WEDNESDAY, MARCH 23, 2016
7:00 — 8:15 a.m.
How PDC Professionals Can Promote Community Health
Robert Ivy, FAIA, EVP/Chief Executive Officer, American Institute of Architects (AIA); Shannon Kraus, FAIA, Senior Vice President, Regional Director, HKS Architects; John Kouletsis, AIA, EDAC, Vice President, Facilities Planning & Design, National Facilities Services, Kaiser Foundation Health Plan, Inc.
This panel discussion led by Robert Ivy, CEO of the American Institute of Architects, will discuss how we shape our communities to promote healthy living. Architects, engineers, and contractors can design and build environments that incorporate physical activity into people's daily routines, give them a community with attractive destinations within walking or biking distance, and keep safety in mind with lighting, "eyes on the street" design, traffic calming, and other techniques to improve pedestrian and bicyclist safety. An upfront investment in good design can save money—and lives—in the long run.
- Discuss the hospital, design, and construction teams' roles in community health
- Identify the key design issues that can improve community health
- Explain the impact of community design on the hospital
- How to encourage physical activity, reduce air pollution, and preserve the environment through healthy design
CONCURRENT SESSIONS VI
8:30 — 9:30 a.m.
Tim Adams, FASHE, CHFM, CHC, Director, Member Professional Development, American Society for Healthcare Engineering (ASHE); & Lynn Kenney, Senior Analyst, Advocacy Team, American Society for Healthcare Engineering (ASHE)
The 2018 proposal process for the FGI Guidelines was open to the public via the FGI website last June through October, and more than 1,000 proposals were submitted. The 2018 Guidelines revision process is now well underway and the Health Guidelines Revision Committee (HGRC) is reviewing and voting on proposals to update the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities. The proposal review process includes input and representation from many professionals in the health care field–including clinicians, caregivers, administrators, facility managers, design professionals, authorities having jurisdiction, and others–to create an internationally-recognized set of guidelines on the minimum requirements for the design and construction of hospital and outpatient facilities. A draft version of the 2018 edition will be published on the FGI website for public comment. This session will provide an overview of the new proposal review process and an overview of the proposed changes. After attending this session, attendees will be able to:
- Explain the history of the Guidelines and the adoption process
- Discuss the new FGI proposal and review process
- Name the major themes represented by the proposals submitted for the 2018 edition
- Identify resources to assist in the use and interpretation of the Guidelines
Kathleen Margolis, Practice Area Leader, Gensler, Sarah Bader, AIA, Principle, Gensler, & Tama Day, FIIDA, FASID, Principal, Gensler
The double-digit expansion of retail clinics has been fueled by the need for expanding access to primary care. Retail health models offer providers varied alternatives for reaching their customers. This session will present strategies for delivering affordable outlets for primary care including partnering with existing market owners, studying delivery methodologies to create cost-effective and flexible real estate solutions, and using brand identity to build fidelity and awareness. Attendees will engage in fact finding, storytelling, and exploration of strategies that may have some relevance to their particular markets.
- Understand market opportunities for engaging non-traditional partners to deliver cost-effective care solutions.
- Describe standard retail industry delivery models and understand their application to health care.
- Explain how creating brand awareness can link expanding retail outlets with existing acute care infrastructure.
- Identify cross industry benchmarks to inform use of effective real estate.
Noah Kahn, AIA, Director, Project Metrics & Benchmarking, Kaiser Permanente
The Construction Industry Institute at the University of Texas established the only external benchmarking and metrics program to gauge the performance of health care facility projects. This session explains how the National Healthcare Facilities Benchmarking Program works and what types of analyses are produced. Interesting findings from the first round of data collection will be presented. Kaiser Permanente will demonstrate how they use the information produced by this program to improve project delivery.
- Describe the benefits that an external benchmarking program provides when comparing the projects of multiple organizations.
- Outline the methods used to normalize project data to establish meaningful comparisons amongst projects.
- Articulate how project performance data are used to explain and organize estimates for proposed facilities.
- Explain the variance and trends in facility programming and space planning across leading health care organizations.
