TUESDAY, MARCH 22, 2016
AIA/AAH SUNRISE FORUMS
7 — 8:00 a.m.
Forum for Professionals Working in Health Care Organizations
Vincent Della Donna, AIA, ACHA, Director, Healthcare, Gannett Fleming Architects & Engineers; Patrick Fugeman, VP, Design & Construction, Christiana Care Health System
The Professionals Forum is a platform for an open discussion between professionals working in health care facilities (including architects, engineers, biomedical engineers, contractors, facility managers, risk managers, and others) and consultant design professionals. This forum will review some of the administrative and practical issues associated with the delivery and operations of health care projects and will feature audience participation.
- Describeand discuss common goals shared by various types of professionals
- Network with colleagues and leaders in the field
- Explain strategies and solutions for common issues with peers
- Identify the concepts and operations of project delivery methodologies
Lisa Charrin, AIA, ACHA, Vice President, Mitchell Planning Associates; Linda Sadler, Sr Communications Consultant, Smith Seckman Reid, Inc
This forum is a platform for an interactive conversation about leading edge technology among owners, architects, engineers, facility managers, contractors, and equipment and technology planners and vendors. With the rise of ambulatory and community health centers, it’s important to understand how medical equipment and technologies play a key role in implementing new care models for: registration and patient tracking; patient assessment and vitals; nursing and physician charting; point of care testing; and other technologies connecting patients, providers, and referring specialists.
- Name technology trends that are changing the paradigm of ambulatory projects.
- Outline strategies for implementing lean concepts for patient registration and assessment and treatment.
- Describe technologies enabling distance medicine and community care models.
- Explain how technology-enabled solutions can improve the patient experience.
CONCURRENT SESSIONS III
8:15 — 9:15 a.m.
Moderator: Kate Wickham, Healthcare Systems & Services, Philips Lighting North America
Panelists: Shay Rankhorn, SASHE, CHFM, CHC, SHSP, CHEP, LLE, Multi Facilities Director, Engineering Services, Mountain States Health Alliance; Arthur Kjos, Executive Director of Facilities Planning, University of Arkansas for Medical Sciences; Von Lambert, CPHIMS, CHFM, CBET, Senior Project Manager, Rider Levett Bucknall
This session features a panel discussion with four health care facility managers who can educate suppliers and ASHE associate members on the essentials of working with and assisting health care organizations in fulfilling their missions.
- Describe how health care is unique from other markets and customers, including the sensitivities specific to health care such as infection control, HIPPA, and the Joint Commission.
- Name the critical factors relative to a facility manager's mission and the challenges that facility managers deal with on a daily basis, and explain solution providers can play a part in mitigating those challenges.
- List the common misconceptions of suppliers and service providers, and the common mistakes they make that can negatively impact an organization's mission and put patients at risk.
- Explain the "business of health care," including the basics of how hospitals are run; how their departments are organized; central versus local decision making; the financial, legal, and compliance standards that facility managers deal with; and how facility managers "do more with less."
Jason Chavez, CEO, Xyicon
In San Diego, Kaiser Permanente is building a 300-bed hospital of the future. Innovative technologies will be incorporated throughout the facility from interactive displays in patient rooms to mobility technology for its members. From its experiences with multiple large-scale construction projects, the company has taken an aggressive approach and deployed web-based “cloud” solutions to enable better management and insight to achieve the 2017 opening date.
- State how a web-based solution enables better planning and management for complex capital building projects.
- Demonstrate the importance of using centralized data for multiple teams.
- Design unique room templates in the cloud, based on department and room type.
- Explain the differences between conventional and automated IT station validations and deployments.
Alyson Cole, Assistant Executive Director, Penn Presbyterian Medical Center, Joseph Reagan, Jr., AIA, Vice President, Development, Wexford Science & Technology, a BioMed Company, & Jhiah Chang, Architect, ZGF Architects LLP
The decision to collaborate with a developer to turn a high-rise office and research tower into a robust patient care center was an innovative approach to delivering convenient outpatient care at a reduced cost and on an accelerated schedule. The base-building and tenant improvement projects at 3737 Science Center in Philadelphia were designed and delivered on similar tracks, promoting a flexible, high-performance design that can accommodate multiple programs.
