WEDNESDAY, MARCH 15
GENERAL SESSION | 7 – 8:15 A.M.
The Surveyors' Perspective: Understanding How Joint Commission Surveyors Conduct Hospital and Ambulatory Surveys
James Kendig, MS, CHSP, CHCM, CHEM, LHRM, Field Director, Surveyor Management and Development, Division of Accreditation & Certification Operations, The Joint Commission; Tim Markijohn, MBA, MHA, CHFM, CHE, Field Director, Surveyor Management and Development Division of Accreditation & Certification Operations, The Joint Commission
This session will discuss how Joint Commission surveyors prepare for surveys and explains the new agenda process–including details on the agenda if a Life Safety Code® surveyor arrives with the team on day one or day two of the survey. This session shows how scoring is completed, explains the SAFER matrix, new Project REFRESH pilots, and reviews the new Joint Commission fire drill matrix. The session will also provide tips on successful surveys for the life safety, environment of care, and emergency management issues evaluated during the building tour. Attendees can ask questions during this session to get answers directly from those overseeing Joint Commission Life Safety Code surveyors.
- Describe how Life Safety Code surveyors prepare for surveys
- Explain step-by-step how Life Safety Code surveyors conducts surveys
- Discuss new Joint Commission survey process initiatives
- Implement tips for a successful Life Safety Code survey
CONCURRENT SESSIONS VI | 8:30 – 9:30 A.M.
Intelligent Health Care Campus Reduces Facility Operations Costs
Sanjyot Bhusari, PE, CEM, LEED AP, Intelligent Buildings Practice Leader, AffiliatedEngineers Inc.; Bradley Pollitt, NCARB, AIA, VP Facilities, UF Health; Mark Dykes, Project Manager of Energy Utilization, UF Health at Shands Hospital – University of Florida
This University of Florida Health case study highlights the importance of people and technology in solving health care facility management challenges such as resiliency, staff retirement, energy, and operational efficiency. By defining its intelligent campus strategies through outcomes rather than technology, UF Health has been able to adopt a holistic approach. Outcomes accomplished through this approach include $5 million in savings in the last 5 years, improvement of patient comfort, and reduction of building system alarms by 80 percent.
- Master the Intelligent Campus concepts and understand the business case for its implementation – possibly at your institution.
- Discover how the convergence of otherwise disparate systems can save significant operations costs, allowing greater investment in capital improvement and other health care programs.
- Acquire a clear understanding as to how to implement an Intelligent Campus approach on a campus or in a specific building.
- Recognize the impact of Internet of Things (IoT) and data on facilities and learn about the job functions you need today.
AMC Benchmarking Study: Facility Condition Assessment and Asset Management
Tony Groh, Director, Healthcare, Strategic Advisory Services, Jacobs; Nina Wollman, Program Manager, Asset Management Strategies, Jacobs; Alexa Braun, Director, Asset Management Strategies, Jacobs
This session is intended for health system leaders interested in learning how academic medical centers collect, manage, and leverage facility condition information. The presenters will offer insights based on a benchmarking study initiated by MD Anderson Cancer Center of its peer institutions. Common facility renewal practices will be identified as well as how data from facility condition assessments informs renewal and capital planning decision making. Top trends, best practices, and associated lessons learned from those best practices will be presented.
- Apply industry survey findings to implement new/improved asset management and facility condition assessment tools and techniques.
- Identify opportunities to improve approach and processes relating to capital asset and facility planning.
- Leverage facility condition assessment data to inform strategic facility planning.
- Gain insights from presenters and other session participants regarding facility condition assessment best practices and lessons learned.
The Big Room: Good, Bad and (Sometimes) Ugly
Jennifer Aliber, FACHA, AIA, Principal, Shepley Bulfinch; Mark Barkenbush, MSEE, Sr. Project Executive, Banner Health; Steven Yanke, PE, LEED AP, NCEES, Principal, Affiliated Engineers, Inc.; Hamilton Espinosa, CHC, Director, DPR Construction; Alison Rainey, AIA, NCARB, Director, Shepley Bulfinch
Co-location–having design and construction team members work together–holds the promise of significant savings in time, dollars, and effort while enhancing the quality of the documents, construction process, and the finished building. This presentation focuses on the Big Room of Banner University Medical Center Tucson. At its heart, co-location entails realignment of practices and priorities from individual organizations to the project. This panel discussion will include project goals, costs, organization, and schedule, as well as outcomes and lessons learned.
- Identify the primary goals and challenges of co-location.
