Health: Planning and Strategies

03 | Planning Object

― Planning and Strategies: Health

Solutions for a complex and evolving health industry

Community Design Transformation

Contents

Introduction ― 4 Services ― 8 Strategic Planning ― 12 Operational Planning ― 16 Facility Planning ― 20 Process Improvement ― 24 Functional Space Programming ― 28 Master Programming ― 32 Strategic Facility Master Planning ― 36

Results ― 40

Front Cover: Wyckoff Health Improvement District, Wyckoff Heights Medical Center, Brooklyn, New York Left: Baton Rouge Health District, Baton Rouge Area Foundation, Baton Rouge, Louisiana

Introduction

We focus on highly efficient solutions through collaborative problem-solving.

4

People

Process

Place

Technology

We’re a multidisciplinary team of clinicians, industrial engineers, architects, hospital administrators, and executive strategists that work together to yield exceptional results for our clients.

By simultaneously addressing people, process, place, and technology, we help our clients find new solutions to their current and future health facility needs. Our unique approach integrates strategic and operational expertise into the design process—ensuring our solutions are practical and implementable.

5

Introduction

Our services extend from planning to post-occupancy evaluation, enabling continuous improvement.

Healthcare is complex. To assist health systems in implementing the best solutions, our integrated experts serve as liaisons in all phases of planning and design.

← Planning workshop with client representatives

↓ Process framework

Plan

Define

Market Assessment Visioning

Operational Planning Space Programming

Strategic Planning Financial Planning Facility Assessments Master Facility Planning

Conceptual Design Technical Due Diligence

Client

Evolve

Implement

Post-Occupancy Evaluations Standards Refinement Change Management

Process Improvement Transition Planning and Activation

7

Services

― OUR APPROACH

Our expertise covers the three important perspectives of healthcare planning: strategy, operations, and facilities. Our integrated approach respects the complex nuances of each segment, with each informing the end result.

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Key Services 1. Strategic Planning 2. Operational Planning 3. Facility Planning 4. Process Improvement 5. Functional Space Programming 6. Master Programming

Strategy

7. Strategic Facility Master Planning

1 6

5 7 Operations

2

Facilities

4

Specialty Services Market Assessment Population Health Assessment Forecasting – Workload, Space Needs, Capital Needs Visioning Facilitation Simulation Modeling Process Mapping Facility Assessments Benchmarking Post-Occupancy Evaluation

9

3

10

The Moses H. Cone Memorial Hospital North Tower Vertical Expansion Greensboro, North Carolina

“This complex expansion of surgery and emergency services required careful collaboration with our client to minimize operational disruption.”

— RICHARD HERRING, ATLANTA STUDIO

11

Services

Strategic Planning

← Regional analysis of acute care beds

MASTER PLANNING KICK OFF

↓ Evolving the levels of care discussion and definition Evolving levels of care

Tertiary/ Quaternary Care Inpatient Outpatient

CREATE SCALE

Emergency Care

CREATE RESPONSIVENESS

Specialty Care Major diagnostic & treatment

CREATE COMPREHENSION

Primary Care (Standard) Lab, Pharm, Light Imaging Ancillary Support (SW, RD, Rx) & Behavioral Health Low Acuity Lab, Pharm

Primary Care (Retail/Virtual) Urgent Care 12

CREATE RELATIONSHIP

CREATE CONVENIENCE CREATE ACCESS

― OUR APPROACH

Understanding market dynamics is the first step in rationalizing our clients’ service delivery strategies and real estate portfolios.

↑ Patient origins with drive times

→ Primary care networks

13

14

Hamad Medical City Simulation Center Doha, Qatar

“The center repurposes an existing building into an expanded medical training facility.”

— JONES LINDGREN, ATLANTA STUDIO

15

Services

Operational Planning

― OUR APPROACH

Focused on optimizing throughput and staff resources, integrated operational planning is the foundation of our clients’ service delivery success.

