Shaping your quality health care

Consultancy services

Shaping your quality health care

Consultancy services

Simed International

Creating conditions for professional care

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Good planning forms the basis of all our projects.

Simed International

Our clients demand state-of-the-art working environments.

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Simed Consultancy services provides professional and creative solutions for health care institutions all over the world. With over a hundred years of experience, you can be sure that our team of consultants is dedicated to adding value to your ambitions in health care. Whether it is planning, project financing, design or project management, we offer tailor-made services with a client focus. Exceeding your expectations in care is our goal.

Tailor-made consultancy

tions. Sustainability is also an important Using its many years of experience, Simed principle for us. We see consultancy as Consultancy services is able to help you a broad concept that includes planning, firealise your health care project. We are nance and design, and which begins with familiar with the current trends and a study to gain insight into the feasibility market issues, relevant in both interof your project, a comprehensive study for national and local health care markets. a business plan, financial advice that is With this background, we identify your tailor-made to suit your circumstances, or specific needs and wishes and translate an architectural design for your hospital. these into a tailor-made solution.

With our knowledge, and through The Consultancy services team intensive contact with our clients, we Our consultants are experienced specialcan make an expert analysis of the task ists with backgrounds in medicine, archiat hand and put this into a wider pertecture, design, technology, finance and spective. Different factors are taken into construction. These individual qualities consideration ranging from the economic are exploited as a team when developing aspects of running a hospital to patient and realising a project. The interaction throughput in a specific department. This between the different qualities in our enables us to provide an efficient and team provides us with the unique opcustomised solution to your proposed portunity to cover all planning aspects in project. one team. We are driven, results-oriented Providing results-oriented consultancy, and provide solutions customised to your however, is not our primary objective. circumstances. Our team is specialised in Our main aim is to implement achievable planning health care infrastructures and solutions that are completely in line with we have planned many hospitals all over mutually determined framework condithe world.

Health care project planning

Simed International

Starting with a strong basis

Dirk Joubert (seated, left) Consultancy Manager with his team

Dirk Joubert is responsible for the Consultancy services department.

Together with his colleagues and other relevant parties, he works on translating a diverse range of client requests into realistic plans of approach. The resulting plan must meet all the client’s content and financial requirements.

“Thanks to the intensive contact with our clients, we can crystallise existing ideas, prioritise the various wishes and requirements, and clarify what is feasible”, Joubert explains.

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“Our clients value our ‘one stop shopping concept’ with multidisciplinary teams”

Discussing with doctors provides clear insight into the users’ requirements.

The consultancy process does not stop once the drawings have been completed; we also provide advice and support throughout the building stage.

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Cooperation and consensus between several disciplines contributes towards the success of a project.

Professional project planning “Integration and client confidence are the core concepts of the service we provide”, Joubert remarks. “By listening attentively and looking at the possibilities available, we can provide clients with a realistic scenario of our approach to their project. Our clients value our ‘one stop shopping concept’. This concept offers the client in-depth feasibility studies, business plans and functional project planning from an experienced team with a hands-on mentality that can handle any project successfully, whatever the size, complexity or location.”

Feasibility study In the planning phase, the purpose is to outline the project and assess its feasibility. Joubert: “Developing the idea for a health care project starts by establishing what our customer wants to achieve and whether the plan is feasible. We start with a thorough market analysis, an evaluation of the project context and its stakeholders, and testing different scenarios against this background. Based on the strategy selected, the intended profile of the facility and financial implications

of the choices are worked out. The financial feasibility and critical success factors enable our customer to make an informed decision before embarking on a full business plan.”

A solid basis: the business plan The business plan provides a solid basis for the financing, design and implementation of the project.

Joubert summarised the importance of a comprehensive business plan as follows: “Using the project strategy as determined in the feasibility study as a base, the project is then planned in more detail. The activity profile, functional plan, necessary resources and budgets for the facility are specified and decisions are made towards the implementation of the project, including the approach to marketing and management. Together with the anticipated investment and operational cash flows, these plans are used as basis for investing in the project.”

Services tailored to the project Consultancy services fulfils a bridging function between the different parties involved in the project.