- Appreciate how co-location may contribute to a redistribution of work effort and processes.
- Recognize the commitment, priorities, and challenges in being a team member in a Big Room.
- Decide if co-location may be right for your organization and what costs may be incurred.
Universal Prep-Recovery: New Paradigm or Smoke and Mirrors?
Dwight Smith, AIA, NCARB, EDAC, Director of Healthcare Planning, Ballinger; Richard Lawless, AIA, LEED AP, EDAC, Senior Project Health Care Planner, Ballinger
Flexibility is at the forefront of many of the decisions made in health care projects. As treatment and diagnostic modalities move toward a surgical suite model having both prep and recovery functions, multitasking seems to be a logical step. This session will look at the ways a universal prep recovery room could help address organizational goals including patient satisfaction, patient and staff safety, staff efficiency, clinical standardization, and building a brand and market share.
- Identify the requirements for both patient preparation and recovery.
- Assess the benefits and the limitations of the universal model.
- Explore where the universal room is applicable.
- Evaluate the effects on patient safety and satisfaction.
Patient Care on the Edge: The Medical Home Model and Serving a Rural Area
Diane Agee, CEO, Redwood Coast Medical Services; Kevin Day, AIA, LEED AP BD+C, Vice President, Design Principal, HGA Architects and Engineers
This session will focus on the divergent needs of a population composed of rich and poor and young and old, all with medical needs being satisfied in a rural location by one clinic, and the clinic's future as a patient centered medical home. The panel will review the site and its rich history, its location near the architecturally inspired community of Sea Ranch, the effect of nature, and the underserved medical needs of a diverse community.
- Explore how population health management affects a community with divergent health care needs and disparate economic means.
- Plan and design concepts and features that strive to improve throughput and operations and metrics comparing traditional models to an integrated care model.
- Assess the community benefits of an innovative clinic that unites a community around needs and beliefs and still addresses the IHI Triple Aim.
- Improve patient satisfaction and metrics expressed in the patient centered medical home model's planning and design features.
Better Together: Risk Management and the Physical Environment
Fran Charney, RN, MS, CPHRM, CPPS, CPHQ, CPSO, DFASHRM, Director Risk Management, ASHRM; Katie Carlson, MSN, MHA, RN, Education Manager, ASHRM
This fast paced, interactive session looks at how medical errors occur, what role the physical environment may play in medical errors, and the importance of interdepartmental teamwork to reduce risk and advance patient safety. Presenters will use video, slides, and audience participation to shine light on how a medical error can occur in a health care setting and how risk management can work with other facility departments to decrease the likelihood of reoccurrence.
- Identify how medical errors occur.
- Discuss the physical environment's role in medical errors.
- Explain the concept of human factors and how it relates to the physical environment.
- Determine how interdepartmental teamwork can decrease the re-occurrence of a medical error.
NFPA Requirements for PDC
James Peterkin, PE, LEED AP, Senior Life Safety Consultant, Fire Protection, TLC Engineering for Architecture
This session will discuss the new provisions of the 2012 NFPA 101: Life Safety Code® and NFPA 99: Health Care Facilities Code adopted by CMS and what will most likely affect the design of health care moving forward.
- Explain the basis for the changes in NFPA 101 and NFPA 99.
- Take advantage of the new provisions and work with authorities having jurisdiction to employ new operational strategies.
- Apply new provisions of the codes to current and future health care design.
- Identify what you can do to get involved in future changes to the codes and standards.
CONCURRENT SESSIONS VII | 9:40 – 10:40 A.M.
How You Can "Own" ASHRAE Standard 170 for HVAC Systems
Laurence Wilson, PE, Principal, SmithGroupJJR; Greg Kozlik, BSEE, MBA, Director, Facility Resources, Saint Joseph Regional Medical Center
This presentation provides an overview of the evolution of ASHRAE Standard 170: Ventilation of Health Care Facilities, including errata, addenda, and official interpretations as well as insights as to what technical issues are currently being investigated. The presentation will focus on design and construction issues including planning. Examples and common problems and their resolutions will be shared. The presentation will focus on systems start up, operation, and maintenance issues related to new construction and renovation projects, ICRA, documentation, accreditation, commissioning, and recommissioning.
- Establish project compliance with respect to Standard 170.
- Identify HVAC system design parameters.
- Identify specific room-by-room fit-out features.
- Assess planning/operation/maintenance requirements.