- Identify the benefits and challenges for health care providers to partner with developers to design and build in leased space.
- Identify the reductions in operational and maintenance costs and improvements in occupant comfort as a result of sustainable measures, including the use of active-chilled beam technology.
- Explain the challenges of designing robust clinical-care space in a building not purpose-built for that use.
- State improvements in patient and staff satisfaction as a result of the flexible clinical design.
Navigating the Continuum of Knowledge: Understanding Key Design Strategies that Impact Patient Outcomes
Carolyn Glaser, MA, EDAC, Director of Operations, The Center for Health Design
Finding solutions to health care issues can be challenging. The Center for Health Design has organized information from peer-reviewed research, expert interviews, and case studies to offer different perspectives to address the tough problems in today’s complicated health care environment. We will share these resources to help you understand design implications to improve outcomes. Attendees will be equipped with the latest knowledge needed to address anxieties we all share about the latest “issue of the day.”
- Assess case studies that describe different approaches to some of the most pressing issues.
- State where to locate expert knowledge about today’s challenges.
- List resources available from The Center for Health Design that address a range of health care design challenges.
- Identify tools that help implement design solutions and how to measure results.
Culture at the CORE: The Built Environment and Patient Experience
Lorissa MacAllister, PhD, BSW, AIA, NCARB, LEEP AP, EDAC, President, Enviah
As health care becomes increasingly focused on the experience provided to patients, research has indicated that the culture of an organization is central to patient satisfaction. This hour-long session will introduce participants to the idea that the built environment can influence organizational culture and that the confluence of the two factors can have a significant effect on patient satisfaction. The session will review evidence from research-based case studies that illustrate these ideas in action, and will show the importance of CORE — culture, operations, responsibility, and environment — on patient satisfaction.
- Explore how the built environment can affect organizations.
- Assess research in the field on the environment’s role in business outcomes.
- Identify key environmental objectives in business outcomes.
- Describe means of improving environment outcomes at your organization.
Allison C. Ellis, P.E., Health Care Specialist, Koffel Associates, Inc. & William Koffel, PE, FSFPE, President, Koffel Associates, Inc.
Understanding regulatory codes is essential for proper maintenance of a health care facility. Recent editions of the codes have introduced new requirements that can ease the difficulties of maintaining a facility, if used properly. Test your knowledge with a live interactive code quiz on NFPA 101, NFPA 72, and NFPA 99, including an open discussion of questions with a lower percentage of correct responses.
- Apply requirements of NFPA 101-2012, as described in the CMS S&C memo: 13-58-LSC.
- Describe new code requirements in NFPA 101-2012 and 2015, NFPA 72-2012, and NFPA 99-2012.
- Assess personal comprehension of regulatory codes based on correct responses to seminar questions.
- Identify top code misinterpretations of various NFPA codes, including recent editions of NFPA 101, NFPA 72, and NFPA 99.
9:30 — 10:45 a.m.
Moderator: Dale Woodin, CHFM, FASHE, Senior Executive Director, American Society for Healthcare Engineering (ASHE)
Panelists: Linda Dickey, RN, MPH, CIC, Sr. Director, Quality, Safety & Infection Prevention, University of California Irvine Medical Center; Barbara Edson, RN, MBA, MHA, Vice President, Clinical Quality, Health Research & Educational Trust (HRET); Carolyn V. Gould, MD, MSCR, CDR, USPHS, Team Lead, Hospital Infection Prevention, Prevention and Response Branch, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC); Dana Swenson, PE, MBA, Senior Vice President & Chief Facilities, UMass Memorial Health Care, Inc.; George Mills, MBA, FASHE, CEM, CHFM, CHSP, Director of Engineering, Department of Engineering, The Joint Commission
The health care physical environment plays a central role in infection prevention and control, and understanding best practices for new construction and existing facilities is critical for health care architects, designers, constructors, and facility managers. ASHE is working on a three-year project with the Centers for Disease Control and Prevention and the Health Research & Educational Trust (HRET) of the American Hospital Association to strengthen infection control practices in hospitals. This session explores how health care acquired infections (HAIs) are related to the built environment and how the work being done as part of this project may reduce HAIs.