SAINT FRANCIS SURGERY NEED FORECAST

CURRENT VOLUMES | CURRENT ALOS

GROWTH ANNUAL SURGERY GROWTH

CURRENT DATA YR

2016

0.00 % 0%

PROJECTION PERIOD

4

years

project to 2020

5%

GROWTH THROUGH 2020

0.00 %

OPERATING VARIABLES - INPATIENT PEAK WEEKS/YR

DAYS/WEEK

52

5.5

TOTAL CURRENT CASES

17,786

cases

HOURS/DAY

8

% PTNTS / PEAK

90

% OCCUPANCY

71

%

%

AVERAGE ROOM TURN TIME

45 minutes TOTAL FUTURE CASES

17,786

15

cases

60

OPERATING VARIABLES - OUTPATIENT PEAK WEEKS/YR

DAYS/WEEK

52

5.5

THROUGHPUT PER OR (28 ORs)

635 cases/OR/yr

ROUND UP:

OR NEED

27.2 ORs

% PTNTS / PEAK

% OCCUPANCY

100 %

71

45 minutes 15

OR NEED AT 2020*:

8

AVERAGE ROOM TURN TIME

*Model assumes fully flexible ORs.

FORECAST RESULTS

HOURS/DAY

%

SERVICE LINE Anesthesiology Cardiothoracic Vascular Cardiovascular Colorectal Dental Surgery Dermatology ENT Gastroenterology General Maxillofacial Neurosurgery Ob-Gyn Ophthalmology Orthopedics Pain Pathology Plastics Podiatry Pulmonary Thoracic Urology Other

NUMBER OF CASES INPATIENT OUTPATIENT

3 928 293 102 20 0 153 22 2,952 32 792 169 11 3,109 2 33 227 62 23 173 649 0

1 43 127 99 240 0 671 20 2,150 30 146 1,099 181 1,033 0 30 632 29 49 7 1,444 0

ALOS / PROCEDURE (minutes) INPATIENT OUTPATIENT

49 247 143 186 92 0 74 45 124 149 149 117 108 127 69 32 120 61 55 146 112 0

21 215 87 62 100 0 63 37 81 81 122 89 92 91 0 37 116 71 62 98 79 0

60 5.0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0

Inpatient Outpatient

INPATIENT NEED

16.4 ORs OUTPATIENT NEED

10.8 ORs

28 ORs

Interactive dashboard provide real time analysis, based on dynamic variables.

16

URGENT CARE CENTER INTAKE OPERATIONS PLAN

Chief Complaint/ Armband

WalkIn

Arrival RN UCC Check-In

Room Available?

Yes

Escort to Exam Room

Complete Triage

Register Patient

Place Orders/ Complete InRoom Tests

Place Orders/ Complete InRoom Tests

RN

Mid-Lvl & RN

PFS

Mid-Lvl & RN

Mid-Lvl & RN

Exam Room

Exam Room/ Bedside

Exam Room

Exam Room

Check-in to Room

cont’d UC 1.2

No

Register Patient

Direct to Wait

Call Patient Back to Triage

Complete Triage

Direct to Wait

Escort Patient to Exam Room

Place Orders/ Complete InRoom Tests

PFS

PFS

Triage RN

Mid-Lvl & Triage RN

Triage RN

RN

Mid-Lvl & RN

Registration Desk

Waiting Room

Waiting to Triage

Triage Room

Waiting Room

Exam Room

Exam Room

OPERATIONS PLANNING Top Urgent care center intake operations plan Right Patient room zones

17

cont’d UC 1.2

18

University of Virginia, University Hospital Expansion Charlottesville, Virginia

Our virtual reality ‘mockup’ visioning methodology enabled immediate buy-in from the client and staff.

