Adding value by health care real estate: parameters, priorities, and interventions

Purpose - Because of the transition of the Dutch health care sector from a governmentally steered domain towards regulated market forces, health care organisations have become fully responsible for their real estate. This paper aims to explore if/how Dutch health care organisations adopt the concept of adding value by corporate and public real estate, which values are prioritised and how these values are implemented in daily practice. Design/methodology/approach - Literature study and a meta-analysis of six student theses (1 × BSc, 1 × MSc, 3 × post-MSc and 1 × PhD) on adding value by health care facilities were conducted, using document analysis and semi-structured interviews with CEOs, project leaders, real estate managers and facility managers. All respondents work in Dutch hospitals, assisted living facilities for the elderly, or mental health care facilities. The interviews were jointly prepared by the students, and the author of this paper being their supervisor. Findings - End-user satisfaction, enhancing productivity and stimulating innovation are highly prioritised. Which values are prioritised depends on the organisational objectives, target group, available budget, position in the life cycle of design, construction and use and external context, in particular governmental policy and competition with other health care suppliers. The operationalisation into concrete design choices and strategic management of buildings-in-use is still underdeveloped. Research limitations/implications - The interviews lasted 1-1.5 hours, which is rather limited to get a complete picture. Although much work has been done to operationalise the added value of corporate real estate and building-related facilities, there is still a lack of a widely agreed taxonomy of added values and how to measure and manage these values. Ongoing international collaboration between researchers and practitioners aims to contribute to a common framework and to develop standardised measurement methods. Practical implications - The insights can support decision-makers in value-adding real estate and facilities management value by public and corporate real estate. The listings of prioritised values and related interventions can be used as a frame of reference to improve the current design and management of health care real estate. Social implications - A clear insight in value-adding management of corporate real estate may result in a better fit among real estate, organisational objectives and end-user needs. Originality/value - The findings link the added value theory to corporate real estate management in Dutch health care practice.