The Future of Work—A Healthcare Perspective

The pandemic has caused most corporations to delay their targets for returning to the office. The extended nature of the pandemic has allowed corporate occupiers to work through questions of which employees need to be in the office, when they should be present and what design and amenities will be needed to support a collaborative and innovative work environment.

Eighty-four percent of the surveyed health executives said their organizations had either begun a return to the office or would do so soon, while 8% remained uncertain about their plans. This uncertainty is due, in part, to healthcare organizations asking the challenging question of who really needs to be in the office. As Seattle Children’s Chief Digital Officer Dr. Zafar Chaudry stated, “There’s a certain number of people who probably should never have had an office…so we can wind down some leases in very expensive locations.”

Figure 1: Expectations Around a More Regular Return to the Office from Healthcare Respondents

Source: CBRE Research, U.S. Office Occupier Sentiment Survey, Spring 2022.

As George Anders of LinkedIn Workforce Insights observed, “Even in healthcare…remote work is making surprising inroads. Current examples include a wide range of support functions that don’t have to be done onsite,” including human resources, record keeping, finance and accounting, lease administration, data analysis, communications and marketing, among others.

THE HEALTHCARE HYBRID

Like many companies, health systems are sorting out who will be in the office and when and the degree to which they will require employees to return. Hybrid work structures that allow employees to work both in the office and remotely are growing in popularity. However, one challenge with this model is the uncertainty of who will be in the office and when. Many employees use the physical office as a gathering space to socialize and collaborate. What happens when one is seeking to collaborate with peers who aren’t on the same schedule? This can prove frustrating to the employee who came into the office seeking interaction with coworkers and can result in discouragement and isolation from the team. To address this concern some health systems have embraced a hybrid model with guardrails or “Hybrid with Guided Flexibility.”

Hybrid with Guided Flexibility requires employees to be present in the office on designated days of the week and allows the employee the choice of whether they will work in the office or remotely on the non-designated days. This approach ensures that workers will be present when team members are in the office while providing employees with flexible work options.

As seen in Figure 2, healthcare is leading other industries in embracing a Hybrid with Guided Flexibility approach toward the return to the office. Hybrid with Guided Flexibility can increase the number of employees working in the office but may also result in challenges as to how best to support employees who are transitioning from fully remote work to partial in-office work. Dallas-based Baylor, Scott & White Health addressed this challenge by providing their business leaders with 'return to work' surveys and toolkits, empowering them to determine which employees are essential in-office workers, which would be candidates for hybrid work, and which could switch to 100% remote roles.¹

Figure 2: Workplace Policy Intentions

Source: CBRE Research, U.S. Office Occupier Sentiment Survey, Spring 2022.
¹ Source: Walter Cassity, Senior Vice President, Baylor Scott & White Health, CBRE Institute, Spring 2022.

As healthcare office workers reenter their workplace—some for the first time in over two years—what will they find? Does today’s approach represent the future of work, or will this be a transition back to the same office they left? The pandemic forced leaders to consider a profound but simple question: Why do we go to the office and what is its purpose?

SPACE DESIGN

An office provides an environment for greater collaboration and innovation. This fact will have a significant impact on healthcare office design, prioritizing space that creates ample collaboration or “we” space in contrast to individually dedicated “me” space. And when it comes to administrative office space, healthcare is significantly behind its non-healthcare counterparts by having 50% more dedicated “me” space over collaboration “we” space (Figure 4). This lack of collaboration space reduces opportunities for health system administrative office workers to collaborate with colleagues and explore new and innovative ideas.

Figure 3: Space Allocation Shifts Towards Collaboration

Source: CBRE Research, U.S. Office Occupier Sentiment Survey, Spring 2022.

The heavy emphasis on “me” space found in most healthcare administration buildings (Figure 3) also leads to a higher allocation (48% more) of space per employee when compared with other industries. The move to open/shared offices, free-address desks (unassigned workspaces) and collaboration rooms improves space utilization for administrative office users. The creation of highly energized collaboration areas will encourage meaningful, serendipitous encounters, enable employees to do their most inspired work and build strong connections with their workplace community.

Figure 4: Right-Sizing Space Standards

Source: CBRE Research, U.S. Office Occupier Sentiment Survey, Spring 2022.

The future of healthcare administrative office design will move to a greater number of collaboration spaces. In some instances, the introduction of free-address workspaces will lead to 30%-50% more efficient use of space for health system administrative functions.

BUILDING DESIGN

CBRE’s Spring U.S. Office Occupier Sentiment Survey shows healthcare office occupiers prefer more collaborative spaces. Indoor air quality also was a top priority, likely due in part to healthcare workers’ awareness of air quality’s impact on health and wellness.

The availability of onsite food and beverage offerings also is also a top preference for healthcare office users. Most hospitals provide cafeteria services, so healthcare office employees expect the same offerings in their place of work. Healthy air quality and nutritious food choices, as well as touchless technologies, are components of a well environment—a growing priority among health system administrative office users. As Joanna Frank, President & CEO for the Center for Active Design stated, 87% of respondents from their investor survey have seen “increased demand for health and wellness during the period of COVID” but also stated that “this is going to be standard reporting going forward.” For example, CHRISTUS Health2 will open a 400,000-sq.-ft. office in Irving, TX in 2023 with balconies on every floor to encourage outdoor breaks and a large outdoor space where workers can convene. The health system also encourages use of nearby walking trails.

