Wednesday, March 7, 2012

7:30 – 8:30 a.m.
Bridging the Gap
Closing Session
Ian Morrison, PhD, Author, Consultant, and Futurist

Conference moderator Ian Morrison will pull together key messages presented during the 2012 PDC Summit during the closing session. This session will enable you to:

Explain insights from the plenary and concurrent sessions in terms of practical messages that can be incorporated into your next project.
Describe practical means for improving collaboration among health care facility project teams.

8:40 – 9:40 a.m.
Clinical Redesign
Rebooting the Existing Hospital: Performance Improvements in Satisfaction, Outcomes and Energy Use
Ryan Hullinger, Senior Associate, NBBJ; Eric Thompson, AIA, LEED® AP, Associate, NBBJ

This session will focus on four hospital performance areas—patient experience, staff operations, brand transformation, and sustainability—and how each of these can be improved through design. Each topic will be presented in two forms: as an illustration of the collaborative design process and as a series of metrics that tie design concepts directly to patient outcomes, patient and staff satisfaction, and energy use. This session will enable you to:

Describe how simulation and building information modeling can improve design collaboration between the architect and the owner.
Explain how rapid prototyping can be used to improve the design process and significantly increase staff buy-in.
Summarize the implications of the 2030 Challenge for hospitals, and describe how an integrated approach to energy load reduction can help meet this challenge.
Diagnose challenges related to transitioning staff from outmoded departments into new facilities that demand new operational processes.

8:40 – 9:40 am
Fundamentals of PDC for HC
Design for Families: A Pediatric Patient Room from a Parent’s Perspective
Jodi Shumbres, Parent & Territory Manager, Lifespan Healthcare, LLC.

The presenters will share one family’s hospital experience from a “design” point of view: what works, and what does not, for parents who “live” at a hospital for days and weeks at a time. Discussed will be what some hospitals are doing through design to support the family experience and the patient care experience. Room layout, equipment access, guest space, ergonomic, acoustic, and infection control issues will be covered. Vignette photos will be used to highlight areas for improvement and demonstrate well-designed solutions. This session will enable you to:

Apply the concept of consciously viewing project designs from the perspective of the patient and patient’s family to improve design solutions.
Describe means of introducing a patient- and family-centered approach to design into your projects, based on examples given.
Discuss aspects of architectural design and detailing, as demonstrated by the case study, that could be improved to respond to issues such as infection control, equipment access, family experience, and acoustics.
Explain the importance of incorporating a patient- and family-centered design approach into a project beginning at the planning phase.

8:40 – 9:40 a.m.
Innovation & Collaboration in the Field
Building a Six-Dimensional Bridge Between Construction and Hospital Facility Management
Clay Haden, Facility Manager, MultiCare Good Samaritan Hospital; Mark Howell, Senior Vice President, Skanska USA Building Inc.; Helen Juan, VDC/BIM Manager, Skanska USA Building Inc.; Clay Ciolek, Operations Supervisor, Good Samaritan Hospital

Speakers will describe the use of BIM models in constructing a 357,000-square-foot patient tower on an aggressive schedule. Models include 3-D for visualization, 4-D to communicate schedule sequencing, 5-D material take-offs and ordering, and a model with a sixth dimension linked to the facility’s operations and maintenance information. This session will enable you to:

Apply the steps described to incorporate a 6-D BIM model into a construction project.
Analyze the tangible and monetary benefits of incorporating a 6-D model into everyday operations and maintenance of a health care facility.
Evaluate the appropriateness, including possibilities for cost/benefit analysis, of using 6-D building information modeling for a capital project.
Discuss the essential training required to enable operations and maintenance staff to efficiently use a 6-D model.

8:40 – 9:40 a.m.
Performance Metrics
Can Single-Patient Rooms Pay for Themselves?
Jerry Switzer, AIA, ACHA, Partner in Charge of Planning/Research, MorrisSwitzer~Environments for Health; Stephanie Taylor, MArch, CIC, CEICC, Director of Research, MorrisSwitzer~Environments for Health

The speakers will present evidence-based research on patient rooms and discuss four factors—medical errors, patient transfers, patient falls, and health care-associated infections—that demonstrate measurable cost differences between single- and multi-bed rooms. This session will enable you to:

Use research data to establish business and clinical cases for building single-patient rooms.
Assess the financial implications of building single-patient rooms, including how they affect debt service on construction financing.
Apply research outcomes to establislh postoccupancy measurement criteria.
Compile a database of research and data related to single-patient room design.