Co-Designing for Patient-Centered Care Delivery: Using Systems Science to Inform Environment of Care Development and Operations
Lisa Platt, MS, CSSBB, EDAC, LEED AP BD+C, Planetree International
Co-designing with patients and using patient-centered performance improvement strategies to guide planning for health care spaces has elicited compelling outcomes. These spaces deliver timely, high quality, and potentially safer care. Process improvement co-designed by patients activates the potential for more innovative and resilient environment and care design solutions. This participatory approach also contributes to increases in patient and staff satisfaction, feelings of increased buy-in on planning decisions, and ownership of improvement outcomes.
- Describe how using participatory design and systems science to shape plans for health care environments can increase the reliability that these settings are adaptive and supportive of patient and staff safety and care efficiency.
- Identify opportunities to apply patient-centered performance criteria to improve the patient and staff experience.
- List a number of specific strategies that can be deployed to elicit and engage patients in co-designing health care environments.
- Describe methods used to measure the impact of patient-centered performance improvement strategies and co-design.
John Reeve, AIA, President, Christner & Jeff Johnston, President, Mercy Hospital St. Louis
To improve on design approaches to health care facilities, three postoccupancy evaluations were conducted at two adjacent facilities over ten years. The objective of doing successive evaluations over time is to establish a continually evolving design strategy based on changing conditions and attitudes. This project highlights findings from those evaluations and presents not only a framework for conducting ongoing building evaluations, but suggests a model approach for research between architecture and health care practitioners.
- Engage a methodology and framework for ongoing building evaluation.
- Identify and address challenges in establishing correlative evaluations over time.
- Develop strategies that foster collaborative research between architecture and health care.
- Assess design strategies that contribute to improvement of health care delivery and patient experience.
User Experience (UX) Mapping: An Initiative to Map Current and Ideal Experiences for the Design of a New Hospital
Adeleh Nejati, Healthcare Architect and Design Researcher, HKS Architects; Nicole Duncan, Assistant Vice President, Advocacy & International Services, MedStar Georgetown University Hospital; Jennie Evans, RN, BS, EDAC, LEED AP, Lean Six Sigma CE, Sr. Vice President, Associate Principal, HKS Architects; Laura Hild, CID, CHID, IIDA, LEED AP BD+C, Vice President, HKS Inc.; Laura Hild, CID, CHID, IIDA, LEED AP BD+C, Vice President, HKS Inc.; & Upali Nanda, PhD, Assoc. AIA, EDAC, Vice President, Director of Research, HKS Inc.
This session will provide new knowledge on how to implement User Experience Mapping in health care settings as a method to deeply engage patients and families to map their current and ideal patient experiences for the design of a new facility. It also provides information on how to conduct a patient experience mapping step by step from discovery, research, and mapping the journey to communicating the journey, identifying the opportunities, and generating the design solutions.
- Describe how the patient experience and operational flow may sometimes be out of sync.
- Understand research tools to develop an experience map that is rich in qualitative insights.
- Identify how sometimes an efficient system and patient experience concerns can be at cross-roads, and how to resolve this conflict.
- Appreciate how engagement and observation are key to designing a better patient and family experience.
CONCURRENT SESSIONS VII
9:40 — 10:40 a.m.
Success in Design-Build Master Plans
Phil Soule, Principal with Cuningham Group Architecture
Panelists: Robert Betz, Executive Vice President, San Diego, McCarthy Building Companies, Inc.; Pat Nemeth, Vice President of Facilities, Sharp Healthcare; & Wayne Hunter, Principal, Cuningham Group Architecture
This session will showcase the benefits of design-build master plans in health care from RFP through project execution. The major differences between design-build and conventional master planning will be discussed as well as the pros and cons of each. Learn how to develop a realistic design approach that is affordable yet that meets facility needs and minimizes effect on existing operations during the implementation process.
- Describe how the master plan met the true facility needs and provided the community with the highest quality of health care services.
- Describe how the team developed a realistic design solution that was buildable and minimized impact to the existing operations during the implementation process.
- Assess and develop an affordable phased approach.
- Identify a clear and realistic road map to meeting SB-1953 seismic requirements by 2030.