This session will enable attendees to:
- Describe how functional planning of space relationships can ensure proper flow of patients, personnel, and materials within facilities to reduce potential for infection transmission
- Explain the current status of infection control risk assessments and the potential for further improvement
- State how this project will address water-related environmental infection control
- Describe multiple perspectives on the impact of the built environment on HAIs from clinicians, operators, and constructors
EXHIBIT HALL, LUNCH, & ARCHITECTURE FOR HEALTH GALLERY
10:45 a.m. — 1:45 p.m.
1:45 — 2:45 p.m.
Maintenance of Power: Do Hospitals Have an Obligation that Goes Beyond Compliance with Current Codes and Standards?
Moderator: Eric Cote, Project Director, Powered for Patients
Panelists: Jason D'Antona, PE, LEED AP, Principal, Thompson Consultants; Robin Guenther, Principal, Sustainable Healthcare Design Leader, Perkins+Will; George Mills, MBA, FASHE, CEM, CHFM, CHSP, Director of Engineering, Department of Engineering, The Joint Commission; Robert Solomon, PE, Division Manager for Building and Life Safety Codes, NFPA; and Kevin Yeskey, MD, FACEP, National Advisor for Public Health Preparedness, Powered for Patients; Eric Ackerman, MBA, Director, Alternative Regulation, Edison Electric Institute; Caleb Haynes, PE, Principal/Director, TME
A hospital is obligated to protect patients by preserving backup power. This discussion will address key issues including the difference between optimal protection of backup power through best practices and new technologies such as co-generation and micro-grids versus simply meeting current codes and standards. A white paper produced from this plenary session will capture the essence of this critical issue and lay out a framework for the regulatory, policy, and legislative changes necessary to help hospitals move beyond code compliance to a best practices approach.
- State the greatest challenges in ensuring reliable backup power according to survey respondents.
- Describe the most recent investments in replacement generators and micro-grid or co-generation technology.
- Identify the planned investments in replacement generators, micro-grids, and co-generation.
- Understand the perceived or real obstacles to implementing enhancements to backup power systems.
CONCURRENT SESSIONS IV
3:00 — 4:00 p.m.
Powered for Patients: Moving to Advanced Power Solutions Through Microgrid and Cogeneration Technology
Eric Ackerman, MBA, Director, Alternative Regulation, Edison Electric Institute; Eric Cote, Project Director, Powered for Patients; Jason D'Antona, PE, LEED AP, Principal, Thompson Consultants; Robin Guenther, Principal, Sustainable Healthcare Design Leader, Perkins+Will; Gerry Kaiser, PE, Senior Director, Facilities Resource Group, Ascension Health
Advanced microgrid and cogeneration technology can help hospitals create more advanced backup power systems. This session explores the factors that are leading some hospitals to invest in this technology, as well as the real and perceived challenges to augmenting traditional backup power systems. The session will also provide the perspective of utilities on hospitals moving to microgrid and cogeneration technology.
- Outline key factors that lead hospitals to invest in cogeneration or microgrid technology.
- Name perceived or real obstacles to augmenting traditional backup power systems with cogeneration or microgrid technology.
- Explain how consulting engineers, architects, and traditional power generation industry leaders view advanced technology in relation to traditional backup power systems.
- Describe the utility perspective on hospitals moving to microgrid and cogeneration technology.