8:40 – 9:40 a.m.
Regulatory Issues
Compliance with NFPA 99 and 101, Now and in the Future
Michael Crowley, PE, SASHE, FSFPE, Senior Vice President, Rolf Jensen & Associates

The speaker will provide a status report on the prospective adoption of the 2012 editions of National Fire Protection Association (NFPA) 99: Health Care Facilities Code and NFPA 101: Life Safety Code® by the Centers for Medicare and Medicaid Services (CMS). He will illustrate major differences between the current CMS reference codes and these new editions, discuss how to apply the new requirements, and review conflicts with the International Building Code. ASHE’s code reform initiative will also be covered. This session will enable you to:

Describe new requirements in the 2012 editions of NFPA 99 and NFPA 101 and how they will affect health facilitiy PDC projects.
Summarize the major differences between the requirements in the 2000 and 2012 editions of NFPA 101.
Discuss CMS’s plans for updating its reference codes.
Explain the goals of the effort by ASHE and the International Code Council to reduce the number of codes applied to health care facilities.

8:40 – 9:40 a.m.
Health Facility Commissioning
Incorporating the ASHE Commissioning Process into the 2014 FGI Guidelines
Mark Kenneday, MBA, CHFM, FASHE, Vice Chancellor, Campus Operations, University of Arkansas for Medical Sciences; R. Clay Seckman, PE, Executive Vice President/Principal, Smith Seckman Reid Engineers, Inc.

Speakers will review the thinking behind proposed language for incorporating portions of the ASHE health facility commissioning (HFCx) process into the 2014 edition of the Facility Guidelines Institute (FGI) Guidelines for Design and Construction of Health Care Facilities, whichis adopted as code in a number of states. Participants will have an opportunity to offer feedback on the proposed language. This session will enable you to:

Explain the importance of verification and documentation of satisfactory system and building component performance.
Discuss the intended definition of “commissioning” in the Guidelines, and the need for owners to develop project-specific commissioning plans.
Summarize the commissioning requirements included in the 2010 edition of the FGI Guidelines and what they mean for project delivery.
Outline the changes proposed for the 2014 edition of the FGI Guidelines and how they would affect PDC processes.

8:40 – 9:40 a.m.
2014 Guidelines for Design and Construction
Changes to Guidelines Parts 1 and 3: Functional Program, Surfaces and Furnishings, and Ambulatory Care Facilities
Jane Rohde, AIA, FIIDA, ACHA, AAHID, LEED AP, JSR Associates, Inc.; Ken Cates, SASHE, Principal, Northstar Management; Bill Lindeman, AIA, NCARB, WEL Designs; Scott Miller, AIA, Moody Nolan, Inc; and Douglas Erickson, FASHE, CHFM, HFDP, CHC, Senior Project Manager, Northstar Management and Chair, Health Guidelines Revision Committee (HGRC)

Owner and designer input is needed on proposed new requirements for the 2014 edition of the FGI Guidelines as well as proposed changes to existing language and removal of outdated requirements. Participants will have a chance to discuss proposed major changes to Parts 1 and 3, including proposals on the functional program, surfaces and furnishings, and ambulatory surgery and other outpatient facilities. A voting system will be used, and all input will be recorded and reported to the 2014 HGRC at their final meeting. This session will enable you to:

Describe how proposed changes to Parts 1 and 3 of the Guidelines will directly affect future design and construction projects.
Identify issues in the planning, design, and construction of ambulatory and other health care facilities that authorities having jurisdiction may expect your projects to comply with.
Gain information from the experiences of others who have used this document for health care design and construction projects to use as lessons learned in your own projects.
Apply your project experience to interpret and suggest improvements to the Guidelines document, which is widely used for design guidance and regulation of health care construction.

9:50 – 10:50 a.m.
Clinical Redesign
Crossroads in Surgery: The Hybrid Operating Room
John Skreenock, Senior Associate, Applied Solutions Group, ECRI Institute; Michael Linehan, Director, Medical Equipment Planning, ECRI Institute

This presentation will focus on the concept of hybrid operating rooms and issues related to the design, layout, and implementation of these highly sophisticated spaces. Several recent projects of this type will be examined, including a review of challenges and lessons learned. This session will enable you to:

Explain the purpose and components of a hybrid operating room (OR) and the major design differences from a standard OR.
Identify, based on the case studies, the procedure types and related imaging systems best accommodated by a hybrid OR.
Describe the benefits and challenges unique to each of a number of different hybrid OR types.
Discuss issues related to hybrid OR design such as systems procurement and functional layout requirements.