19

Services

Facility Planning

EXISTING

LEVEL 08

LEVEL 07

LEVEL 06

LEVEL 05

BONE MARROW PICU

NEURO (STEPDOWN)

NEURO ICU

ACUTE CARE

SICU

SHELLED

NICU

SHELLED

(TBD INPATIENT)

NEURO (ACUTE CARE)

ORTHOPAEDICS (ACUTE CARE)

SHELLED

STEPDOWN

ACUTE CARE

PSYCH

ICU (28 BEDS)

CARDIAC

ICU (28 BEDS)

TRANS NURSERY

CARDIAC

LEVEL 04 LEVEL 03

WOMEN’S L&D

PEDS ACUTE

WOMENS ACUTE

PEDS ACUTE

ACUTE CARE

MICU

NEW

ICU

ACUTE CARE

DIALYSIS

MSICU

ICU (28 BEDS)

GERI.-PALL.

MECHANICAL

LEVEL 2M

LAB / BLOOD BANK

LOCKERS

LOUNGE

LEVEL 07

LEVEL 06

LEVEL 05

LEVEL 04 LEVEL 03

LEVEL 2M

HEART CENTER

SHORT STAY

SURGERY

HEART CENTER: CATH & EP

INVASIVE SERVICES

FOOD SERVICES

PA T

IMAGING SUPPORT SERVICES

ED SUPPORT / IMAGING

EMERGENCY

LEVEL 02

LEVEL 02

LEVEL 01

LEVEL 08

DIGESTIVE HEALTH

ENDO

HBO

SUPPORT SERVICES

LEVEL GR

ASD

EXISTING

AMBULANCE

SUPPORT SERVICES / BASEMENT

LEVEL 01

LEVEL GR

NEW

↑ Stacking diagram

↓ Plan flow diagram

Arriving patients dnd visitors To and from PACU / Phase Ii recovery or inpatient beds To and from prep and procedure

ADMIT / REG PREP / PHASE II (19) 17 GEN+2 ISOL RMS

SURGERY SUPPORT/ ADMIN

VACATED CARDIO CLINIC (9,980 SF)

EXISTING PATHOLOGY

(26) PREP / PHASE II: 19 GEN+3 ISOL+4 BLOCKS

EXISTING BLOOD BANK

Arriving patients and visitors To and from PACU / Phase Ii recovery or inpatient beds To and from prep and procedure

(49) ADULT PACU: 43 GEN+6 ISOL RMS

IMRI

PREP / PHASE II (33)

INTERVENTIONAL PLATFORM

From procedure to PACU

20

― OUR APPROACH

We assist health systems in understanding their real estate assets: current state and fitness for future purpose.

↓ Building components

EXTENSION OF EXISTING

NOTCH

GREEN ROOF

CORE AND HELIPAD

GREEN ROOF

LOBBY/DROP OFF

NCEPT DIAGRAMS

VERSITY HOSPITAL EXPANSION

21

22

CARTI Little Rock, Arkansas

“Our Lean methodologies resulted in improved workflows and throughput processes within this new facility.”

