Edward Pfleging’s Master Plan to Improve Care

After Montefiore Medicine Academic Health System's decade of unprecedented expansion, Edward Pfleging uses master planning to draw the organization's many facilities into a strong network of patient resources

Montefiore Medicine Academic Health System has expanded exponentially over the past decade, acquiring eight hospitals and assuming operational responsibility for the Albert Einstein College of Medicine. It now has campuses in Rockland, Westchester, and Orange Counties in New York, as well as its original headquarters in the Bronx, and it has increased its footprint by 10 million square feet to a total of 12.5 million.

With the onset of this expansion came questions about how to consistently provide the best patient care across the entire Montefiore system. To answer these questions, Montefiore embarked on a yearlong process to develop a master strategic plan that prioritizes comfort and ease of access for patients and clinicians, as well as how to maximize research and education synergies with Einstein.

Edward Pfleging, Montefiore Medicine Academic Health System Courtesy of Montefiore Medical Center

The executive at the helm of this master plan is Edward Pfleging, senior vice president of facilities and real estate. He joined Montefiore more than thirty years ago in an entry-level engineering position and has been with Montefiore his entire career. Over the course of Pfleging’s tenure, he has been exposed to all aspects of the hospital system’s operations, putting him in a prime position to harness the master plan’s potential as a vehicle for exceptional patient care.

Pfleging’s team has retained Perkins Eastman, a design firm specializing in healthcare, as the master planner. Stantec, a community-centric design firm, is providing project management services. Involving internal stakeholders in the master plan is critical for an organization as expansive as Montefiore. Pfleging describes several levels of leadership in this process, including a committee that comprises members of Montefiore’s board of trustees who have real estate experience and a steering committee that includes executives from across the entire hospital system who meet once a month.

At these steering committee meetings, Pfleging’s team presents data collected by Perkins Eastman and actively solicits members’ opinions on potential master-planning scenarios. “It’s important that any scenarios and big ideas align with our ability to actually implement them. We’ll go to the steering committee and build a consensus around potential scenarios, then bring them to our real estate planning and development committee on the board of trustees,” Pfleging explains.

The goal during the first year of the master-planning process is to create a road map that integrates all of Montefiore’s campuses into a unified health system. “In a big way, it’s mostly how we can achieve the best use at each of our facilities,” Pfleging says. By the end of the first year, Pfleging wants a plan in place for each campus, including where any new structures will be built, which buildings will be rehabbed or expanded, and what the development of the surrounding area will look like.

Pfleging’s team is also evaluating Montefiore’s real estate holdings from a financial perspective, identifying underutilized assets that could generate capital. “Many healthcare systems sit on a tremendous amount of owned properties that have a lot of value, and part of this valuation is to see if we can monetize any of those assets and build funds to further our mission,” says Pfleging.

“Ed Pfleging is a true professional who understands the big picture and appreciates small details, said Joe Simone and Guy Leibler, owner and president of Simone Development, respectively, in a joint statement. “He knows healthcare design and facilities management are key to the industry to deliver a comfortable and confident environment.”

Generating the master plan road map is broken into three phases. The first, which was completed in January 2019, was focused on gathering information. Pfleging’s team had extensive conversations within Montefiore to determine the specific needs of each site and to create a collective vision. They also examined the zoning around each of Montefiore’s campuses and the real estate valuation of Montefiore’s properties.

In the second phase, the information discovered in phase one is used to create scenarios for each of Montefiore’s sites and to establish a set of common principles. At the core of these principles is the end goal of elevating the experience of patients, students, faculty, and clinicians; integrating all of Montefiore’s sites and resources into a cohesive, interconnected system; and strengthening Montefiore’s financial standing. The third phase involves building on the scenarios created in phase two and sharing the details of the master plan with the Montefiore community at large.

“Ed and his team have adopted a system-wide, high-reliability approach to support their environmental health and safety efforts that has resulted in significant quality improvements, cost containment, and is well received by regulators,” says Don Death, founder and CEO of Readiness Rounds.

To further integrate Montefiore’s many campuses and build a network of care for patients, Montefiore is looking to create two main hubs, one in the Bronx and one in Westchester County. Each of these hubs provides complex patient services such as transplants, heart surgery, and other higher-level care.

The master plan also includes updates to many of Montefiore’s buildings. “Our facilities provide safe and compliant care, but they’re old, and the healthcare delivery system has changed dramatically,” Pfleging says. “Customer service is a big piece of this, not just in terms of access and care, but having hotel services and amenities and the aesthetics that a patient deserves.” Semiprivate rooms will be converted to singles. Amenities such as more dining options, better furnishings, and family visiting spaces will be added. Wayfinding and parking will be improved to better accommodate patient access in many of Montefiore’s campuses that have grown organically over the years. Green spaces will be added as a respite for visiting families, clinicians, staff, and faculty.

Although much of the master plan is internally focused, Pfleging’s team remains cognizant of changes happening in the areas surrounding Montefiore’s campuses. As such, the organization has participated in public transportation work groups. Many transit options are being added to the Bronx, including bus lines and three train stations, all of which will increase access to Montefiore’s sites.

Pfleging says that a master plan is long overdue, but he’s glad that it’s happening at the tail end of Montefiore’s unprecedented expansion rather than several years prior. This way his team can take all of Montefiore’s sites and resources into account to create a fully integrated regional academic health system.


Zetlin & De Chiara LLP congratulates Ed Pfleging and Montefiore Health Systems on this richly deserved recognition. We admire your continued dedication to excellence and innovation in healthcare, as exemplified by the Montefiore New Rochelle Hospital project. As your construction counsel, we share your excitement in building a healthier world.