Postoccupancy Evaluation or Patient's Observation of the Environment? How Patient Feedback Influences Design
Moderator: Vincent Della Donna, AIA, ACHA, Director, Healthcare
Panelists: Kara Freihoefer, PhD, EDAC, LEED ID+C, Associate|Healthcare Research Specialists, HGA Architects and Engineers; Mary Lindeman, AIA, EDAC, LEED AP, Project Manager, CHD Partners Inc.; Jennie Mae Evans, RN, BS, DEAC, LEED AP, LEED SIX SIGMA CE, Associate Principal & Senior Vice President Healthcare Group, HKS Architects
The challenges faced by health care systems and executives today are more complex than ever. How can they know that they are putting their limited design and construction resources toward creating the best patient experience? Collecting data and evidence for benchmarking and decision making increases the odds. Postoccupancy evaluations (POEs) can be a valuable source to obtain, understand, and incorporate the patient's perspective. This moderated panel of experts will explore how postoccupancy evaluations are being used as a valuable tool for improving the patient experience through health care design.
- Explain what constitutes a substantive and useful POE with respect to discovering patient experience outcomes.
- Describe key lessons learned about the patient experience using POE case studies.
- Articulate the relationship between POEs and the design process.
- Describe how POEs can be used as a design tool to enhance the patient experience in future projects.
Jeremy Krug, Field Sales Engineer, Cambridge Sound Management
This session explores the principles behind acoustic and speech privacy as it relates to patient privacy and sleep quality in health care. Attendees will learn the fundamentals of how speech privacy is achieved and understand the goals for acoustic privacy in health care. The implementation of sound masking will be discussed and compared to other available options in terms of efficacy, difficulty, and cost. Attendees will explore the results of sound masking deployment in health care facilities.
- Describe the importance of acoustic privacy in the health care environment.
- Explain what speech privacy is and how it affects patient safety and satisfaction.
- Articulate what sound masking is and what role it plays in speech privacy.
- Explore the results of sound masking deployment in health facilities.
Christina Grimes, AIA, LEED BD+C, EDAC, Associate, Ballinger, Louis Meilink, Jr., AIA, ACHA, ACHE, Principal, Ballinger, Cathy Weidman, MPA, BSN, RN, CNML, Director of Medical Surgical Services, The Chester County Hospital, & Debbie Phillips, AIA, ACHA, EDAC, Senior Healthcare Planner, Ballinger
Most design projects include lofty goals for improved patient outcome and patient satisfaction and improved staff performance, but once the project has been completed and occupied, how often are those goals measured and evaluated against the new environment? This session will present the postoccupancy evaluation (POE) of Penn Medicine Chester County Hospital's three newly constructed patient units. Upgrades to the physical environment and changes in operational protocols will be assessed. From insights gained, a cost-benefit metric will be assigned to the different categories for the future design.
- Identify design concepts that provide the most impact on HCAHPS scores, either because of patient satisfaction or through better staff performance.
- Calculate the cost savings from different design interventions and assess first costs (construction) against longer term (operational) costs.
- Compare staff responses from POE against the initial goals and expectations for the project.
- List which design interventions performed well enough to merit repetition in upcoming building construction.
Michael Hatton, MBA, CHFM, RPA, SMA, SASHE, Vice President of Facilities Engineering, Memorial Hermann Health System & Lindsey Brackett, Director of Facility Management Services, TME
Although patient satisfaction is subjective to each individual experience, quantifiable metrics have been established as a mechanism to compare and benchmark facilities and their performance. This session explores these metrics and how they are directly impacted by the PDC process and influenced by operational excellence. A case study will demonstrate how Memorial Hermann Health System has successfully implemented this approach during several projects, leading to cost benefits.