— MARVINA WILLIAMS, ATLANTA STUDIO

23

Services

Process Improvement Process Detection

Process

Process

Process

RNA

CRNA

244 SF

130 SF

Process

Process

Process

Process

Pre PCR

Template

PCR

RT PCR

225 SF

225 SF

148 SF

244 SF

I nputting

Process 140 SF

Process

Extraction

Process

Process

Master Mix

PCR

205 SF

514 SF

Process

Process

Process

Analysis

Chair Review

Pathologist Review

150 SF

120 SF

170 SF

Accessioning

Process

473 SF

Process

418 SF

DNA

Labeling 244 SF 140 SF

Process I nputting

157 SF

Process Accessioning

314 SF

Process

Process

Tissue Processing

Processing

Process

Process

Pre PCR

Detection

244 SF

140 SF

Process

Process

Process

Processing

Pre PCR

Template

157 SF

537 SF

200 SF

Process

Process

PCR

RT PCR

539 SF

200 SF

Process Master Mix

Process

200 SF

Research

Process

Process

PCR

Analysis

200 SF

422 SF

428 SF

Current state

Process CRNA

Process Detection

120 SF

Process

Process

Process

Accessioning

I nputting / Labeling

Processing

300 SF

100 SF

250 SF

Process

Process

Process

Process

Process

Process

Process

Ext r a ct ion RNA / DNS/ Tissue

Pre PCR

Template

PCR

RT PCR

Analysis

Chair Review

Pathologist Review

800 SF

1000 SF

300 SF

1000 SF

300 SF

900 SF

200 SF

120 SF

Process

Process

Process

Master Mix

PCR

300 SF

Process Research

500 SF

Future state

FUTURE STATE CMDL

24

300 SF

― OUR APPROACH

Process improvement enhances workflow, saving space and money while also ensuring user satisfaction.

Sports Medicine Flow 2 – Flexible Provider Based S Practitioner 1 Room 1 7:30 AM

Provider 2 starts at 8:10 AM

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Sports Medicine Flow 2 – Flexible Provider Based Scheduling Practitioner 2

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Provider 2 starts at 8:10 AM

Provider 3 starts at 8:40 AM

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Process maps showing reduction 1.75 of inefficiencies 3:40 PM 0.75 0.1 0.75 1.75 0.75 1.75 3:50 PM 1.75 0.1 0.75 0.75 1.75 1.75 between current and future states.