Angela Mazzi, AIA, ACHA, EDAC Moderator; David Allison, FAIA, FACHA, FACHA Legacy Project Award Jury Chair; Winning project architect - Winner names to remain confidential until award presentation; Winning project owner - Winner names to remain confidential until award presentation
The American College of Healthcare Architects created the Legacy Project Award to celebrate outstanding healthcare design that has stood the test of time and contributes to advancements in the future. This award recognizes healthcare architecture that has and continues to demonstrate superior planning and excellence in design performance over an extended period of time, and remains of enduring significance.
This session will describe how the original planning and architecture has evolved to stand the test of time and contribute to a changing health care environment. Discussion will focus on the leadership qualities, project drivers, team experiences and the story of this year’s award winning place of healing and its impact on subsequent design and patient care.
- Understand how initial design and planning decisions addressed the issues of the time and provided flexibility for future change.
- Articulate key drivers, planning and design concepts that have endured for more than 15 years.
- Recognize the impact of great planning and design in support of evidence based practices.
- Identify principles of iconic work that contribute to the knowledge base of health care facility planning and design to become worthy of a Legacy project.
Jason Wolf, Ph.D., President, The Beryl Institute
Engage in a collective conversation on what matters in patient experience excellence. This session will provide an overview of the foundational elements of patient experience, expand perspectives on the market trends driving health care, and integrate the current global data that reinforce those trends. All voices matter, every interaction matters, and you matter in today’s health care environment. Come prepared to share ideas, challenge current thinking, and leave with the seeds of new ideas that will positively impact your work in partnership with patients, families, and peers.
- Describe the key elements of patient experience today.
- Explain market trends driving the shift to health care consumerism.
- Outline the current state of patient experience globally.
- Articulate the patient experience centrality of needs, grounded in people, process, and place, and build a plan of action around what matters in patient experience excellence
John Kreidich, AIA, CHC, LEED AP BD+C, Manager, Healthcare Services, McCarthy Building Companies, Gary Davis, Area Vice President - Hill-Rom, & Brendon Buckley, Healthcare Technology Director, North America, Systems and Services, NA, Johnson Controls, Inc.
At the start of the twenty-first century it was common to refresh room finishes after 8 to 12 years, but in today’s environment a patient room built in 2005 may need to be totally reworked. This presentation addresses the merits of a bundled design-build approach aggregating costs and benefits into a total project ROI proposition. Panelists will discuss the potential return from technology not available as little as 10 years ago and the benefits of bundling upgrades into a design-build package to maximize speed-to-market and minimize effects on patients and caregivers.
- Recognize the relationship between characteristics of the physical facility and the risk of reduced reimbursement tied to the PPACA.
- Understand the how advances in technology can reduce risk to patients, to patient satisfaction, and to a hospital’s bottom line.
- Effectively advocate expenditure of capital within the acute-care unit of a health care organization that reduces operating cost and avoids reductions in reimbursement.
- Lead a discussion on how bundling patient room improvements could accelerate the project’s financial benefit while reducing the effect on patients and caregivers.
Chad Beebe, AIA, CHFM, CFPS, CBO, SASHE, Deputy Executive Director of Advocacy, American Society for Healthcare Engineering (ASHE), Rebecca Lewis, AIA, FACHA, CID, Principal, DSGW Architects, Scott Miller, NCARB, FACHA, Associate Director, Navigant, Allison C. Ellis, P.E., Health Care Specialist, Koffel Associates, Inc., & John Williams, Program Manager, Construction Review Services, Washington State Department of Health
The code interpretation process of the authority having jurisdiction (AHJ) surrounding a code “event” is often clouded in mystery about what information is needed, format, response time frame, and how strict the AHJ adheres to the code versus a “friendly” interpretation. AHJs and designers bring a wealth of experience, biases, past code experiences, and their own individual processes to each situation. This session will discuss what is required (as to both information and format) to achieve a successful interpretation.Â
- Describe the process of how code interpretation is made by AHJs.
- Follow AHJs through their process of reviewing the facts of the situation and its relationship to the current code.
- Explain the knowledge needed to successfully present the situation to an AHJ for review.
- Illustrate the tools required to craft the interpretation request.
