Avoiding Disaster: The Texas Medical Center Story
Terry Scott, MBA, CHFM, CHSP, SASHE, System Director of Engineering Services, Memorial Hermann Health System; Bert Gumeringer, MBA, MSIT, CHFM, FASHE, Assistant Vice President Facilities Operations, Texas Children’s Hospital; Michael Hatton, MBA, CHFM, RPA, SMA, SASHE, Vice President of Facilities Engineering, Memorial Hermann Health System; Timothy Peglow, PE, SASHE, Associate Vice President, Patient Care and Prevention Facilities, MD Anderson Cancer Center
When Tropical Storm Allison hit the medical center in 2001 it caused hundreds of millions of dollars in damage to these facilities. Through careful planning, design, and construction, area hospitals invested in a system that was put to the test on August 24, 2017, when Category 4 Hurricane Harvey made landfall, causing more than $100 billion in damages to southwestern Texas. Even after more than 40 inches of rain, these hospitals were able to maintain operations and care for patients.
- Compare the impacts of Tropical Storm Allison and Hurricane Harvey on Texas Medical Center
- Describe the process that ensued after Tropical Storm Allison to ensure damages would be limited in future events
- Describe the mitigation techniques used and the goals of the program in developing the flood mitigation network at Texas Medical Center
- Discuss the value the system has on the community’s confidence and the commitment of the health care providers
8:30 – 9:30 a.m. | Concurrent Sessions VI
Patient-Centered Programming: Form, Function, Economy, and Time
James Easter, ACHE, FAAMA, March, Principal, Easter Healthcare Consulting; Andy Collignon, JD, AIA, NCARB, LEED, Starting Point Health; Tom Testerman, NCARB, ACHA, HFR Design, Inc.; Debbie Gregory, DNP, RN, Senior Clinical Consultant, Smith Seckman Reid, Inc.
The patient-centered aspects of health care delivery begin with experienced functional programming. Assessing the clinical and operational needs with those of the patient and staff is a balance of function, form, economy, and time. The ability to apply structured functional programming in the context of a campus master plan is the most appropriate and proven approach. This discussion conveys the value-added attributes of the full continuum of planning for gaps in the system, recruitment, retention, and process change.
- Define the most effective method of functional programming and outline the best methods to determine the key planning units
- Define how programming differs between facilities needing to be upgraded and facilities and programs starting from scratch
- Outline the priority attributes of a functional program within a health care delivery system, compared to a standalone acute care hospital
- Determine the value-added attributes of a functional program and whether standardization prototypes should be considered
- Ensuring the “most effective” balance of technology, systems and service delivery (patient care first and foremost)
Infection Prevention: Collaborations in Design and Construction
Jayson Casallo, LVN, AC, LEED Green Associate, President/Owner, Casallo Healthcare Construction Consulting; Pamela Redden, MS, BSN, RN, EDAC, Associate Principal & SVP, HKS, Inc.; Richard Rucksdashel, AIA, Vice President, HKS, Inc.; Timothy Peglow, PE, SASHE, Associate Vice President, Patient Care and Prevention Facilities, MD Anderson Cancer Center
Infection transmission is a constant concern in medical settings, posing threats to patients and staff and negatively affecting the organization’s bottom line. Projects offer opportunities to support safety and infection prevention but the complexity of design and construction can be fraught with obstacles, especially when translating design to construction documents. This presentation addresses the facility implications in planning for infection transmission prevention, recommendations for developing an infection prevention team, and insights from project leaders.
- Discuss the programmatic implications of access to personal protective equipment
- Identify two areas where gaps in information affecting infection prevention can occur when design documents are translated into construction documents
- List at least four departments/roles that should be represented on an infection prevention team
- Explain two infection prevention implications of technology additions to inpatient rooms
FGI and ACEP: New Ideas in Emergency Design
Walt Vernon, PE, MBA, JD, LEED AP, EDAC, FASHE, CEO, Mazzetti+GBA; Virgina Pankey, AIA, EDAC, LEED AP, Associate, Christner
This session builds on the Facility Guidelines Institute workshop conducted during the 2016 PDC Summit. The session will apply the principles of design thinking, coupled with deep clinical expertise, to identify pressing needs and opportunities at the intersection of planning and delivery. In this session, a “Shark Tank” format will be used to explain the principles of design to demonstrate how the FGI uses these tools to improve Guidelines development and to test new ideas for the emergency department.