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0.75

0.1

0.75

0.75

1.75

0.1

1.75

0.75

0.1

0.75

1.75

0.75

1.75

1.75

0.1 0.75

0.75

0.1

1.75

0.1

0.1

0.75

0.75

0.75

0.1

0.75

1.75

1.75

0.75

0.75

0.75

0.1

0.1

0.75

1.75

0.1

0.75

0.75

1.75

1.75

0.75

0.1

0.1

1.75

0.75

0.1

0.75

0.75

1.75

0.1

0.75

5:10 PM

0.1

5:20 PM

0.1

5:30 PM

0.75

0.75

0.1 0.75

1.75

0.1

0.75

0.75

0.75

5:40 PM 5:50 PM

0.1 0.75

1.75

0.75

0.75

0.1

0.1

0.75

0.75

0.1

0.1

0.75

0.1

0.1

6:00 PM

0.75

6:10 PM 6:20 PM

Total

6

4

4

5

4

Legend Registration / Check out

5

4

1.75

0.75

0.75 1.75 0.750.75 0.1 0.750.75

1.75

0.75

0.75

1.75

0.75

3:50 PM1.75

1.75

0.75

0.75

3:40 PM0.75

0.75

0.75

0.75

0.75

1.75

0.75

0.75

1.75

0.1 0.1

0.75

0.75

0.1

1.75

0.75

0.75

0.75

0.75

0.1

0.1

0.1

1.75

1.75

0.75

0.1

0.75

1.75

0.75

0.75

1.75

0.750.75 1.75

0.1

1.75

0.75

1.75

0.1

0.75

1.75

1.75

1.75

3:20 PM

12:30 PM

1.75

0.11.75

0.75 0.1

1.75

1.75 0.75

0.75

0.1

0.10.75 0.75

0.75

1.75

1:10 PM

0.1

0.75 1.75

0.1

0.75

1:00 PM

0.75

1.75 0.75

0.75

0.75

12:10 PM 12:20 PM

0.75

0.1

0.75

1.75

0.75 0.1 0.75 0.75

3:10 PM

0.1

1.75

1.75

0.75

0.75 1.75

0.75 1.75 1.750.75 0.1

0.1

0.75 1.75

0.1

0.1

0.1

0.75

0.75

1.75 1.75

1.75

0.75

0.75

1.750.75

0.1

1.75

0.75

10:50 AM

0.75

1.75

1.75

1.75

1.75 0.75

0.75

0.75

1.75

2:20 PM

0.1

0.75

0.75

0.75

1.75

1:00 PM

0.75

1.75

1.75

0.75

0.75

1.75

1.75

0.75

0.75

0.1 0.75

0.1

10:10 AM

10:40 AM

1.75

0.1

10:00 AM

0.75

0.1

0.75

0.75

0.1

0.75

0.75

11:50 AM

1.75

0.75

Room 12

11:30 AM

1.75

0.1

0.75

11:40 AM

0.75

0.75

1.75

0.75

12:30 PM 0.1

1.75

0.75

0.75

0.75

0.1

1.75

0.1 0.75

0.1

0.1

0.75

0.75

0.75

0.75

0.75

1.75

1.75

0.1

0.1

0.1

0.75

1.75

0.75

Room 11

0.75

0.75

0.75

0.1 0.75

1.75

1.75

0.75

0.1

0.75

Room 10

1.75

0.75

0.75

Practitioner 30.1 0.75 1.75

1.75

0.75

12:10 PM0.75

1.75

0.1

1.75

0.1

0.75

11:10 AM

12:20 PM0.75

1.75

0.75

0.75

1.75

11:20 AM

0.75

0.75

12:50 PM

0.75

Room 9

0.75

0.75

1.75

0.75

0.1

0.75

0.75

0.75

0.75

0.75

0.75

9:10 AM

10:20 AM

1.75

0.1 0.75

9:20 AM

0.1

1.75

0.1

0.1

0.75

9:30 AM

0.75

1.75

0.75

0.1

0.75

0.1

0.75

0.1

0.1

0.1

0.1

0.75

1.75

0.75

9:30 AM

0.75

0.1

1.75

0.1

9:40 AM

0.75

8:50 AM

0.75

0.1

Room 4

0.75

8:40 AM

11:00 AM

8:20 AM

10:30 AM

0.75

7:50 AM

10:10 AM

Room 7

7:20 AM Provider 1 starts at 7:40 AM

7:40 AM 8:00 AM

10:00 AM

Practitioner 1 Room 2

Room 3

Provider 1 starts at 7:40 AM

Provider 3 starts at 8:40 AM

Room 1

Room 2

7:20 AM

5

3

6

25

4

4

5

4

5

4

5

3

6

4

4

5

4

5

4

5

3

26

American University of Beirut Medical Center, New Medical Center Expansion Beirut, Lebanon

“Now under construction, this building will be the connector of the medical center to the research and academic campus.”

— JEAN MAH, LOS ANGELES STUDIO

27

Services

Functional Space Programming

New Addition

95 Building

OP Diag Heart Clinic Offices Pre/Po Imaging st – OP Imaging

South Tower

Surgery Logistics & Surger

Mechanical Shell Beds Shell Beds Shell Beds Shell Beds Acute Beds Acute Beds Critical Beds Shell Clinical Shell Surg.

Mechanical y OP

Cath – EP Surgery – CVOR – Pr ep/Post Logistics

CEP Plaza & Below Grade Parking Deck – 3 Levels Approximately 140 Spaces

↑ Stacking diagram

→ Comparative facility benchmarks

― OUR APPROACH

Driven by operational optimization, our space programming aligns physical needs with future state operational goals.

28

2012

2020

2012

2020

2017

Greenfield Projects (Overall Summary)

Year Built

Project A North Texas

Project B South Texas

Project C Pennsylvania

Project D South Texas

Project E Northern California

Hospital Type

Not-for-Profit

For-Profit

Not-for-Profit

Critical Access

Academic Pediatric

Hospital Beds Day One

84

75

170

45

198

Hospital Beds with Future Shell

132

72

172

45

198

Total Departmental Gross Area (DGSF)

152,189

133,788

294,059

153,080

352,832

Interdepartmental/Building Circulation

17%

13%

11%

8%

Mechanical/Electrical Infrastructure

4%

19%

6%

1%

Exterior Wall Estimate

5%

3%

5%

6%

DGSF>BGSF Grossing Factor

Min

Max

Avg

27%

8%

27%

15%

13%

1%

19%

9%

8%

3%

8%

5%

1.15

1.48

1.29

1.26

1.35

1.23

1.15

1.48

192,027

179,435

361,915

175,820

521,378

BGSF/Bed

2,286

2,392

2,104

3,907

2,633

2,104

3,907

2,665

BGSF/Bed (with future shelled beds)

