Capital Project Solutions – August 2011
Facility Readiness- Is Your Team Ready For The Move? Gary P. Wilkinson Senior Consultant
The “Three Legged Stool� It is not a hyperbole to say that a well defined and executed Relocation Plan resembles that of a three legged stool. Last month, we discussed that Operational Readiness involves planning for new processes and practices that define the way an organization will conduct business in a new facility. It requires an emphasis on review and design of clinical and business operations to allow their future state to be in harmony with the changed physical environment, thereby enabling the organization to achieve desired outcomes. The effort to achieve true Operational Readiness will involve education, training, and orientation that must be effectively coordinated and balanced with the Facility Readiness and Move Management components of the overall relocation planning work. If the future state of operations was well defined and integrated into the design effort from the onset of the project, achieving Operational Readiness will be the result of more implementation planning and less process redesign work later on in the project delivery process. Running parallel to planning and coordinating the operational components of the relocation strategy is the Facility Readiness piece. There is an abundant amount of preparation that must be done in order for the facility to be completed in time for the patient move. The absence of a well defined Facility Readiness Plan will pose the biggest risk of any activity associated with relocating into a new facility. Facility Readiness Plan The development of a Facility Readiness Plan centers on preparing the building and/or facility to accept patients and
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Capital Project Solutions – August 2011
hospital operations. It is well understood at the most basic level that in order to begin operations, construction will be complete and all building systems will be installed. To make that happen it is important to understand many of the more detailed components that must be completed to ensure a successful transition. Equipment Procurement Process: Throughout the course of the design and into construction, numerous planning and coordination meetings will be held with almost every stake holder in the hospital to review needs and requirements for medical equipment. Careful planning as to architectural parameters as well as mechanical, electrical, and plumbing details is needed to ensure that the equipment will be installed correctly and prevent costly change orders later down the road. One planning element that cannot be avoided is the detailed coordination of the procurement process associated with equipment. To guarantee the successful distribution of the medical equipment there are many key decisions that must be made: Equipment Delivery Model - Will the medical equipment be shipped “Just in Time� (JIT) or will an offsite warehouse be used? Often times with larger projects, the JIT method is extremely difficult due to loading dock constraints, the size of the equipment and number of pieces being delivered. Hospital Receiving Methods - Once the medical equipment is received at the facility there are numerous hospital protocols that must be followed. How will the following be coordinated? o Asset tagging o Biomedical checks o Delivery of equipment to end point location o Assembly of equipment o Hanging and placement of equipment A definitive equipment procurement process must be developed to ensure that these questions do not become problems during this chaotic phase of the project. It is recommended that a mover/logistics firm be engaged after you complete the Design Development phase to coordinate these activities. By hiring a firm of this nature prior to the issuance of the purchase orders, a 2
Capital Project Solutions – August 2011
streamlined procurement and delivery process can be established; thus eliminating chaos when the equipment is delivered. IT Systems: Often in capital healthcare projects, the Information and Technology budget is second only to that of construction. For many healthcare facilities, the race to keep up with the ever changing and advancing technologies is almost unwinnable. With the vast amount of systems and applications that are being installed and constructed in facilities today, it is crucial to coordinate the following to prepare the facility for a timely move. Training, Training, and More Training - Prior to moving into any facility and “Going Live”, the most difficult and cumbersome aspect is getting all of the end users trained and indoctrinated on all of the new IT applications and systems. These systems not only affect the clinicians; but registration, accounting, and medical records applications as well. The most critical element concerning training is to allow enough time between the issuance of the Certificate of Occupancy to the actual “Go Live” date. Far too often, healthcare organization do not allow sufficient time to properly train staff on new systems which results in total chaos and confusion in the new facility. Proper training is achieved when specific systems training is combined with a comprehensive macro level education on how each system works together to influence workflows and operations. It is not enough just to have the vendors come and train on each system independently. Develop and IT Implementation Team - The best way to keep your project on schedule and prepared for Move Day is to make sure that there is a dedicated team to lead and coordinate all of the IT related items. In most cases, there is a “Technology Consultant” or “Low Voltage” planner that assists in the design of the IT systems. However, to assume that they will be there to follow through on the installation, certification, testing, and training of the systems is a mistake made by too many hospital 3
Capital Project Solutions – August 2011
leaders. The IT Team should be responsible for identifying gaps in this process as well providing solutions for the gaps. We recommend that you look at options for contracting all technology systems through a Technology Integrator rather than having multiple systems installed by multiple parties that are managed by multiple individuals. Schedule and Accountability: There is no doubt that by the time the project is coming to a close and the Facility Readiness planning is in full swing, the owner has seen his/her fair share of schedules. Information such as Overall Project Schedules, Near Term Schedules, and Milestone Schedules have all made their way across his/her desk more than a time or two. However, in the case of planning the “Go Live” date and preparing the facility for the event, it is necessary to develop the Relocation Schedule so that dates and durations that are critical can be successfully managed. One helpful way to track the Relocation Schedule is to form a Facility Relocation Committee. This Committee should be composed of key stakeholders from the hospital Facility and Operational Team, IT and Medical Equipment Representatives, Construction Team, and hospital administration. This Committee will hold teams accountable as well as monitor and track the Relocation Schedule to ensure that deadlines are being met. Conclusion There are many moving parts associated with preparing for Facility Readiness. Success in this phase of the project is dependent upon the attention given to detail in the implementation of the building plan. Streamlining all medical equipment and IT functions is just one step in the right direction for a smooth relocation. Combined with oversight by the Facility Relocation Committee of key stake holders and one can begin to build a Facility Readiness Plan that is achievable and easily implemented. 4