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
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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
Room 3
Room 4
Room 5
Room 6
7:30 AM
Provider 2 starts at 8:10 AM
Provider 3 starts at 8:40 AM
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9:50 AM
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0.750.75 1.75
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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. 4:00 PM
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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