- Discuss the Affordable Care Act and Value Based Purchasing (VBP) from the perspective of operational sustainability
- Identify measures that start early on in the PDC process, carry over well beyond the warranty phase, and have the greatest impact on the hospital's operating margin
- Learn the benefits of operator training programs and how they decrease overall costs and increase patient satisfaction
- Discuss the benefits of a total team approach that bridges the gap between design and operation
Mythbusters: Reality versus rhetoric regarding public-private partnerships
Allyn Stellmacher, Design Partner, ZGF Architects LLP, Walt Massey, National Healthcare Practice Leader, Balfour Beatty Construction, Dave Ingram, Executive Director and Chief Project Officer, Provincial Health Services Authority, Chris Arthur, Senior Vice President, Balfour Beatty Investments
A new hospital in British Columbia (BC), Canada that will provide care for the most seriously ill children and most complex obstetrical cases in BC is being delivered by a 33-year, fixed-price public-private partnership (P3). P3 contracts for design, build, finance and maintenance are common for major health care projects in Canada and interest is growing the United States-but hesitation from owners still remains. Does on-time, on-budget delivery mean sacrificing patient-centred design? Is a thirty-year partnership really sustainable? How can you successfully marry all the elements of design, build, finance, and maintenance in one consortium while handling the risk allocation among consortium partners? In this session, the clients and project architect will debunk the myths associated with the P3 and discuss how they built a patient-centered health care facility with a life cycle extending beyond 20 years.
- Explain the complexity of P3 delivery and how it differs from traditional approaches.
- Recognize the rewards and potential drawbacks of the P3 delivery method.
- Describe how to negotiate a P3 agreement and continue the conversation throughout the project's design, construction, and management.
- Highlight key design elements that have provided the double bottom line of providing a healing environment for patients and extending the project's life cycle beyond 20 years.
Stephanie Fagan, LEED AP, Sustainability Program Director, HFS
Addressing the high usage of resources in health care starts with a discussion on a corporate-wide sustainability strategy. Learn how to evaluate and set sustainability goals while calculating the best balanced solution for a successful project, including the best return on investment options to fit your project objectives. Identify sustainability options within your operations and learn how to implement and manage these options. Obtain the tools you need to organize and engage your team to develop, review, and implement corporate sustainability initiatives.
- Identify sustainability opportunities within the facility.
- Describe how to build a sustainability team within the organization.
- Explain how to establish goals and a workable sustainability plan.
- Obtain necessary links and knowledge for resources and additional guidance.
CONCURRENT SESSIONS VIII
10:50 — 11:50 a.m.
Ashley Umaña, EDAC, LEED AP, Senior Project Manager, Stanford Healthcare & George R. Tingwald, MD, Director of Medical Planning, Stanford Healthcare
Stanford Health Care (SHC) is undergoing a core business transformation to provide preventative and wellness-focused care. SHC plans to build a 50,000 square foot integrated digestive health center. As a new business model, a multi-year 3P (production, preparation, and process) effort was undertaken to map current and future state operations and design a facility that will support those needs. Come learn how our team embraced 3P to design an innovative facility that is poised to provide the highest quality of patient care.
- Describe the benefit of engaging both physical and virtual simulations in the planning, design, and construction process.
- Explain how the 3P effort facilitates planning operational and facility design in conjunction with each other.
- State the importance of user-driven planning and design.
- Identify the importance of exploring and evaluating all possible facility design solutions.
Strategies for Taming Chaos, Consolidations and Capital Budgets
Cathy Dolan-Schweitzer, MA, President, Health Well Done
In the chaos of consolidation and capital budget management we focus on efficiencies in order to cut costs and save money. This works well until the human element enters the picture. Efficiency can quickly disappear when people's emotions and feelings become involved. How would healthcare be different if the environment was designed by listening to the personal stories told by patients, families or staff? Stories recount passionate histories that enable better communication and collaboration leading to more effective design and implementation. This interactive storytelling workshop presents a simple project delivery system with a big-picture, long-term strategy that is patient and staff engagement driven.
- Assess your facility talent for leading patient-centered project teams.
- Explain the three parts of the project delivery model and how they fit together.
- Describe the benefits of the art of storytelling in designing healing environments.
- Identify three action items to improve the project success rate.
Toward Improved Healing Environments Through Evidence-Based Design: Patient Rooms in Mansoura University Hospitals, Egypt
Ahmed Eldeep, Assistant Lecturer, Kafr Elsheikh University, Elsheikh City, Egypt
The patient room is one of the most important elements of the health care environment. When considering the patient room, the designer must keep in mind both the physical and psychological needs of the patient as well as the cost of the design and its impact on the level of service provided. The presenter will discusses his work in the city of Mansoura and the evolution of health care in Egypt, and how his conclusions will affect the future hospital design.
- Explain the status of patient rooms.
- Describe some of components of the existing patient rooms in Egypt.
- List the elements of good patient room design.
