Danbury Hospital’s six-bed sleep center had an eight-week waiting list for patients needing help with sleep problems, and no more room at the hospital to add beds. So it did what a growing number of hospitals around the country are doing: It leased rooms from a hotel.
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| A Danbury Hospital sleep technician at the new Southbury Sleep Center monitors a patient's progress throughout his overnight sleep test. |
In April, the hospital opened two more bedrooms for sleep testing at the Heritage Hotel in Southbury, Conn.; it leased a third room located between the two for the technician’s control room.
One big advantage was that the hotel rooms already had the comforts and amenities patients prefer for their overnight sleep tests. And renovating the leased rooms, which included adding one bathroom, cost a total of $2,400, not counting the testing equipment—far less than the $75,000 to $100,000 cost of building new sleep lab rooms. After two years, Danbury Hospital has the option of leasing two more rooms.
Now patients wait only a week or two for a physician consultation and sleep test. They go to the hotel lobby and a technician escorts them to the third-floor rooms, to be hooked up for monitoring. The new location, 18 miles from Danbury, also tapped into a new market.
Hospitals, physicians and independent business operators are opening a growing number of sleep centers and labs across the country in response to surging demand.
The American Academy of Sleep Medicine (AASM) now has accredited about 1,800 centers, up from 915 in 2005. For space, cost and patient satisfaction reasons, many are locating their labs in hotels, satellite medical offices, senior living centers and other off-campus sites, though they often keep their treatment services on campus. Both Harvard and Vanderbilt universities recently opened labs in hotels.
Sleep labs should be designed to make patients feel safe and comfortable when they arrive in the evening for their overnight test, says Dr. Lisa Shives, a board-certified sleep specialist who opened a freestanding eight-bed center in Evanston, Ill., in 2007. Patients should be able to park close and find the lab easily, preferably without having to wander through an empty office or hospital building.
The facility, Shives says, should be well-signed, well-lit and cheery, preferably with a direct entrance on the first floor. She also thinks it’s best to offer one-stop shopping, with daytime exam rooms and services connected to the lab, since sleep disorders often are chronic. Rooms must be soundproofed, given how loudly some sleep disorder patients snore, she notes. Every room must have its own bathroom with shower, including one with a handicapped-accessible bathroom.
For patient safety reasons, many sleep centers prefer to test older, sicker and more disabled patients in their hospital-based facilities rather than in their hotel-based or other off-site labs. But off-campus sites need to establish clear procedures for overnight medical emergencies, which are uncommon. The typical procedure is to simply make sure the sleep technicians and hotel staff call 911 if needed.
Hospitals opening off-site sleep labs should make sure they can link their off-site testing equipment to their hospital-based record systems. They also should check the availability of certified sleep physicians and technicians. Another issue is the likely growth of home-based sleep testing, for which reimbursement currently is lower, says Dr. Clete Kushida, the AASM’s president and acting medical director of Stanford University’s sleep center.
For now, though, Lisa Messina, Danbury’s vice president of operations, says her hospital and its patients are pleased with the new hotel-based sleep lab. “Hotels are already set up for sleep,” she says.
This article first appeared in the October 2009 issue of HFM.
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