1,455

2,492

2,104

3,907

2,633

1,455

3,907

2,518

Total Building Gross Area (BGSF)

12%

3%

15%

28% 42%

Year Built

2014

2018

2019

2019

2017

Expansion Projects

Project F North Texas

Project G North Texas

Project H North Texas

Project I Oklahoma

Project J Southern California

Hospital Type

For-Profit

Not-for-Profit

For-Profit

For-Profit

Academic

Project Beds Day One

320

28

90

144

105

Project Beds with Future Shell

320

56

90

144

140

Min

Max

Avg

Total Departmental Gross Area (DGSF)

548,541

66,750

80,309

299,779

204,816

Interdepartmental/Building Circulation

13%

11%

12%

18%

11%

11%

18%

13%

Mechanical/Electrical Infrastructure

2%

23%

22%

16%

9%

2%

23%

14%

Exterior Wall Estimate

9%

7%

13%

5%

5%

5%

13%

8%

DGSF>BGSF Grossing Factor

1.24

1.42

1.47

1.39

1.25

1.24

1.47

1.35

307,227

94,635

117,977

416,247

255,736

BGSF/Bed

960

3,380

1,311

2,891

2,436

960

3,380

2,195

BGSF/Bed (with future shelled beds)

960

1,690

1,311

2,891

1,827

960

2,891

1,736

Total Building Gross Area (BGSF)

4%1% 12% 21%

62%

INPATIENT

DIAGNOSTIC & TREATMENT

SUPPORT SERVICES

29

PUBLIC ADMINISTRATION

OUTPATIENT

30

Memorial Sloan Kettering Monmouth Regional Cancer Center Middletown, New Jersey

“Our post occupancy evaluation determined how spaces are working, captured data to use as a benchmark for future decision making, and provided best practices for future projects.”

— ANTHONY MISTRETTA, LOS ANGELES STUDIO

31

Services

Master Programming WING 1

LEVEL

BEDS

UNIT / DEPARTMENT

P

WING 2

BEDS

UNIT / DEPARTMENT

SP

WING 3

P

SP

NICU

5

16

21

UNASSIGEND PATIENT BEDS

14

2

16

P

SP

VIP

2

0

2

11

0

11

TECHNOLOGY

4

3

MEDICAL / SURGICAL

42

6

48

ON-CALL TECHNICAL

PARENT CENTER

PICU

16

0

HEART CENTER

16

16

0

16

CATH LAB

DIALYSIS

2

1

BEDS

UNIT / DEPARTMENT

DAY SURGERY / PREP-POST

PACU

SURGERY

ADMINISTRATION

ADMINISTRATION & FINANCE

DOCTORS' OFFICES

PUBLIC / STAFF LIBRARY

CLASSROOMS

REHABILITATION UNIT (INPATIENT)

AUDITORIUM

13

2

15

OUTPATIENT DEPARTMENT LOBBY DISCHARGE

ADMINISTRATION

CHILD DEVELOPMENT CENTER

LINEN

HSKPG

IMAGING

BULK STORAGE TECHNICAL

MENTAL HEALTH

PHARMACY (OUTPATIENT) EMERGENCY DEPARTMENT

ADMISSION & CUSTOMER HAPPINESS

BB

COFFEE SHOP

RESTAURANTS

LABORATORY & PATHOLOGY & RESEARCH LAB TEEN CLINIC

OUTPATIENT DEPARTMENT

LOBBY

G

MEDIA STATION

OUTPATIENT PHYSIOTHERAPY, SPEECH TEHRAPY, & REHAB

SOCIAL SERVICES

MATERIALS MANAGEMENT, BIOMED / FM

CALL CENTER

FOOD SERVICE

NUCLEAR MEDICINE

ADMIN

PHARMACY

STAFF LOCKERS & LOUNGE

MORTUARY

CENTRAL STERILE SUPPLY

TECHNOLOGY

SB

WING 1 BED TOTAL

Private Semi-Private All Beds

P

SP

71

8

79

WING 2 BED TOTAL

TOTAL BED COUNT 119 26 145

Top Departmental adjacencies Left Configuring the inpatient unit Opposite Stacking diagram