No Bump in the Night (or the Day): A Finish-Out Success Story
Rachel Knox, AIA, ACHA, EDAC, LEED AP, LSSGB, Associate Principal, HKS Inc.; Gwen Jones, RN, BSN, CPN, Manager, Care Area 8, Phoenix Children's Hospital; Jennifer Crawford, RN, BSN, CPN, Manager, Care Area 9, Phoenix Children's Hospital; Sidney Smith, AIA, NCARB, Associate Principal, HKS Inc.; Aron Kirch, CHC, Project Manager, Kitchell
When the time comes to build out shelled space, owners can be faced with constraints related to design, operations, schedule, and phasing, not to mention facing a major construction project in the midst of an operational hospital. This session will present the story of Phoenix Children's Hospital and some of the innovative tools used by the design and construction team. The owner will also present strategies used to accommodate the patients, families, and staff on the neighboring units during construction.
- Develop observations from your current state to inform optimal future state environments.
- Employ full-scale departmental mockups to improve the final design and increase staff and contractor buy-in.
- Develop effective communication strategies with staff during construction, and understand how to reduce noise and disruptions in an active facility.
- Empower staff to become champions of the design and construction process, and create enthusiasm and ownership over the finished product.
Planning for Security in Emergency Departments
Dennis Vonasek, AIA, NCARB, ACHA, CID, Vice President, HGA Architects and Engineers; David Fashant, Regional Director of Facility Services-South Region, Fairview Health Services; Roger Hunwardsen, CHC, LEED AP, Senior Project Manager, Knutson Construction
Security was an early design consideration for the Fairview Southdale Emergency Department addition. From planning for behavioral/mental health patients to mass casualty situations, the design and construction team focused on zones, control points, circulation routes, and egress paths to keep patients and staff safe during different high-stress situations. This session diagrams the unique security challenges and solutions designing emergency departments for wide demographics, highlighting lean strategies to increase operational efficiency and safety.
- Describe the impact of behavioral/mental health patients in the emergency department.
- Define security zones and protocols for patients, families, and caregivers in sometimes volatile situations.
- Address process improvement strategies to monitor and safeguard patient movement within the ED, prevent patients from leaving undetected, and handle "frequent fliers" (return) patients.
- Identify lean processes for improving protocol for mass casualty situations.
Power Play: Begin With the End in Mind
Clark Reed, ENERGY STAR Healthcare Program Manager, U.S. Environmental Protection Agency; Marty Lanning, CMVP, LEED, Partner, Energent Solutions
Hospitals are some of the largest energy-consuming buildings in the United States and are built to last 50 or more years. Best efforts are made to build the most functional, best looking, and most efficient buildings. However, when it comes to value engineering to reduce construction cost, what is considered value? Upfront cost? A 5-year simple payback? Learn how the EPA's Portfolio Manager can help benchmark the proposed building during the design phase. See how your design stacks up to real buildings nationwide.
- Assess whether the metrics used during the value engineering process are providing the best value for hospitals.
- Discuss the correlation between hospital age and ENERGY STAR score of Ohio's 100 hospitals in the Ohio Hospital Association database.
- State real examples of energy inefficient hospitals that are less than 10 years old and the savings lost by not designing for energy efficiency.
- Explain the ENERGY STAR Portfolio Manager design feature and how it can help architects and engineers get a benchmark during the design phase of a project.
Bringing Comprehensive Musculoskeletal Care Closer to the Community
Kathy Bell, AIA, ACHA, Healthcare Programmer/Planner and Architect, Associate, The S/L/A/M Collaborative; Stephen Carbery, BE, MBA, Vice President Facilities, Design, Construction & Real Estate, Yale New Haven Health; Mary O'Connor, MD, Director and Professor, Center for Musculoskeletal Care at Yale School of Medicine and Yale New Haven Hospital; Professor of Orthopaedics and Rehabilitation, Yale School of Medicine; Terri Frink, IIDA, Studio Leader for Interior Architecture Studio, Principal, Interior Designer, The S/L/A/M Collaborative
The Yale-New Haven Health System and Yale School of Medicine established a Center for Musculoskeletal Care in Stamford, Connecticut. The center brings comprehensive musculoskeletal services into the community and enhances coordination throughout the multi-disciplinary facility. When there is more dialogue between providers, resources are used better, driving lower health care spend per patient. This session examines the impact of the design of a multi-disciplinary clinic on staff efficiency, communication between providers, value and quality of care, and the patient experience.
- Establishing the importance and role design can play in driving a better patient experience.
- Identifying the need for a highly collaborative, multi-disciplinary atmosphere that promotes efficiency and improved patient outcomes.