Joubert clarifies this function: “From their perspective as an independent party, our multidisciplinary teams can advise you and fulfil a bridging function between members of staff, suppliers, fitters, builders and other relevant parties. This is unique due to our broad experience in the different aspects of a project. We subsequently work according to certified project management standards to ensure that each phase of the project is managed efficiently.”

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Customer & project finance

Simed International

Making finance work for you

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Derk van Ebbenhorst Tengbergen Customer & Project Finance Manager

The Customer & Project Finance department advises clients on financial structures and arranges finance where necessary. The department serves as an intermediary between the client, financial institutions, insurers and other parties involved in project financing.

“We offer the best long-term financial solutions”

Van Ebbenhorst Tengbergen explains how Customer & Project Finance works: “In order to reach a suitable financing proposal, we make an assessment of all the relevant project information. Is it a public or private client? What part of the project has to be financed? What are the desired deadlines and conditions? Does the client have a business plan? To what degree can the project costs be recovered? Every project has its own unique set of challenges and goals, and these are all specific questions that we address.”

According to Van Ebbenhorst Tengbergen, it is also important to take the context of an assignment into account: “We do business in many different countries, also in emerging markets, so it is essential that we assess the potential risks. We therefore look at the available budgets, whether interest rate risks or currency risks are involved, the political stability in the client’s country, and of course Simed International’s past experience but also, and in particular, that of other parties involved such as financial institutions. All these elements are hugely important with regard to the structuring of the financing.”

There is a highly diverse product portfolio from which the consultants can choose a suitable type of financing and a matching financial institution for their clients.

Financing schemes can be divided into several categories: 1. Commercial loans (suppliers’ and buyers’ credits) 2. Credit supplied by development banks (local or multilateral institutions) 3. Asset-based financing, for example leasing or mortgage 4. Mixed credit with a subsidy element

the other hand, usually involve several financial institutions at once. This applies primarily when longer-term funding is required, for example in the case of project financing and Public Private Partnerships (PPPs), or if it involves construction work, in which case we seek local financers or financers such as development banks, which are able to finance local building costs.”

With buyers’ credit, banks extend credit to the client whereas with suppliers’ credit, it is Simed International that supplies the client with credit. Van Ebbenhorst Tengbergen provides an example here of a financing structure Financing options using buyers’ credit: “We arranged According to Van Ebbenhorst Tengan attractive buyers’ credit structure bergen, several categories are often for a client in Georgia. This structure combined in order to create tailor-made involved an internationally operating financing: “The suitability of a financing Dutch bank, a Dutch credit insurance instrument or partner depends greatly company and a local Georgian bank.” on what the project entails, but also on This made it possible to use a buyers’ the country and, of course, the client. credit structure and for the Dutch bank A reasonably simple buyers’ or suppliers’ to support the financing. However, credit may be adequate if the financing without the contribution from local is for a transaction that involves only banks, which served as our ‘ears and the supply and installation of medical eyes’ on the local market, this structure equipment. More complex projects, on would not have been possible.

Subsidy schemes and payment structures A wide range of subsidy schemes are available for emerging markets. These provide the extra budgetary support often needed to make a project feasible.

Van Ebbenhorst Tengbergen and his fellow consultants make every effort to evaluate these schemes and carry out or oversee the application procedure for clients. In addition to arranging financing structures, Customer & Project Finance consultants also set up an attractive and practical payment structure as an integral part of the financing.

Van Ebbenhorst Tengbergen: “We are familiar with all types of payment instruments. It is the aim of Customer & Project Finance to link the client’s wishes with the options available within the financial world. We are genuine entrepreneurs and always look for the best long-term financing solutions.”

Simed International

Solutions for financing issues

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Facility planning

Simed International

Planning every detail

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Herman Olthaar Health Care Technology Consultant Wim Heesbeen Health Care Technology Consultant

The basis of many projects at Simed International is functional planning, which takes into consideration the various functions within a hospital as well as how the departments complement each other, the hospital environment, users, patients, financial possibilities and the culture of the country. Together, all these factors must ultimately form a united whole, and it is for this that the Health Care Technology Consultants within the Consultancy services department are responsible.