32

P

SP

35

18

53

WING 3 BED TOTAL

P

SP

13

0

13

ION

― OUR APPROACH

Master programming aligns projected workloads with future space needs to inform long-range planning.

LEVEL 08 PATIENT ROOMS LEVEL 07 PATIENT ROOMS LEVEL 06 PATIENT ROOMS LEVEL 05 PATIENT ROOMS LEVEL 04 PATIENT ROOMS LEVEL 03 PATIENT ROOMS

LEVEL 02M SURGICAL SUPPORT & BUILDING SUPPORT

LEVEL 02 INTERVENTIONAL PLATFORM

LEVEL 01 EMERGENCY DEPT

LEVEL 0G AMBULANCE ENTRY, BUILDING SUPPORT & LOADING DOCK

33

34

UTSW Radiation Oncology Dallas, Texas

“The first-of-its kind two-door vault creates a more efficient and pleasant treatment environment for patients and staff.”

— SAPNA BHAT, DALLAS STUDIO

35

Services

Strategic Facility Master Planning

― OUR APPROACH

We help our clients better understand their market and opportunities to reduce waste and optimize system resources.

All

3.13

Ministry Count

Bed Count

14

2,916

Bed Mix

Function by Ministry Admin

Semi-Private 1,318

System Score

3.13

Function

100% % of Total LOD Gross Dept SF

Assessment Score

Grossing Factor

Private Beds

1.34

1,598

Private 1,598

D+T

80%

Other Patient Care

60%

Support and Logistics 40%

20%

Building Count

(OSHPD Only)

Semi-Private Beds

152

1,318

4,344,105

Grossing Factor

Assessment Score by Ministry

HIR

MH

S R MS

MHL B

S JO

S MMC

QVH

S R MH

GHE

S JMC

S JE

HNB

P VH

Total Gross Square Feet

R MH

0%

SF per Bed 4.20

4,000

2,000 21 2

278

80

35

457

21 1

84

1 38

443

Hoag Hospital Irv..

Santa Rosa Memo..

Hoag Memorial H..

Santa Rosa Memo..

Mission Hospital L..

St Joseph Hospita..

Mission Hospital R..

St Mary medical C..

Petaluma Valley H..

St. Joseph Hospit..

Queen of the Vall..

St. Jude Medical..

Redwood Memori..

The General Hosp..

GHE

HNB

S JE

HIR

S JMC

QVH

S JO

P VH

R MH

MH

S R MH

S MMC

S R MS

S R MS

R MH

HIR

GHE

S JO

MHL B

QVH

S R MH

S JE

HNB

S JMC

MH

S MMC

P VH

MH

HIR

S JO

All

Building Assessment Score by Age

Extended Life 31.82% Optimal Life 43.27%

Obsolescent 24.91%

Avg. LOD Discipline Assessment Score

Functional Life

HNB

S JMC

S

0 S JE

R MH

P VH

QVH

M

S

HL B

MMC

S R MS

R MH

1

207

345

351

60 MHL B

1 .49

1 .50

1 .47

1 .42

1 .41

2.03

1 .39

3.38

1 .39

3.1 8

1 .29

3.1 8

1 .30

3.1 4

1 .22

3.03

1 .24

2.91

Region License Name

1

2

2.50

2.73

1 .1 7

2.48 2.03

2.65

15 6,000

SF/Bed

4 3

Grossing Factor 2 3

3.71

3.85

1 .1 5

4

GHE

Avg. LOD Discipline Assessment

5

5

4

3

3.080

2

1 0

5

10

15

20

25

30

35

40

45 Age

50

55

60

65

70

75

80

85

90

Facilities infrastructure assessment dashboard

36

Market Assessment

Forecasting

Assess the dynamics and demographics of services area population

Estimating future demand based on key demographics, market share, and utilization trends