- Developing and implementing brand standards across the ambulatory setting.
- Aligning patient's needs with facility needs in a flexible environment including both private and provider based services.
Area Calculations for Hospitals: Are You Planning With the Best Information?
D. Kirk Hamilton, FAIA, FACHA, EDAC, Professor of Architecture, Texas A&M University; Amy D. Kircher, M.Arch, LEED AP BD+C, EDAC, Experience Designer & Strategist, SmithGroupJJR
Texas A&M University, with support from Herman Miller, the Academy of Architecture for Health Foundation, and Alberta Infrastructure, conducted a research study of recently constructed North American hospitals to measure net gross ratios, building gross ratios, and the allocation breakdown within building gross components. This session presents the methodology and procedures used to measure the projects, and the important lessons learned in calculation methods. A survey and analysis of the past and present "rule of thumb" ratios used by the profession will be discussed in relation to the results of the study. The status of the research study, current results, and interesting conclusions that could impact assumptions in contemporary hospital space programming will be shared.
- Describe how precision and consistency of area calculation methods can improve benchmarking internally and externally.
- Explain how area allocations in recent hospital designs compare to past and present 'rules of thumb'.
- List components that make up the elements calculated as part of the building gross ratio.
- Discuss the value of consistently applying the methods from this study in your own practice.
Prescription to Move: Designing Active Environments
Moderator: Brian Raymond, MPH, Senior Health Policy Consultant, Kaiser Permanente
Panelists: James F. Sallis, Ph.D., Distinguished Professor of Family Medicine and Public Health, Chief, Division of Behavioral Medicine, University of California, San Diego; Sunil Shah, Executive Director - Capital Projects Group, Kaiser Permanente; Rachel MacCleery, Senior Vice President, Content, Urban Land Institute
Active design includes innovations adopted by hospitals and health systems to encourage physical activity. This session will discuss how innovations adopted by hospitals and health systems can encourage physical activity and give patients, visitors, and staff opportunities to engage in "active transportation" such as biking, walking, and using public transportation.
- Identify the principles of active design.
- List opportunities to incorporate active design with little or no cost to a project.
- Explore case studies where active design has made improvements to occupants' health and well-being.
- Discuss ways to approach active design concepts with hospital leadership and decision makers.
CONCURRENT SESSIONS VIII | 10:50 – 11:50 A.M.
Designing Community Health Clinics and Retail Centers in Kenya: An Interdisciplinary Approach from Texas A&M University
George J. Mann, Architect, AIA, The Ronald L. Skaggs, FAIA Endowed Professor of Health Facilities Design, College of Architecture, Texas A&M University
This session will explore how students at Texas A&M University created next generation health facilities in Kenya with the goal of promoting health and preventing disease. The yearlong effort involved 80 architecture and landscape students and four faculty members, and resulted in design concepts for dozens of primary care centers in Kenya and a biomedical industrial city proposed near the Kenyan capital, Nairobi. The designs considered human health, economic health, animal health, and environmental health.
- Describe the challenges and issues in undertaking an international research and design effort
- List steps to approaching an international project
- Explain the health problems Kenya experiences
- Improve communications between the client/owner and the design team
Designing and Transitioning to a Private Room NICU
Jamie Norwood, AIA, EDAC, LEED AP BD+C, Senior Associate, Hord Coplan Macht; Heather Flannery, EDAC, Senior Associate, Hord Coplan Macht
When MedStar Franklin Square was planning the relocation of an open-bay NICU to create private patient rooms, the challenges involved getting clinicians, administration, and families to align on the project vision to maintain the highest level of care. This session will look into the design process and how designers and clinicians worked together using design and technology to focus on a patient- and family-centered environment.
- Identify operational challenges related to moving to a private room NICU.
- Explain the integrated design process with key stakeholders.
- Explore initial patient and family outcomes post-occupancy.
- Identify design solutions to promote family-centered care.
Most New Hospitals Guzzle Energy: Keys to Break the Pattern
Alan Neuner, CHFM, Vice President, Facility Operations, Geisinger Health System; Kevin Gombotz, PE, Vice President of Engineering, Envinity; Mark Dykes, Project Manager of Energy Utilization, UF Health at Shands Hospital - University of Florida
Modern hospitals consume nearly the same energy as those of the 1960s, lagging behind other building types. Yet some facilities stand far ahead in energy performance, resulting in an emerging market to retrocommission hospitals shortly after construction, often cutting utility costs 20 to 30 percent with little capital expenditure. Why build it twice? How can the planning team sell energy enhancements up front, rather than as a retrofit? This session will unpack the issue with clear examples and actionable steps.