Figure 5: Preference for Better Buildings

Source: CBRE Research, U.S. Office Occupier Sentiment Survey, Spring 2022.
² Source: Lance Mendiola, System Vice President of Facilities Management and Construction, CHRISTUS Health, CBRE Institute, Spring 2022.

The survey also reflected healthcare office users’ heightened interest in workplace productivity. New technology, such as enhanced video conferencing, occupancy sensors and smart building sensors, lead to better space utilization and improved building operations.

The move to more productive, collaborative and healthier work environments is the future of healthcare administrative office space. This shift is key to an organization’s ability to attract and retain the best and brightest talent.

Figure 6: Greater Interest in Enhanced Technologies

Source: CBRE Research, U.S. Office Occupier Sentiment Survey, Spring 2022.

The pandemic forced healthcare leaders to consider how to maintain their culture and sustain their mission and purpose in the community.

The ability to interact in the workplace and experience serendipitous moments with coworkers is a prime example of the role the office plays. In these moments, colleagues share personal updates, work progress and current work challenges, which is also where culture is reinforced and strengthened.

Culture is also reinforced through visual cues. This mission-message occurs when seeing patient care in action, reminding healthcare administrative office workers of their purpose and mission.

Not all roles require physical office space but bridging the culture gap between the in-office worker and the remote worker has presented a new challenge for health system leaders as they consider hybrid work. One response to this challenge is to bring mission-messaging to the employee’s desktop via screen savers. Additionally, hosting social events that bring together colleagues creates an opportunity for employees to build relationships and promote an effective mission-driven culture.

EMPLOYEE EXPERIENCE

As they expand plans for a return to the office, many health systems are placing a renewed emphasis on employee experience to build a strong corporate culture. Enhancing the employee experience may include improving food and beverage offerings; providing highly engaged reception and concierge services, wellness rooms and fitness facilities; and incorporating outdoor spaces and game rooms as break areas. These service offerings are now supported through smart phone apps that allow employees to reserve collaboration rooms, order their favorite coffee drink and schedule a dry-cleaning pick up, among other tasks. A concierge service offers high-impact services focused on providing a positive employee experience and guest care through smartphone apps and highly trained professionals serving as culture ambassadors.

Prior to the pandemic, many health systems were focused on reducing the size of their administrative office footprint. The consolidation of administrative services, the restructuring of space to reflect actual utilization versus occupancy (typically a 25%-30% space efficiency gain) and the implementation of free address for desk assignment all led to a reduction in the office footprint. The pandemic and the broad acceptance of remote work has accelerated the trend toward a reduced footprint. The survey reflected this sentiment with healthcare significantly outpacing other business sectors in the view that their portfolios will be reduced. This is due in part to healthcare lagging other industries pre-pandemic in the move to reduce space and is now catching up with non-healthcare peers.

Figure 7: Long-Term Expectations for Portfolio Size

Source: CBRE Research, U.S. Office Occupier Sentiment Survey, Spring 2022.

AGILE WORKSPACE

Recent years have seen increased demand for agile or flexible office space. This shift likely reflects healthcare’s growing acceptance of and desire to test alternative work environments and the need to provide a more distributed network. Agile workspaces also allow health systems to rapidly occupy office space without having to invest capital for tenant improvements or fit-outs. Whether this high level of interest results in actual occupancy of agile office space by healthcare organizations will be determined as systems continue to map out their return.

Figure 8: Flexible Office Space Demand Growth

Source: CBRE Research, U.S. Office Occupier Sentiment Survey, Spring 2022.

The pandemic has left the clinical healthcare worker exhausted and office workers concerned about what work expectations will be.³ The workplace will play a significant role in healthcare workers’ acceptance of the next normal. An increased interest in well buildings, sustainability and overall workplace experience are front of mind for employees who want to return to a healthier, more energized work environment.

Health systems are facing growing economic challenges that will require heightened vigilance to ensure that offices provide an attractive, healthy work environment that results in high utilization and improved work performance.

The pandemic has proven that healthcare workers are both resilient and dedicated to those they serve. It has also paved the way for a work model in which innovation and collaboration are at the center of the workplace. Whether in a remote work setting or the emerging hybrid workplace, the new dynamic places the healthcare business leader in a position to design the workplace around the worker to support innovation, improved business results and the retention of world-class talent.

³ Source: Modern Healthcare, Surgeon General warns of escalating healthcare workers burnout, Lauren Berryman, May 23, 2022.

KEY TAKEAWAYS

1. The return-to-office for healthcare administrative office users is well underway for most health systems but is occurring gradually.
2. Hybrid with Guided Flexibility (administrative office workers required to be in the office on specified days of the week) will be the predominant approach for healthcare administrative offices with in-office guidelines determined at the business-unit level.
3. The healthcare administrative office environment will experience a significant shift from dedicated workstations, private offices, and private conference rooms to collaboration centers and “free-address” workspaces. This is expected to result in 30%-50% more efficient use of office space.
4. Preference for better buildings and technology enhancements will play a significant role in motivating employees to return to the office.
5. Collaboration between hospital executives and business unit leaders will be critical to the success of a return-to-the-office program. The effort will also benefit from providing enhanced video capabilities, effective COVID protocols, curated employee on-site social events and culture ambassadors who support the mission and employees.
6. Healthcare leaders expect to reduce their real estate portfolios and sharply increase agile work environments in the future.