Current Capacity

Current Volume

% OP

Actual Throughput per Capacity

Target Throughput per Capacity

Emergency Department

48

113,072

74%

2,355

1,250 – 2,000

Constrained

Surgical Services – Main

21

12,517

51%

596

750 – 1,000

Under Utilized

Cath & EP

7

6,885

40%

983

1,000 – 1,500

Achieves Target Throughput

Interventional Radiology

2

2,593

70%

1,296

1,200 – 1,500

Achieves Target Throughput

Endoscopy

6

6,010

77%

1,000

1,200 – 1,500

Under Utilized

9,788

8,000 – 10,000

Achieves Target Throughput

Department/Service

Capacity Condition

Imaging – Diagnostic Rad

7

68,518

Imaging – CT

8

38,943

15%

4,867

6,000 – 8,000

Under Utilized

Imaging – Ultrasound

9

20,617

37%

2,290

4,000 – 5,000

Under Utilized

Imaging – MRI

1

4,420

.01%

4,420

3,000 – 4,000

Constrained

10%

Gap Analysis

Scenario Development

Knowing your existing key capacities against modeled current and future need exposes challenges

Modeling forecasted activity to operational preferences calculates key program units of space

37

38

University of Cincinnati Gardner Neuroscience Institute Cincinnati, Ohio

“Our design team, including our Human Experience (Hx) Lab, partnered with the client to envision how neuro-architecture can create spaces that support the needs of neurocognitive patients.”

— AMY CORNELIUSSEN SICKELER, ATLANTA STUDIO

39

Results

How would you envision maximizing your operational efficiency?

01.

02.

03.

04.

Patient Safety

Nursing Efficiency

Improved Staff Efficiency

Lean Design Principles

We helped reduce patient fall incidents from 0.63 per 100 patient days in the old facility to 0.46 in the new facility.

Patient falls per patient day decreased by 27%.

Staff efficiency increased between 44% and 59% (depending on staff position and shift time) in a newly designed hospital unit.

130% improvement in walking efficiency for day-shift PCTs

Applying Lean design principles to a fasttracked emergency department redesign, we provided 241 hours of additional patient care each day.

90% improvement in walking efficiency for day-shift RNs 56% improvement in walking efficiency for night-shift PCTs 78% improvement in walking efficiency for night-shift RNs

40

Post-occupancy evaluations of our projects continually inform our design process.

05.

06.

07.

Staff Satisfaction

Reduced Length of Stay

Reduced Waiting Time

Staff turnover rates have declined over the past four years. With an average cost of $47,100 per turnover, data suggest the hospital may have benefited from an annual cost savings of between $1.3 million and $2 million.

ALOS reduction of 0.35 days translates into an annual savings of almost $5.3 million annually.

Using simulation modeling for surgical services at a major university hospital, we reduced average wait times from 52.8 minutes to 3.9 minutes.

41

Since 1935, we’ve demonstrated that design has the power to make the world a better, more beautiful place.

That’s why clients and communities on nearly every continent partner with us to design healthy, happy places in which to live, learn, work, play, and heal. We’re passionate about human-centered design, and committed to creating a positive impact in people’s lives through sustainability, resilience, well-being, diversity, inclusion, and research.

In fact, Fast Company named us one of the World’s Most Innovative Companies in Architecture. Our global team of 2,700 creatives and critical thinkers provides integrated services in architecture, interior design, landscape architecture, and more. Our partners include Danish architects Schmidt Hammer Lassen; retail strategy and design consultancy Portland; sustainable transportation planning consultancy Nelson\Nygaard; and luxury hospitality design firm Pierre-Yves Rochon (PYR).

For more information, contact: health@perkinswill.com