- Evaluate the root cause of energy intensive health care design.
- Navigate the barriers to adopting energy management best practices.
- Identify common energy efficiency design opportunities left on the table.
- Apply case study lessons learned to future capital planning projects.
USP 797/USP 800: Is Your Pharmacy Ready?
Robert Falaguerra, CHFM, Vice President of Facilities, Construction and Support Services, Saint Francis Hospital and Medical Center; Frank Peropat, Northeast Business Director, Grifols USA, LLC; Ronald Gorham, Associate AIA, Associate Principal/Architecture, TRO
Sterile compounding pharmacies have become one of the most regulated areas in a health care facility. The regulations set forth by USP (United States Pharmacopeia) and local boards of pharmacy have been changing significantly, leaving even recently constructed pharmacies out of compliance. Many owners are trying to understand how the regulations will affect the built environment and how pharmacy staff will work within it. This presentation will address how to be in full compliance and the action steps for a successful outcome.
- Outline the proposed standards for USP Chapter <797> Pharmaceutical Compounding–Sterile Preparations Standards, and <800> Hazardous Drug-Handling in Healthcare Settings and their dates of expected compliance.
- Explain the importance of forming an integrated design team, which includes pharmacy staff, facilities, infection control, architects, engineers, and other key stakeholders.
- Identify how local pharmacy boards are enforcing the USP standards.
- Describe how to translate pharmacy operational processes into effective space planning that keeps staff and patients safe.
Designing Critical Access and Rural Health Care Facilities
Ryan Turner, AIA, LEED AP, Architect, DSGW Architects; Mark O. Vizenor, CBET, Facility Operations Manager, FirstLight Health Syste
More than 29 percent of America's hospitals are either critical access or defined as rural health care facilities. In the pursuit to develop regulations, policies, and standard operating procedures we often forget about the unique challenges these small facilities face in complying with some of these requirements intended for their "big brothers" The design of these facilities often requires a creative, multipurpose approach.
- Identify the limitations of CAH's and similarities with small rural hospitals.
- Review successful case studies where these facilities are able to meet community needs with a very small average daily census.
- Identify some of the unique regulatory requirements for CAHs and some of the requirements that CAHs have difficulty meeting.
- Develop strategies to identify how these hospitals can be used as a community hub for other activities.
On-Site Power Solutions: The Benefits of Cogeneration
Jim Salvino, MEP Executive, Clark Construction Group, LLC; Claudia Meer, Managing Director, Clark Energy & Structured Finance, Clark Construction Group, LLC; Gregory J. Swaluk, PE, LEED AP, Principal CMTA Inc.; Donald Allik, Director of Facilities, University of Maryland Medical Systems, Upper Chesapeake Health
Clark Construction Group's Energy and Structured Finance (ESF) division is helping the University of Maryland Upper Chesapeake Medical Center to save millions of dollars, significantly reduce emissions, and increase reliability during prolonged power outages. Clark ESF designed a highly efficient two megawatt combined heat and power system, which serves as the primary power source for the hospital's electrical load. Using a unique partnership structure, Clark ESF delivered the system with no upfront costs to the hospital.
- Identify the benefits of a combined heat and power system as an on-site power technology;
- Determine the considerations when evaluating a combined heat and power system installation;
- Understand the financial benefits of using a power purchase agreement for implementation of a combined heat and power system, including mitigation of single point of failure of diesel generator for critical care loads;
- Articulate the benefits of turnkey delivery of a combined heat and power system as an on-site power technology.
Designing for the CMS Conditions of Participation
John Williams, Program Manager, Construction Review Services, Washington State Department of Health; Chad E. Beebe, AIA, CHFM, CFPS, CBO, FASHE, Deputy Executive Director of Advocacy, ASHE
The 2012 edition of NFPA 101: Life Safety Code® has been adopted by the Centers for Medicare & Medicaid Services (CMS) as part of its Condition of Participation (COPs). This session will introduce attendees to the latest provisions of the code for new construction as well as compliance requirements for existing facilities. The presenters will also lead a discussion on the next steps for future Life Safety Code adoption and participation opportunities for attendees.
- Identify the new CMS requirements for several different provider types.
- Distinguish between facility provider types and the applicable sections of the code.
- Plan a compliance strategy for existing hospitals.
- Discuss the differences between the COPs and local regulations that may affect construction projects or operations.
CHC EXAM | 1 – 4 P.M.