“The solution we offer must be sustainable, affordable and stable” Sustainable solutions

Design follows function

Wim Heesbeen and Herman Olthaar are Health Care Technology Consultants.

“In this department, we deal with the functional planning, the plan of approach and the feasibility study in parallel”, Olthaar explains. “This culminates in a plan that leaves nothing to chance and guarantees the best results for the future. We organise the functional planning down to the last detail because the solution we offer must be futureproof. We opt for solutions that are sustainable, affordable and stable.” He continues: “It is only really possible to manage a client’s request thoroughly if you are open to their wishes and expectations.” Heesbeen responds by saying: “It is our aim to plan and equip health care institutions in such a way that they comply fully with both the functional and the commercial requirements of the client.”

According to Heesbeen, functional planning forms the basis for the facility design: “Before any building can be designed, it should be defined what functions it needs to fulfil. This is especially true for medical facilities. Moreover, proper equipment planning in an early stage of the project design allows for accurate budget estimates with which clients can make timely decisions on the balance between functionality and cost implications. Every room has its own function, every function its own equipment, and every piece of equipment its own detail.”

Many aspects of health care are technology-driven, which requires comprehensive technology management.

The aim of technology management is to ensure the safe and effective use of medical devices in a complex hospital environment. Our team of consultants also take this into consideration when planning your facility.

The Room Book is a comprehensive list of all necessary medical equipment and provisions.

Simed International

HIPS: unique hospital planning software by Simed International.

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Specialised software – HIPS At Simed International, we work with HIPS, which stands for Hospital Integrated Planning System. This is a unique software tool developed by Simed International for an integrated approach to planning for hospital facilities and hospital equipment.

The database contains a great deal of data on medical equipment, medicalrelated equipment, furniture and surgical, medical and other related instruments. Each article includes technical specifications, budget costs and technical data for installation purposes. The database also contains a comprehensive history of planned and completed projects which can be used as a reference for new projects. HIPS is linked directly with ADB, the activity database of the National Health Service in the United Kingdom, with AutoCad® for enhanced drawings and REVIT® for creating three dimensional model drawings.

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An accurate inventory is one of the necessary conditions for an efficiently functioning operating theatre.

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Functional planning

Equipment outline and budgeting

Construction budgeting

Functional planning starts with an assessment of the services and capacity required. On the basis of this general profile, the functional programme summarises all the services to be provided (clinical, clinical support and nonclinical support functions), the scope and type of patients that will be served by the project, and the relation to other facilities in the area. It also defines the operational policy of each of the functional units and the relationship between them.

The functionality and capacity are translated into requirements for medical equipment and furniture. While the equipment is specified at a later stage, it is important in this stage to clarify what level of equipment is needed and what major items are required in terms of budget and size. It provides an estimate for the budget per department.

Based on the space planning and estimated volume, an indicative budget for the construction of the facility can be made. This should serve as a basis for the design and decisions taken during the design phase will be weighed against it.

Activity planning and capacity calculations Workload projections are required for the spatial programme and equipment planning. They also determine what the total capacity of the facility will be.

The expected number of procedures and patient visits are basic parameters with which to determine the capacity for services and supporting facilities.

Space planning Space planning serves several purposes. It provides our architects with an overview of all functional areas to be included in the facility along with the net square meters to be assigned to each. Space planning ensures that no vital functions are omitted and that adequate space is assigned to each. To the customer, space planning represents a monitoring mechanism for the project cost and conformity to the agreed role.

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The logistical processes and facilities are brought together in the functional plan. In this way, the flow of patients, staff, visitors and supplies are optimally coordinated with the hospital services.

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Health care facility design

Simed International

Designing tailormade health care facilities for you

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All design aspects included in the plans are taken into consideration in order to achieve a good design.

Simed International

The knowledge and experience of doctors and health care specialists provides important input for the various plans.

The design of a facility should always be based on a strategic plan and facility planning as these determine the functions and activities of the facility.

