Case Study: Off-Site Service Center Study A Deeper Look Most hospital campuses grow organically, and often become land-locked over time. With this growth, ancillary departments can run out of space for new equipment, supply storage and updated process workflows. Discover inside how Array has helped one highly-regarded health system determine what departments might benefit from moving off-site, and how services left on-site can best take advantage of the vacated space.
Off-Site Service Center Study CHALLENGE
PROJECT OVERVIEW
To develop high-level planning criteria for an off-site facility to house select support services.
system to develop a high-level plan for an off-site facility to house select support services. The
SOLUTION
Site Service Center will also support community-based primary and specialty care centers and
•
•
•
•
Right-size select departments for current operations and for future system demand, space needs and strategies.
Our team worked with the Planning + Design Department at a consistently top-ranked health resultant Off-Site Service Center is intended to support the future needs of the growing health system. The inpatient platform, across two campuses, is projected to grow to 800 beds. The Offambulatory surgery sites. The desired outcome of the study was the quantification of an order-of-magnitude square footage requirement and construction cost for the off-site facility, as well as quantification of potential vacated space in the main hospital. The team toured, shadowed and conducted interviews with designated representatives from
Identify shared staff support and amenities for the Off-Site Service Center to create parity in staff experience.
departments deemed as potential candidates for relocation to determine departmental func-
Quantify required departmental areas for the Off-Site Service Center, define adjacency criteria and develop access and dock requirements.
we reviewed with representatives from the Planning + Design Department. A recommended
Identify on-site space available for repurposing as a result of the relocations.
tions that could be relocated off-site, functions that had to remain in the hospital and to define the operational impacts. The team then developed a matrix defining small, medium and large off-site scenarios which scenario was then selected, weighing departmental considerations, potential system strategies and long-term opportunities. The recommended scenario quantified the need for an approximately 150,000 BGSF Off-Site Service Center. To support the transportation logistics between the main campus, community-based inpatient facility and satellite locations, additional vehicles and employees would be required. A shared service model was explored to identify potential inter-departmental synergies aimed at transportation and staffing efficiencies.
PAGE 2 | case study: off-site service center \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\
While desirable to have vacated space on the main campus as a result of support service relocation to the Off-Site Service Center, it is unlikely that there will be a net-gain of space due to the significant under-sizing of current services and the increased space demand as a result of projected growth. The shift of select aspects of support services to the off-site location, however, will allow appropriate sizing of departments, proper departmental relationships and adjacencies and potential operational efficiencies as necessary to support future Health System demand.
FUTURE STATE FEARS
CURRENT STATE PROBLEMS
Feasibility Study OPERATIONS/ PROCESSES ADAPTABILITY
SERVICES
QUALITY OF SPACE MAINTAIN SIMILAR RESPONSE TIMES & CAPABILITIES ONSITE WHEN OFF-SITE IS BUILT
REGULATORY
SPACE ADEQUACY
LOGISTICS
PREDICTIVE SERVICES SERVICES
DECENTRALIZED DECENTRALIZED STORAGESTORAGE INEFFICIENCIES INEFFICIENCIES
TRAFFIC/ TRAFFIC/CONGESTION CONGESTION @ @LOADING LOADINGDOCK DOCK
LACK OF SPACE -LACK BEDSOF SPACE - BEDS - SUPPLIES - SUPPLIES - INVENTORY - INVENTORY - BIOMED - BIOMED -HOMECARE -HOMECARE
PRESSURE PRESSURE OF VERTICAL VERTICAL OF CIRCULATION CIRCULATION TRANSPORT SURGICAL SOILED CARTS IN A TIMELY MANNER
STRATEGY
SERVICE LEVEL AGREEMENT
REGULATORY
CHANGE MANAGEMENT
LOGISTICS
STAFFING
NOT THINKING THROUGH PROCESSES
ABILITY TO PROVIDE SIMILAR RESPONSE TIMES & CAPABILITIES
REGULATORY COMPLIANCE
CUSTOMER ALIGNMENT
EMERGENCY MANAGEMENT SYSTEM CONTINGENCY PLAN
EMPLOYEE ENGAGEMENT
NOT PLANNING FAR ENOUGH OUT
24-HOUR ACCESS TO SERVICE CENTER. ASSETS READILY AVAILABLE.
INFECTION CONTROL COMPLIANCE
SILO MENTALITY CONTINUATION OFF-SITE
INBOUND / OUTBOUND ACCESS TO LOADING DOCK
STAFFING IMPACTS
PLAN “B” IF OFF-SITE DOES NOT GET APPROVAL
ABILITY TO PROBLEM SOLVE ON-SITE
TRAFFIC
UNION VS. NON-UNION
INVENTORY TRACKING/ MANAGEMENT SYSTEMS
MISSION VISIBILITY
MULTIPLE LEADERS SHARED SAME CONCERN
ON-SITE REMAINING SPACE USED EQUALLY & EFFECTIVELY
OFF-SITE SUPPORT SERVICE CENTER FEASIBILITY STUDY We worked with health system leadership to identify potential departments (or portions of) that are viable for off-site service relocation. Departments identified include: Supply Chain & Procurement, Central Processing, Biomedical Engineering, Pharmacy, CallCenter, select Lab Services, Home Care, Environmental Services, Dietary Services, Information Technology, Construction Mock-Ups, Facilities and General Storage. In order to finalize the departmental selections and determine department components to consider for off-site relocation, we conducted workshops which evaluated departmental activities, future work processes, and synergies with the mindset of streamlining workflows, minimizing waste and creating efficiencies. These workshops provided employees and staff with the opportunity to gauge what they believed would be the best strategies for successful departmental operations and engagement of the work force at both an off-site service center and the System’s main campus . This new model of support service delivery is anticipated to yield greater operational efficiencies for the System and will positively influence their “patient and family first” mission.
