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Today's hospitals are facing not only slim operating margins, but an aging physical plant and demands for expensive new capital equipment for systems such as computerized physician order entry, bar coding of pharmaceuticals and other products, and electronic medical records.

Through a survey of hospital CEOs nationwide, funded by The Robert Wood Johnson Foundation's Changes in Health Care Financing and Organization (HCFO) program, HRET assessed the current capital financing environment, explored the magnitude of quality and safety infrastructural demands on capital, and identified hospital spending priorities and competing needs.

Specifically, this survey helped HRET examine the strategic processes used to make decisions related to hospital capital investment in an era of tight resources and growing demands.

The study addressed the following questions:

• What competing factors are involved in the strategic planning process?
  
• How are these factors prioritized?
  
• What impact will quality and safety initiatives, government compliance requirements, and tightening operating margins have?
  
• What strategies are executives in health care organizations of varied sizes and financial conditions employing to overcome the financial burden of capital acquisition?

In addition to the survey, HRET conducted targeted interviews to pinpoint some of the more innovative approaches to financing capital investments in today’s demanding environment.

The findings present best practices for future capital decision making and long-term capital planning for U.S. hospitals.

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Funding: The Robert Wood Johnson Foundation's Changes in Health Care Financing and Organization (HCFO)