9:50 – 10:50 a.m.
Fundamentals of PDC for Health Care
Growing Pains: Safe Patient Care During Construction
Kelly Cuddeback, MBA, PMP, Associate Project Director; Robert Ray, PE, MBA, Director of Operations and Maintenance; and Pamela Redden, Director of Clinical Facilities Development, MS, BSN, RN, EDAC, from The University of Texas MD Anderson Cancer Center; and Ben Johanneman, LEED AP BD+C, CHC, Project Director, McCarthy Building Companies, Inc.

This panel will discuss effective collaboration methods for multidisciplinary teams working on health facility construction projects. Topics will include communication methods, coping techniques, crisis avoidance, and transition planning during construction. Panelists will present projects that vary in scope and complexity to provide participants with a range of examples. This session will enable you to:

Implement project team communication strategies that support successful outcomes for construction projects.
Identify important clinical concerns and corresponding action plans to address issues of well-being and safety for staff, patients, and visitors throughout the construction process.
Describe project team coping methods and crisis avoidance activities that support on-time and on-budget project completion.
Explain the role of facility operations staff during the construction process, including management of multiple groups’ expectations throughout the project.

9:50 – 10:50 a.m.
Innovation & Collaboration in the Field
Innovative, Collaborative Project Delivery at Walter Reed National Military Medical Center
Joe Hogan, Senior Vice President, Clark Construction Group, LLC;

This session will examine the use of the design-build approach for delivery of the new facilities for the Walter Reed Medical Center, a LEED Gold-certified project. The discussion will cover the project’s focus on mission success, improvements in overall project delivery, streamlined decision-making methods, use of evidence-based design decisions to support patient and staff well-being, and planning to facilitate future changes required by advances in the delivery of health care services. This session will enable you to:

Summarize how the project team accounted for developments in health care technologies to facilitate adoption of future advances in medical practice.
Explain how evidence-based design was used to improve patient and staff well-being and safety, support the patient healing process, and reduce stress.
Describe how the “one-team” approach improved overall project delivery and streamlined decision-making.
Explain how to factor sustainability objectives into a project in ways that meet or exceed the owner’s goals and expectations.

9:50 – 10:50 a.m.
Performance Metrics
Benchmarking Results: Gross and Building Gross Data
D. Kirk Hamilton, FAIA, FACHA, EDAC, Professor, Texas A&M University; Sarel Lavy, PhD, Assistant Professor, Texas A&M University

This session will review Texas A&M research on the calculation of building gross square footage for health care facility projects, including lessons learned about the need for precision and consistency in calculation methods, preliminary data results, and early conclusions about how the research results could affect space programming for health care projects. Time will be allowed for Q&A. This session will enable you to:

Express how precision and consistency in area calculation methods can improve an organization's internal and external measurement comparisons.
Apply the information provided when assessing which building components to include in net area calculations and which to include in gross square footage calculations.
Discuss how and why area allocations in recent hospital designs have changed from traditional allocations for the same spaces.
Apply techniques discussed to revise preparation and use of hospital space programming information for a particular facility.

9:50 – 10:50 a.m.
Fundamentals of PDC for Health Care
HVAC Design for Patient Rooms
J. Patrick Banse, PE, LEED AP, Senior Mechanical Engineer, Smith Seckman Reid, Inc.

Using building plans, sketches, and photos of various patient room types, the speaker will present methods for heating, cooling, and maintaining optimal air change rates to create a comfortable room environment. Topics will include comfort control, air distribution techniques, and ways to minimize noise in patient rooms. This session will enable you to:

Describe HVAC requirements appropriate for different patient room types.
Select HVAC systems that can accommodate function and room requirements.
Interpret code requirements applicable to patient room HVAC design.
Identify and select HVAC air distribution methods that will support patient comfort.

9:50 – 10:50 a.m.
Health Facility Commissioning
Meeting Your Energy Efficiency Goals—Part I
Steven Ross, PE, LEED AP BD+C, CxA, Vice President, Director of Commissioning, SSRCx; Ron Holdaway, PE, CEM, LEEDAP, TITLE, SSR

This session is the first of two that will focus on the ASHE recommended process for establishing and reaching energy efficiency goals in new buildings, additions, and renovations. The speaker will discuss activities recommended for the predesign, design, and construction phases of a project, including setting energy efficiency goals, using energy modeling, and verifying functional performance of energy-related systems through review of control diagrams and control system programming. This session will enable you to:

Explain the benefits of and methods for implementing the multidisciplinary approach to energy modeling recommended by ASHE.
Summarize the key features of functional performance testing used to verify the efficiency of energy-related systems.
Describe new energy-efficient methods for installing and programming automatic temperature control systems.
Discuss common factors that influence an organization’s ability to meet its energy efficiency goals.