Team thinking while designing new units No silo meetings during design phase
Opportunity to clean out the garage
Inventory management systems
\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\
Emergency Preparedness
case study: off-site service center | PAGE 3
\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\
Current State SCENARIO REVIEW BY DEPARTMENT Supply Chain
•
Preventive Maintenance to be located at Off-Site Service Center Consider a cellular phone program for staffing efficiencies of those working at an off-site location
•
Consider ability to support research and clinical functions
•
•
Consider ability to store product for select Lab Services and Pharmacy
•
Information Systems / Information Technology
Disaster supplies to be stored on-site
•
•
Acceptable to maintain space for clinical equipment on and off-site
New equipment infused into the system will be received and processed at the Off-Site Service Center
•
Low priority break-fix to be managed off-site
•
Storage required for 12 days off-site and two days on-site
•
Construction special project staging can be off-site
•
Supply Chain staff will assume responsibility for packing/ unpacking at the Off-Site Service Center
Central Processing Department
•
Ideal to provide instrument processing for inpatient platforms and ambulatory surgery centers. Consider stat instrument processing at all sites.
Environmental Services Department/Linen/Bed Storage
•
Pick off-site and deliver a day’s worth of product
•
Scrub and linen picking can be off-site
•
Bed storage can be off-site with base levels at each hospital
•
Assess if total number of linen carts are fully utilized
•
Assess cost of rental vs owning materials and supplies
•
Existing Ambulatory Surgery Center processing space to remain as-is
•
Consignment trays and vendor products to remain on-site
•
Ensure enzymatic spray protocol for proper transportation of soiled instruments to an off-site location
•
No shared transportation - dedicated clean and soiled trucks.
Pharmacy
•
All cases to be transported in case carts.
•
•
Consider aligning staffing with Supply Chain for soft-goods picking
Biomedical Engineering
Select Lab Services
•
candidates for off-site relocation
Agreement that non-pharmaceutical product storage can be off-site however other functions should remain at the hospitals
•
Evaluate opportunities to share services and storage between Pharmacy and Home Care services
•
Desirable to move as much off-site as possible
•
New equipment infused into the system will be received and processed at the Off-Site Service Center
•
Replace and transport broken equipment to appropriate location for repair
Facilities
•
Call Center and minimal storage can be off-site
•
Staff must be at hospitals for STAT repairs
•
Facilities workshops to remain on-site
•
Infection Control Risk Assessment barriers / construction materials and supplies to remain on-site
IT
PROCUREMENT
Ultimately decided that Lab services were not viable
Dietary Services PHARMA
BIOMED
SUPPLY CHAIN
ENVIRONMENTAL SERVICES CENTRAL PROCESSING
DIETARY SERVICES
MISC STORAGE
•
Ingredient prep/control, storage and bulk production can be at the off-site location
•
Hours of operation to be determined in the future
•
Need for refrigerated box trucks for transportation
•
Consideration of vendor deliveries and schedule is required
Call Center
•
Ultimately decided that Clinical Call Center was not a viable candidate for off-site relocation
OPONL
PAGE 4 | case study: off-site service center \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\
\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\
Who We Are
SERVICES RECOMMENDED FOR INCLUSION AT THE
ARRAY-ARCHITECTS.COM
OFF-SITE SERVICE CENTER
•
Supply Chain and Procurement
•
Central Processing Department
•
Biomedical Engineering
•
Environmental Services Department / Linen / Bed Storage and Repair
•
Non-Pharmaceutical Storage / Home Care
•
Information Systems / Information Technology
•
Facilities
•
Dietary Services
•
Conference and Staff Support/Amenities to serve the Off-Site Service Center
•
Miscellaneous Storage
We Are Healthcare Architects We are a team of architects and designers with unique backgrounds, but we all have one thing in common - we share a strong desire to use our expertise and knowledge to design solutions that will help people in moments that matter most.
The next steps for the Health System is to prepare a detailed
This focus makes us leaders in our field. There’s a degree of compassion, empathy, and sensitivity that goes into every project that we touch. It’s designing a team center with sight lines to every patient. It’s building a Behavioral Health facility without corners, so that patients are safe. It’s translating the operational needs through the technical details to fine tune the lighting system in a neonatal unit so caregivers can match the lighting to each baby’s stage of development. It is a deeper understanding, honed through relationships spanning
business case to support the Off-Site Service Center.
decades.
PROPOSED FUTURE STATE
Together, we discover optimal solutions with our clients. It is our four decades of specialization that allows for effective communication, collaboration and precision in the complex, changing world of healthcare.
•
High level validation of each Department’s proposed future state
•
Work with departments to refine on-site and off-site requirements
•
Develop department-specific evaluation criteria and operational plans
•
Define high-level timeline for relocation of services to the off-site service center
We believe strongly in sharing our expertise and knowledge with others. We invite you to explore each of our thought leaders and share your thoughts with the healthcare design community.
•
Develop detailed business case
Click here to visit our Thoughts page.
Array’s Knowledge Communities
Click here
to view our thought leadership on continuous improvement
\\\\\\\\\\\\\\\\\\\\\\\\\\ case study: off-site service center | PAGE 5
Published: December 2018
Boca Raton / Boston / New York City / Philadelphia / Washington