Ronald Galloway, PE, Director of Construction Management, Cone Health, Jeremy Jones, PE, EDAC, LEED AP, Healthcare Market Leader, Affiliated Engineers, Inc., & Robert Sherman, PE, LEED AP, Principal, Affiliated Engineers, Inc.
As part of a 96-bed expansion project in 2013, Moses Cone became the first hospital in the United States to use active chilled beams in patient care areas. As an aggressive energy savings measure, this innovation has received much industry attention. With this system now operational for over a year, the engineer and the owner will share data related to patient and user satisfaction and energy performance to aid the industry in evaluating this technology for future projects.
- Understand active chilled beam technology.
- Discuss common objections and areas of concern offered against the use of chilled beams.
- Present actual measured data and user experience from an installed and proven case of active chilled beams within patient rooms.
- Provide tools to evaluate the applicability of active chilled beams on your next patient care project.
Walt Vernon, PE, MBA, JD, LEED AP, CEO, Mazzetti; & Richard D. Moeller, PE, FASHE, LEED AP, HFDP, CHC, Principal, Mazzetti
The FGI has engaged in an extensive effort to establish its foundations in science, and has created a model for other organizations to follow in transparency, analytical rigor, and reliance only on real data for policy making. This session will examine the methodologies for understanding what evidence (not science) means, and how to use it. It will focus on the ways these notions drive the FGI research initiatives, and examine the research results and the ways the research might be used in developing the next iteration of the Guidelines.
- State how the FGI uses evidence in evaluating its existing text.
- Describe how the FGI intends to use evidence in evaluating new proposals
- Describe the results of the FGI research into the evidentiary foundations of the current text.
- Articulate how the FGI could evolve in light of these new findings.
CONCURRENT SESSIONS V
4:10 — 5:10 p.m.
Eric Cote, Project Director, Powered for Patients; Robin Guenther, Principal, Sustainable Healthcare Design Leader, Perkins+Will; Gerry Kaiser, PE, Senior Director, Facilities Resource Group, Ascension Health; Gene Kogan, Director, Center for Sustainable Energy
Getting buy-in from hospital executives is a critical step in creating more advanced power systems and robust backup power capabilities. This session offers advice from hospital facility managers that successfully implemented cogeneration or microgrid solutions. The session also features a hospital executive perspective, allowing facility professionals to learn how to make the case for investments in their power systems.
- Describe ways facility managers have made the case for increased investment in power systems.
- Name potential allies to help gain C-Suite support.
- Explain lessons learned from early adopters of microgrid and cogeneration technology.
- Outline how utilities can support a hospitalâ€™s adoption of microgrid and cogeneration technology.
Mark Kenneday, MBA, CHFM, FASHE, Vice Chancellor of Campus Operations, University of Arkansas for Medical Sciences
Redefining health facility projects using the total project alignment strategy ensures improvement in all three areas of the triple aim. The project collaborative should include all parties in a total cost of ownership delivery model. This session is interactive with some audience response questions to better define existing bias and identify the various players and their roles. These processes ensure high quality, effective and efficient product delivery and not just additional occupancies.
- Discuss why facilities must focus on total cost of ownership instead of just initial cost.
- Build the alignment model with audience participation to ensure each role is identified and their motives clarified.
- Explore the interactions and hand offs between the lean team; the 3D planning, design, and construction team; and the sustainability teams.
- Review a case study using the alignment technology
Health Care’s New Normal: Employing Cognitive Research to Create Patient-Centered Solutions and Promote Wellness
Angela Mazzi, AIA, ACHA, EDAC, Architect and Senior Healthcare Planner, GBBN Architects
The experience of treatment has a far greater impact on patient outcomes than has previously been realized, from stress levels to compliance with a care plan. This session will share cognitive research that indicates how specific aspects of health care environments can foster healing and recovery. Attendees will learn techniques to work as a multidisciplinary team of designers and stakeholders to make patient -centered issues a design driver in their projects.
- Identify the top three things to promote well-being through design.