9:50 – 10:50 a.m.
2014 Guidelines for Design and Construction
Proposed Changes to Guidelines Part 2: Hospital Nursing Units and Diagnostic and Treatment Locations
Moderators: Kurt Rockstroh, AIA, ACHA, Steffian-Bradley Architects; Douglas Erickson, FASHE, CHFM, HFDP, CHC, Senior Project Manager, Northstar Management and Chair, Health Guidelines Revision Committee (HGRC)

Owner and designer input is needed on proposed new requirements in the draft of the 2014 edition of the FGI Guidelines, as well as proposed changes to existing language and removal of outdated requirements. Participants will have a chance to discuss new material that applies to hospitals of various types, particularly proposals regarding critical care, emergency care, behavioral health, imaging, and nursing units as well as architectural details. A voting system will be used, and all input will be recorded and reported to the 2014 HGRC at their final meeting. This session will enable you to:

Describe how proposed changes to Part 2 of the Guidelines will directly affect future design and construction projects.
Identify issues in the planning, design, and construction of hospitals that authorities having jurisdiction may expect your projects to comply with.
Gain information from the experiences of others who have used this document for health care design and construction projects to use as lessons learned for your own projects.
Apply your project experience to interpret and suggest improvements to the Guidelines document, which is widely used for design guidance and regulation of health care construction.

11:00 a.m. – Noon
Clinical Redesign
The Changing Role of Nurse Call Sytems in Facility Design and Operations
Terry Miller, BS, EE, Executive Vice President, Gene Burton & Associates

The presenter will examine the evolution of nurse call technology, including changes in the function and placement of system components, opportunities for interoperability with medical equipment, and advances in infant security and other in-room technologies. This session will enable you to:

Recognize, based on examples provided, the design issues presented by the function and typical placement of nurse call system components.
Discuss the opportunities for improvement in patient safety offered by changes in nurse call technology.
Describe the coordination needed to integrate nurse call and medical equipment technologies, using the examples given.
Identify the operational impact of design decisions by comparing building code requirements to the functional requirements for call completion.

11:00 a.m. – Noon
Fundamentals of PDC for Health Care
Using BIM for Facility Management
Michael B. Shanahan, AIA, Director, Facilities Planning & Development, Palomar Pomerado Health, San Diego; Thai Dinh, AIA, Associate Principal, Mascari Warner Architects, San Diego; Michael N. Smith, BIM Manager LEED® AP, C.W. Driver Ontario, Calif.; Frank Shadpour, PE, LEED AP, SC Engineers, Inc., San Diego

Information lost in the transition from construction to operations and maintenance in health care facilities is estimated at $15.8 billion annually. The presenters will explore how electronic documentation created during design and construction can be used to help reduce these costs now and in the future. Through case studies, they will discuss the effectiveness of using BIM (building information modeling) as a vital tool for health care facility management. A question and answer period will follow. This session will enable participants to:

Recount the questions owners should ask as they plan for the transfer of electronic information from design and construction to facility operations and maintenance.
Describe how BIM can be used to increase efficiencies in hospital facility management departments.
Describe typical facility management problems, using examples given, that can be addressed using BIM technology.
Discuss advanced uses for radiofrequency identification (RFID) technology as a means of tracking equipment using BIM.

11:00 a.m. – Noon
Innovation & Collaboration in the Field
Lessons Learned from Applying Design Templates to Renovtion Projects
Mark Barkenbush, Sr. Project Executive, Design & Construction; Steve Eiss, Senior Project Manager; and Susie Faz-McCann, Senior Director, Design and Construction from Banner Health; John Niziolek, AIA, LEED AP, Vice President, HKS

This session will feature members of the Banner Health design and construction team, including the lead architect, who will share lessons learned during two recent renovation projects in which in-house design standards and templates were used from planning and budgeting through occupancy. The panel will focus on the design efficiencies achieved by using templates as well as how the templates were changed and enhanced to meet the needs of both projects. This session will enable you to:

Explain, using the case studies presented, how design standards and templates bring efficiency to design efforts.
Describe the processes used in the case studies to update and improve design templates and adapt them to meet the needs of a particular project.
Explore how user understanding and satisfaction is improved through the application of design templates.
Discuss challenges related to using design standard templates on renovation projects vs. new construction.