Facility design comprises the following phases: – Conceptual design – Preliminary design – Final design

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Conceptual design

The conceptual design is based on the decisions taken in the facility planning phase. The conceptual design will result in a cluster plan in which the relationship between the departments and their Health care facility design requires locations will become clear. A room book coordination and cooperation between is compiled in parallel with the cluster different experts in their fields. The plan. A room book lists all rooms in the process requires input from a medical facility by department and indicates facility expert, medical technology their function. Another important specialist, an architect and engineers. milestone is the room-to-room equipThe functional design provides the basis ment planning. For each room, the for the civil and architectural design and equipment schedule is defined based on the requirements for mechanical and its pre-set functionality. This planning electrical installations. results in a bill of quantities for the medical and nonmedical equipment in the project. Together with cluster plans, work flow visualisations, mechanical & electrical and/or architectural concept, the information and design so far are summarised in an ‘architectural brief’.

This is a document that serves as a guideline for the architectural work involved in the preliminary design.

Preliminary design Based on the architectural brief containing details of the conceptual design, the architect combines all components of the facility into a preliminary design.

At this stage, essential issues such as functionality, logistical flows and urban planning are incorporated into a preliminary design. The structural engineer will subsequently review the designs for construction issues and loading capacity. During the preparation of the preliminary design, the architect works in close collaboration with the health care facility consultant. The consultant makes sure the design reflects the functional plans agreed upon.

Simed International

Providing a good visual presentation is an essential tool in showing all stakeholders a view of the proposed building.

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Finetuning with the client This phase involves frequent meetings and discussions. The architectural drawings and the engineering design are brought in line with the required functionality. The equipment and technology in hospitals are often only used for a number of years, while the building itself is projected for at least thirty to forty years. In this respect, form does not follow function, but rather the flexibility in the possible changes in function during lifetime. All these factors must be dovetailed with the wishes of the client.

Final architectural & structural design The final architectural design is based on the preliminary design and the discussions conducted with all parties in the project. Changes are incorporated and the design is further developed to become the final design. The structural engineer will calculate loading capacities and the consequences for the construction, and draw all structural components. At this stage, there has to be a clear understanding of the medical equipment, installations and specific materials to be used, and the implications of these on the design and budget.

Another important aspect is interior design. This can distinguish the facility from others and ensure that patients and staff feel at ease in the environment.

Moreover, it is increasingly recognised that the interior design of health care institutions influences treatment outcomes and should be taken into consideration when developing any health care institution. The final stage of the design is the preparation of contract packages, specifying all materials needed for the facility in a bill of quantities.

A healing environment A health care facility’s interior and environment also play a role when it comes to staff performance and patient recovery. What patients consider to be a ‘healing environment’, however, is determined by culture.

In some cultures, patients prefer to be surrounded by family rather than by high-tech medical equipment, while in Europe, people are reassured by the presence of modern medical equipment. This type of cultural difference affects hospital design. In order to achieve the most suitable healing environment, the Consultancy team first conducts a study to gain insight into the culture of the country in question, taking into account factors such as social conventions and customs. Local circumstances such as climate, prevailing construction methods and local building materials are also taken into account when considering the appearance of the building. Furthermore, issues such as the presence or absence of a permanent water or energy supply determine to a great extent the ultimate design. The strength of Simed International lies in the fact that projects are approached from various disciplines concurrently.

This makes it possible to effectively analyse the often complex needs and requirements of clients, and to offer tailor-made solutions, be they in the form of a hospital extension in the Netherlands, a private clinic in Africa or a university hospital in Turkey.

Simed International Implementation Simed International can offer project management to organise and manage all project activities and ensure that the project is completed within the defined scope, time and budget. We can assist you in the challenge to deliver a project within the defined constraints and optimise the allocation and integration of the input needed to meet the requirements.

During the project implementation, we can offer supervision of construction and engineering to ensure that all works are carried out according to the specifications in the contract packages. This includes supervision of quality, progress and costs.

