. One is the sheer logistical challenge of assigning patients to doubles: Hospitals don’t mix patients of different genders, or those who are contagious. The result is that many double rooms have an empty bed.
Another important factor is safety: It’s harder to prevent patients from catching infections when they’re just a few feet from another sick person.
And reducing infections, a persistent and costly problem in the hospital industry, could help offset the significant expense of new private rooms, according to some research. While nonprofit hospitals run large fund-raising campaigns to underwrite these projects, the costs of new buildings ultimately get built into the prices patients, insurers, and employers pay for health care.
Massachusetts hospitals are required to contain the growth in their overall spending to 3.1 percent a year, and hospital leaders argue these new facilities won’t result in dramatically higher costs for patients.
Indeed, while private hospital rooms were once considered a luxury, insurers now commonly pay the same rates for both shared and private rooms.
For Mass. General and other hospitals, the shift to private rooms is largely about keeping pace with the competition.
The Mayo Clinic recently built dozens of new private rooms as part of a $200-plus million renovation of its Rochester, Minn., campus. At Mayo, 91 percent of the 1,296 patient beds are now in private rooms.
“A lot of folks come here expecting we probably have all private rooms,” said Ken Ackerman, associate administrator for hospital operations at Mayo. “It is something that our staff sometimes have to deal with. Patient experience can take a hit when patients have to share a room.”
The Johns Hopkins Hospital in Baltimore opened a new facility in 2012 and renovated other buildings so every patient, except those in psychiatric units, has a private room. That means 96 percent of patients stay in singles.
At the main campus of the Cleveland Clinic, 53 percent of the beds are in private rooms, and, guided by patient surveys, the hospital is looking to increase that figure, a spokeswoman said. The Pittsburgh-based UPMC system is spending $2 billion on three new specialty hospitals with all private rooms.
“It’s something that you have to do today to be a modern hospital,” said Joan Saba, partner at NBBJ, the design firm working on Mass. General’s new project.
While some patients benefit from the social interaction that comes with having a roommate, the drawbacks of shared rooms are clear. There is little space for family and friends to visit or talk intimately. Sensitive conversations with doctors can be overheard. The room can get noisy with TVs blaring or multiple sets of conversations going at the same time, with just a thin curtain separating the two patients.
“You have some illusion of privacy . . . but they still hear everything,” said Galdos, the Mass. General heart patient. “It’s kind of like having a stranger in the room when you’re having a doctor’s visit. You don’t really feel free to talk to people when there’s somebody on the other side of the curtain.”
The last patient tower that Mass. General built, the Lunder building in 2011, has all private rooms. In surveys, the majority of patients who stayed in Lunder’s bright, spacious singles said the hospital felt quiet at night, while those in Mass. General’s older double rooms reported more noise.
Hospitals today look vastly different from the early 20th century, when patients stayed in large open wards. There was little expectation of privacy, but the setup allowed doctors and nurses to keep watch over multiple patients at one time.
In the building boom after World War II, with more Americans covered by health insurance, hospitals began building more shared — or “semiprivate” — rooms, said Robin Guenther, principal at Perkins+Will, another firm that designs hospitals.
As medical care advanced, and patients began requesting more privacy, hospitals constructed single-bed rooms. Since 2006, the Massachusetts Department of Public Health has required hospitals that build additions to construct only private rooms for medical and surgical patients.
The newest patient rooms at hospitals today are usually divided into three zones: an area near the hallway for doctors and nurses, a space for visitors, and the patient bed in the middle. These rooms come with pull-out couches where a family member can spend the night, and private bathrooms. They might include perks like extra outlets to charge phones and laptops, Wi-Fi connections, and streaming video.
Changes in medical care have also made double rooms feel cramped. During rounds, several doctors, nurses, and other staff might squeeze into a room to examine a patient. The proliferation of technology has filled rooms with bigger computer screens and more equipment, such as ventilators and medication pumps.
And the typical patient who stays overnight in a hospital today has more complex medical needs than in the past. “It means that the equipment around the bed is more intense, the level of care is more intense,” Guenther said.
The availability of private rooms ranges widely across Massachusetts hospitals. At Brigham and Women’s, 73 percent of beds are private. Next door, at the much smaller Dana-Farber Cancer Institute, all 30 beds are in private rooms.
Other hospitals still rely heavily on double rooms, because of cost, lack of space, or other reasons. At Tufts Medical Center, 59 percent of beds are in private rooms. Fewer than half the beds at New England Baptist Hospital are private. And Boston Medical Center has just 13 percent of its beds in singles.
At Children’s Hospital, two-thirds of the patient beds are currently in private rooms, and a $1 billion project to build a new inpatient tower with more private rooms is underway.
Beth Israel Deaconess Medical Center also received state approval in January to build a 10-story tower in the Longwood Medical Area, at a cost of about $630 million. This will increase the percentage of private beds at the hospital to 55 percent, from 37 percent.
“That is still kind of barely competitive with the national and the local marketplace, as places like the Brigham and the General have built more buildings than we have,” said Peter Healy, president of the hospital. “This is our first major building or bed tower in the last 20 years. It’s been a while, and we need it.”
At Lahey Hospital & Medical Center in Burlington, all patient rooms are private. The Burlington hospital, long known as the Lahey Clinic, was built about four decades ago.
“Lahey was well ahead of its time,” said the hospital’s chief executive, Dr. David Longworth.
“I do believe it’s a competitive advantage,” he added. “I think we could do a better job at marketing this.”