- Describe techniques to build consensus for design decisions around the patient viewpoint.
- Explain how to quantify projects in terms of value and improved outcomes, not just first cost or life cycle cost.
- Name specific amenities that can provide patients with a greater sense of control over the management of their care.
Robin Ringwald, AIA, LEED AP, Senior Associate, Christner Inc. & Jayne Huseman, PE, LEED AP, Construction Project Manager; Priscilla Burton, Designer, Arch Framing & Design, Inc.
Artwork in the patient environment is often an afterthought and its selection is primarily limited to blending with the interiors. When designers identify the opportunities and integrate art from the beginning, benefits include an enhanced patient experience, improved wayfinding, and beneficial community involvement. This session describes the process and benefits of including custom artwork in an inpatient addition at Blessing Hospital in Quincy, Illinois.
- Identify opportunities for inclusion of custom art in the inpatient environment.
- Develop a selection process for art for various types of spaces.
- Discover opportunities within the local community for artist involvement.
- Get the most from the art budget.
Insights for an Integrated Approach to Code-Compliance, Sustainability, Commissioning and Patient Experience (HCAHPS)
William Koffel, PE, FSFPE, President, Koffel Associates, Inc. & Lynn Kenney, Senior Analyst, Advocacy Team, ASHE
What do HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Suppliers survey), sustainability, commissioning, and code compliance have in common? They all affect a hospital's bottom line and reputation while supporting patient outcomes. As value-based purchasing models continue to evolve, it is more important than ever to consider strategies that optimize efficiencies and maximize ROI. This presentation will discuss an integrated approach to several improvements that can affect HCAHPS, sustainability, and code compliance.
- Review the impact and importance of HCAHPS, sustainability, and commissioning.
- Discuss how specific improvements can have a positive effect on each of these.
- Discuss the code compliance considerations for each of the listed projects.
- Present case studies and examples that illustrate these concepts.
Super Track: The Evolution of the Split Flow Emergency Department
Robert Masters II, AIA, NCARB, LEED AP BD+C, Senior Vice President, CannonDesign & John D'Angelo, MD, FACEP, Senior Vice President & Executive Director, Emergency Medicine Service Line, North Shore-LIJ Health System
Health care organizations are looking for ways to respond to the evolving needs of emergency departments. Two new emergency department expansions at North Shore-LIJ were planned and designed using the “Super Track” split-flow clinical model to target effective throughput of lower acuity patient volumes, effectively manage patient wait times, and reduce length of stay in emergency departments throughout the system. A few years ago, North Shore-LIJ retrofitted several emergency departments to implement an acuity-based split flow concept. This session explains how the organization’s experience drove the design of the new Super Track emergency departments, which are functionally and clinically optimized to support a well-managed patient care experience.
- Articulate the value of the Super Track split-flow organizational approach in emergency departments as an effective lean process re-design strategy.
- Discuss the implications of the Super Track approach on the planning and design of emergency departments, both for renovations and new construction.
- Reference examples of how design can impact throughput and average length-of-stay in the emergency department.
- Implement strategies that enhance design team and medical team collaboration for better operational and clinical outcomes.
Facility Optimization for the C-Suite
Gerald Bauers, PE, NEBB CP - Commissioning, National Program Executive, Outcome Construction Services
Electronic systems provide mountains of data to manage energy and regulatory compliance in U.S. medical and support facilities. Sorting through the data to create actionable tasks to improve performance and optimize energy cost effectively can be overwhelming. This presentation will explore the use of a cloud-based analytics system that automates this process. This approach provides hospital personnel with specific guidance in assigning personnel and capital to sustain hospital operations.
- Discuss the results of a five-year process of retrocommissioning for the ten VA Medical Campuses in the southeast network of Department of Veteran Affairs.
- Explain how the data can generate an actionable report and prioritize items for the C-Suite with an economic effect to enhance their mission of health care.
- Provide a cost tool for common retrocommissioning issues.
- Realize the cost reductions retrocommissioning provides.