11:00 a.m. – Noon
Performance Metrics
More Than Metrics: Strategies Behind an Emergency Department Success Story
Ray Gerbi, Facilities Consultant, and Michael Lynch, MD, Head of Emergency Services, from Concord Hospital; David Meek, Associate AIA, Senior Associate, Shepley Bulfinch

The head of clinical services, the facility director, and the project designer for Concord Hospital will present their perspectives on the design and planning process for transforming an emergency department. Using plan diagrams, baseline data, and volume projections, the presenters will discuss competing pressures, expectations, and demands for the project as well as the strategic decision-making process used to address them. This session will enable you to:

Implement a collaborative culture that stresses collective needs to achieve a patient-focused facility design.
Develop a design template that can accommodate an appropriate level of design variation and apply it as a strategy for cost-effectiveness and high utilization.
Plan a major expansion and multiphase renovation of a functioning emergency department that delivers project goals while meeting schedule and budget demands.
Establish internal departmental communication to foster design decisions and promote process change.

11:00 a.m. – Noon
Regulatory Issues
How Design and Construction Can Increase Quality, Boost Efficiency, and Maximize Profit
Mark Furgeson, ACHA, AIA, Managing Principal, FreemanWhite; Randy Keiser, Vice President, Healthcare Group Manager, Turner Construction Company, Dan Scher, MBA, Director Facilities Resource Group, Ascension Health

As mandated by the Affordable Care Act, the Centers for Medicare & Medicaid Services has adopted rules for value-based purchasing. Along with how hospitals meet these requirements, CMS will be assessing each hospital’s performance as evaluated by its HCAHPS program. The CMS scoring based on these programs will affect hospital reimbursements for services rendered. The presenters at this session will discuss how hospitals can use the PDC process to improve their scores in these CMS programs. Examples will be used to demonstrate increases in health care quality in new facilities that can be attributed to the physical environment. The discussion will include designs that improve patient safety, create a safe environment for staff, reduce staffing needs, and reduce hospital-acquired infections. This session will enable you to:

Explain how project planning, design, and construction methods can be used to improve a hospital’s CMS score.
Discuss design features and construction methods that support creation of a safer hospital.
Describe the CMS value-based purchasing program and how design and construction projects can affect reimbursement through CMS.
Apply lessons learned from the examples given to design a more efficient hospital (that is, one that requires fewer FTEs).

11:00 a.m. – Noon
Health Facility Commissioning
Meeting Your Energy Efficiency Goals—Part 2
Ed Tinsley, PE, LEED AP, HFDP, CHFM, Managing Principal, TME, Inc.; John Hayes, CEM, Founder/CEO, Hayes Energy Services

This is the second of two sessions covering the ASHE recommended health facility commissioning practices. This session will cover the activities recommended to facilitate the transition from construction to the occupancy and postoccupancy project phases. Topics will include operations and maintenance (O&M) dashboards, maintenance staff training, control system trends, postoccupancy testing, and measurement and verification of actual energy performance. This session will enable you to:

Explain how to establish and use O&M dashboards, including how to recognize and interpret trends in equipment performance, system performance, and overall energy performance.
Describe the ASHE recommended process for measuring and verifying actual energy performance, including setting the baseline; establishing linear regression models based on cooling degree days and heating degree days; using energy metering, and generating energy efficiency reports (daily, monthly, and annual).
Describe the key features of the ASHE recommended training for O&M staff and how they support sustainable energy-efficient performance of new building systems equipment in the long term.
Discuss the ASHE recommended process for postoccupancy testing of equipment and system performance.

11:00 a.m. – Noon
2014 Guidelines for Design and Construction
Changes to Guidelines Part 4:Residential Care Facilities
Moderators: Jane Rohde, AIA, FIIDA, ACHA, AAHID, LEED AP, JSR Associates, Inc.; Douglas Erickson, FASHE, CHFM, HFDP, CHC, Senior Project Manager, Northstar Management and Chair, Health Guidelines Revision Committee (HGRC)

Owner and designer input is needed on proposed new requirements for the 2014 edition of the FGI Guidelines as well as proposed changes to existing language and removal of outdated requirements. Participants will have a chance to discuss proposals updating text on skilled nursing, hospice, assisted living, and adult day health care facilities as well as new material on several other residential health care facility types. A voting system will be used, and all input will be recorded and reported to the 2014 HGRC at their final meeting. This session will enable you to:

Describe how proposed change to Part 4 of the Guidelines will directly affect future construction projects
Identify issues in the planning, design, and construction of residential care facilities that authorities having jurisdiction may expect your projects to comply with.
Gain information from the experiences of others who have applied this document to design and construction projects to use as lessons learned in your own projects.
Apply your project experience to interpret and suggest improvements to the Guidelines document, which is widely used for design guidance and regulation of health care construction.

Wednesday, March 7, 2012

Demonstrating value through integrated teamwork