Patient Parking
or...Learning to Wait for an Available Space

By Virginia L. Pastuszczak, Business Development Mgr.
Provan & Lorber, Inc.

How many times has your appointment rushed in breathless and said, "Sorry I’m late. I had trouble finding a place to park." According to a 1999 survey of New England health facilities conducted by Provan & Lorber Inc. consulting engineers, 35% of the facilities reported having a parking management problem.

It's not surprising. The past ten to fifteen years have seen significant changes in health facility utilization. Administrators often believe that reducing the number of patient beds will create a reduction in staff and visitor parking. The reality, however, is just the opposite. Expanded outpatient services are the primary reason for fewer parking spots. This has been coupled with building expansions that have eliminated existing or potential surface parking areas. Add changes in staffing shifts from traditional 8-hour to 12-hour and flex time shifts and you can understand why many facilities now have a problem. Even front doors are being moved ...literally. Redesign of interior building space has often resulted in a new front entrance. What used to be "front door" parking is now at the back or side of the building and no longer convenient. It's not the average daily number of patients, visitors and staff – it's the high vehicle turnover rate and convergence of users at peak times that creates the problem.

Health facilities are increasingly in competition, marketing specialized treatment services, home-like atmospheres and other amenities. We are starting to see trends toward campuses that are whole-health care and wellness centers, offering day surgery, medical group practices, alternative medicine and fitness centers, even drive-through pharmacies! The overall image being marketed has now moved outside of the building to include the driveway approach and parking area. Convenient physician and visitor parking services must be part of the package being offered.

Even elder care facilities are not immune. Yesterday's nursing homes are becoming today's assisted living and residential care facilities. Many facilities have added skilled nursing units and interim care services. These changes can impact parking needs, requiring more spaces for added staff such as rehabilitation and occupational therapists, and additional, more accessible resident and visitor parking.

Data-based "supply and demand" parking models and parking ratios formerly used by engineers and architects have become obsolete for health facilities. Today's parking plan begins with a comprehensive parking utilization study. This will form the basis for coordinated access plans and enhanced mobility design, while minimizing impact on capital and operating budgets and creating an appropriate "first impression" of the facility. Each plan is tailored to fit the individual roles and unique characteristics of each facility. Because no single formula is correct, the design of parking solutions has become more of an art than a science. Rapid changes in health care services has made it difficult at best to provide a long-term parking solution. Developing flexible allocation models that can adapt to changes over the short-term (approximately 10 years) will at least help buy some time before the next re-design.

On average, employees account for 75% of a hospital's parking demand. Understanding the dynamics of staff shift turnover is one part of parking design. Much of this planning can be accomplished by in-house staff who better understand facility operations. However, meeting the needs of the other 25% of "transient" users – doctors, patients, visitors, and students at teaching hospitals – is more exacting. Design here has become much more than just satisfying demand; parking space allocation is an integral part of the equation. Determining the percentages of these user groups and how the groups use the facility is critical to developing a suitable parking plan. Only by understanding the combinations and the dynamics involved can the right parking integration plan be achieved.

Here are some important considerations to keep in mind when developing a parking master plan:

1. The patient is your customer. Locate patient and visitor spaces near the point of service or access door to minimize long walks and way-finding confusion and frustration.
2. Keep in mind maximum acceptable walking distances for patients, visitors, physicians and staff. Studies have shown that for patients, physicians and visitors the maximum walking distance is 300 feet, and for employees it is no more than 600 feet.
3. Assigned spaces should be flexible, available for other users when they would typically be vacant. For instance, share assigned parking for different groups, such as physician spaces and second shift staff, or patient spaces and second shift.
4. Minimize reserved spaces when possible.
5. The mix of assigned spaces and open spaces appropriate to your facility's use is unique. Don't try to use a formula, which can have a margin of error of plus or minus 20%. At $1,500 per space in a surface lot, too many spaces can be costly, and 20% too few can be a big mistake.
6. Be cognizant of the "first impression" approach to the facility. Clear signage and easy mobility will help ensure a positive experience, even before the visitor goes into the building.
7. Today's SUVs and pickup trucks are longer and, on average, three inches wider than cars. They require a larger parking space and a wider turning radius.
8. Lots or garages must be well-lit and visually open. Consider landscaping designs that won't pose a safety risk, particularly for the night shift.
9. Most health facilities have an adequate number of ADA compliant parking spaces, but the location of these spaces should be revisited as the facility evolves.
10. It is recommended that "transient" parking lots (for patients, visitors and physicians) have excess capacity of 15% built in to the design.

Land for accessible surface parking lots is disappearing, zoning restrictions are more evident as facilities become landlocked, and at an average of $7,000 per space, parking garages are a major capital investment. Mistakes here can be costly. If you have made a large investment in your staff and building, you can't afford to leave the parking design to chance. As in health care, the design and building trades are becoming highly specialized. Consult with a firm that is experienced and who understands the special needs of health care facilities.

Virginia L. Pastuszczak is Business Development Manager with Provan & Lorber, Inc., engineers and planners for New England's health care industry.