title: Adding Value by Hospital Real Estate: An Exploration of Dutch Practice.
abstract: OBJECTIVE
  To explore how hospital real estate can add value to the healthcare organization, which values are prioritized in practice, and why.
  
  
  BACKGROUND
  Dutch healthcare organizations are self-responsible for the costs and benefits of their accommodation. Meanwhile, a lively debate is going on about possible added values of corporate and public real estate in the fields of corporate real estate management and facility management. This article connects both worlds and compares insights from literature with experiences from practice.
  
  
  METHODS
  Added values extracted from literature have been discussed with 15 chief executive officers and project leaders of recently newly built hospitals in the Netherlands. Interviewees were asked (1) which values are included in the design and management of their hospital and why, (2) to prioritize most important values from a list of nine predefined values, and (3) to explain how the chosen real estate decisions are supposed to support organizational objectives.
  
  
  RESULTS
  Stimulating innovation, user satisfaction, and improving organizational culture are most highly valued, followed by improving productivity, reducing building costs, and creating building flexibility. Image, risk control, and financing possibilities got lower rankings. The findings have been used to develop a value-impact matrix that connects nine values to various stakeholders and possible interventions.
  
  
  CONCLUSIONS
  The findings and the value-impact matrix can make different stakeholders aware of many possible added values of hospital real estate, potential synergy and conflicts between different values, and how to steer on value add in different phases of the life cycle.
authors.affiliation: Department of Architectural Design and Management, Faculty of Architecture and Fine Arts, NTNU: Norwegian University of Science and Technology, Trondheim, Norway johan@van-der-zwart.eu.
authors.forename: Johan
authors.initials: J
authors.lastname: van der Zwart
authors.affiliation: Department of Real Estate & Housing, Delft University of Technology, the Netherlands.
authors.forename: Theo J M
authors.initials: TJ
authors.lastname: van der Voordt
mesh_terms: D002202:Capital Financing; D004469:Economics, Hospital; D006749:Hospital Design and Construction / Q000191:economics*; D006801:Humans; D007449:Investments; D009426:Netherlands
keywords: accommodation; added value; hospital; real estate; value-impact matrix