As an independent partner, we have procured, supplied, delivered, installed and commissioned medical equipment for health care facilities worldwide. For impartial advice you can draw upon our extensive experience. We can also take care of all the necessary steps from preinstallation drawings to end-user training to ensure proper installation and use of the equipment. The experienced consultants at Consultancy services oversee every facet of your health care project.

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Hospital management consulting

Simed International

Enabling the future of health care providers

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Mark Sluiter Specialist in the field of hospital management.

Training medical staff increases both user confidence and service quality.

Simed International

“A project is not finished when the building is completed”

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Having a modern hospital with state-of-the-art equipment is not the only objective; a smooth-running organisation is also essential.

Managing a hospital is a complex task and although all countries are different, the principles of managing a hospital are similar all over the world. Many aspects have to be dealt with, such as translating a strategic plan into a realistic multiannual policy and objectives, patient logistics, portfolio management combined with the availability of medical specialists and medical staff, financial issues and medical insurance.

Simed is also able to assist in this task using its knowledge and expertise on various management aspects ranging from management structure to interim management and hospital management consulting. Our clients range from academic hospitals to smaller community hospitals and from state-owned to private owned hospitals.

Hospital management services Our consultants are driven by the challenge to make things work for the client. This means we are flexible and

pragmatic and we accept that different clients have different needs and that each requires a different approach. Our team of consultants are specialists with proven track records in hospital management services.

The main topics dealt with are: – Health care governance – Management structure – Strategy development – Portfolio management – Interim management – Execution of strategy and project management – Change management – Management development programmes and training Other activities include: – Development of an overall health care strategy for local and national government – Definition of health care insurance models

The integral approach

Simed International

Presenting you our turnkey solutions

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Having shown in this brochure what we can do, we are proud to share with you some of the latest projects that Simed International has been involved with.

Latest trends in equipment Equipment planning for the “Hospital of the Future” in the Netherlands with its high technology and innovative way of working. This paper-poor hospital boasts the latest trends in equipment used to optimize workflow and efficiency. This is also the case in the latest hospital in Dubai, where a new stateof-the-art hospital is built with modern equipment and the latest techniques available with which to treat patients.

where the programme manager of the Maasstad Hospital in Rotterdam says about our work: “Simed International has distinguished itself through its specialist knowledge and experienced staff working on major hospital projects”.

Tailor-made services

No project is a run-of-the-mill project to us and this can also be seen in the hospital that was requested by the Belgian navy for one of their ships.

A 50-bed on-board hospital was deCurrent and future customer needs signed in which the challenges posed During the planning phase, it is someby a ship, and the circumstances it was times necessary to think about the to be used in, had to be overcome. Our relocation of equipment and departinvolvement in the design of a specialments to different sites. This was done ised cardiac clinic in St Petersburg, at two major sites in the Netherlands Russia, or a clinic in Belgium, brings

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high-quality design and experience to the customer.

Partner in professional projects In short, whether it is a feasibility study, business plan, full design with equipment plan and project management or support in hospital management, Simed International is your partner in health care projects. Simed International has a long experience in setting up hospital management, strategic reviews, change management, arranging staff recruitment and staff training, in many different countries over the world.

This enables us to guarantee that our services have earned their place with many governments or private stakeholders everywhere.

Making health care work

Simed International B.V. Middenwetering 1 P.O. Box 9486 3506 GL Utrecht The Netherlands T +31 30 265 22 00 F +31 30 261 88 97 E simed@simed.com www.simed.com Simed International has branches in Belgium, China, Germany, Russia and the United States of America. For all contact information, please visit www.simed.com.

Published by Simed International, Utrecht, the Netherlands Concept, editing and design Total Identity, Amsterdam, the Netherlands Sieds de Boer, Yvonne van de Wal, Julius van der Woude Printing Badoux Houten, the Netherlands Photography and illustration Simed International, Utrecht, the Netherlands Renders Fotografie, Amsterdam, the Netherlands Ger Vendel, Amsterdam, the Netherlands Co de Kruijf/Hollandse Hoogte Cablon Medical B.V. Nationale Beeldbank/Berbara Houweling Philips Maasstad Ziekenhuis Cover illustration: The Human Ear, Ger Vendel Š 2012, Simed International