- Identify a new design for a healing room.
Mary Alcaraz, PE, LC, CEM, LEED BD+C, Senior Project Manager, The Children's Hospital of Philadelphia; Mariana Figueiro, PhD, FIES, Professor & Program Director, Lighting Research Center — Rensselaer Polytechnic Institute; Karyn Gayle, MIES, EDAC, Vice President, Healthcare, Acuity Brands; Edward Clark, Sustainable Designer, ZGF Architects, LLP
This session challenges our industry to design lighting for an improved environment of care. The presenters will showcase leading research in lighting and health, review the soon-to-be-published Illuminating Engineering Society (IES) Recommended Practice in Lighting for Hospitals and Healthcare Facilities, RP-29, and outline a bridge to incorporating research, technology, and standards to improve the patient experience from the owner's perspective.
- Explain the basics of visual and non-visual systems and how light affects these two biological systems.
- Discuss lighting schemes that can be implemented in health care facilities to increase sleep quality, improve visibility, and reduce falls for patients. Discuss lighting schemes that can be implemented in health care facilities to increase alertness.
- Understand the important updates to the IES Recommended Practice in Lighting for Hospitals and Healthcare Facilities, RP-29.
- Demonstrate how new technology can be applied to design lighting for improved patient care in health care facilities.
Walt Vernon, PE, LEED AP, EDAC, FASHE, Board Member, Facility Guidelines Institute; Virginia Pankey, AIA, EDAC, LEED AP, Senior Medical Planner Christner, Inc.; Gloria A. Cascarino, Senior Associate, Director of Medical Equipment Planning, Francis Cauffman Architects
Today we are challenged to create health care facilities that can reduce costs for effective care delivery. Technology has played a critical role in this process by eliminating the need for certain functions and facilitating acuity-adaptable rooms and shared departments across health care systems. Revisions for the 2018 FGI Guidelines are under development this year, and one of the major issues being discussed is technology. What is the impact of technology on the health care built environment, and how should the revised Guidelines address these changes? This session is not a presentation-it is a workshop for attendees to provide their input on making revisions to the Guidelines. Walter Vernon will provide a brief update on the status of the proposals currently under consideration. Then working groups facilitated by a Health Guidelines Revision Committee member will explore the influence of technology in current and future health care planning, design and construction; and how the Guidelines should be revised to capture this transformation. The number of attendees will be limited to 60.
- Distinguish between different kinds of evidence.
- Participate in facilitated discussions on the future of health care technology.
- Provide a series of recommendations for consideration by the Health Guidelines Revision Committee.
- Explain how FGI committees will use this information to formulate proposed language for the 2018 edition.
Roger Call, AIA, ACHA, LEED AP, EDAC, Director, Healthcare Kaizen Architecture, Herman Miller Healthcare
This presentation will describe the connection between lean, physical facilities, and health care operations using a case study at Bluewater Health in Sarnia, Ontario. Lean requires systemic thinking.
Health care is a system of interacting or interdependent components forming an integrated whole; this presentation will look at lean as it applies to design, construction, and operations of a health care facility. The new challenge for health care facility designers and managers is to create facilities that are adaptive, that is, designed to be changed with minimal capital costs.
- Review the basics of lean as taught by Toyota and how they apply to cost, quality, and patient experience in health care.
- Understand the changing connections between design, construction, and operations.
- Compare cost and value.
- Understand the effect of rate of change on return on investment.
Gary Walker, PE, CFM, Administrative Director, Stanford Health Care & Eric Dillinger, Vice President, Jacobs
Stanford Health Care is working to align to the recently published ISO 55000 asset management standard to serve as a framework for strategic decision making from the planning stage to daily execution that reduces life cycle costs, improves patient experience, and enhances building health. This session provides a case study of the implementation process over the first 18 months of a 3-year initiative and will provide key steps, lessons learned, and the ongoing value proposition for the program.
- Identify opportunities to improve total cost of ownership in the facility lifecycle.
- Develop a strategic asset management program in a health care environment.
- Create a clear alignment between facility metrics and organizational objectives.
- Engage ISO 55000 standards for improved performance.
CERTIFIED HEALTHCARE CONSTRUCTOR (CHC) EXAM
2 — 4 p.m.