- Identify the basic principles of design thinking
- Review how FGI is evolving and how it is using design thinking and clinical expertise to improve future Guidelines content
- Gain exposure to new ideas for emergency services design
- Have fun shaping a further research agenda for the FGI by helping to pick a best topic
Cardiovascular Service Line Design: Improving Patient Care Delivery
Jim Albert, Principal, Hord Coplan Macht; Katherine Brown, MSN, RN, Vice President, Clinical/Strategic Consulting, Corazon, Inc.; Sunita Vadakath, MD, FRCA, MPA, Cardiovascular Service Line Director, MidMichigan Health
Vertically integrated cardiovascular service lines provide better coordinated patient care, with improved outcomes. Integrating a cardiovascular service line requires thoughtful redesign of operational processes around the patient’s needs. The service line model also requires investments in equipment and facilities. Properly designed facilities reinforce operational models and elevate how patients experience their care. This session provides an overview of MidMichigan Health’s vision for a patient-focused cardiovascular service line and demonstrates how the organization partnered lean workflow redesign with progressive facility approaches.
- Describe how an integrated service line approach can provide a better patient experience throughout the entire continuum of care
- Explore a joint facility design and operational approach to cardiovascular service line organization
- Evaluate how architecture enhances the clinical operations of a cardiovascular service line
- Differentiate your organization’s strategic vision and brand its clinical expertise through a cardiovascular service line design
Without Interruption: Rebuilding an Occupied 482-Bed Patient Tower
Karl Sonnenberg, AIA, ACHA, ASHE, Partner, ZGF Architects LLP; Brad Nile, AIA, LEED AP, ASHE, Senior Project Manager, Andersen Construction Company; Mark Tobin, PE, SE, Principal, KPFF Consulting Engineers; Nancy Roberts, MPH, Chief Operating Officer, Providence St. Vincent Medical Center
Many hospitals must decide what to do with older buildings with significant infrastructure and interior quality issues. Providence St. Vincent Medical Center faced this challenge with its 482-bed main tower. This session will illustrate the collaborative and transparent design process that enabled the team to evaluate multiple options, and how complex decisions were made. Solutions included big concept moves to micro details. As a result, a 40-year-old fully occupied nursing tower was rebuilt to serve patients for another 40 years.
- Identify the key decision points, opportunities, and issues involved in updating all the building systems of a large four-decade-old nursing tower
- Explain how a collaborative and transparent design process can efficiently solve complex problems
- Describe how to mitigate the impact of major and invasive renovations on patients
- Demonstrate how multiple-phase projects can continually improve on design and construction results
9:30 – 9:40 a.m. | Networking Break
9:40 – 10:40 a.m. | Concurrent Sessions VII
Behavioral Health for the ED: A Safe Space
Anne Cox, AIA, LEED AP BD+C, EDAC, WELL AP, Senior Medical Planner, HKS; Jennifer Cayton, AIA, NCARB, LEED AP, Manager of Design, Ascension Planning Design and Construction (PDC)
This session will gather information and testimonials from the emergency department, social workers, and facilities staff that helped to design the behavioral health section of an existing emergency department. This emergency department expansion began with the goal to create a calm and thoughtfully purposed addition to an existing emergency department. The session will include reflection on the successes and failures of the project and a discussion of product selection as well as the tools useful for behavioral health design.
- Discuss the needs of behavioral health in the emergency department and different strategies for success
- Explore the Patient Safety Risk Assessment Tool
- Discuss sucessful product selections for behavioral health
- Compare staff testimonials regarding sucesses and failures of the space
- Provide lessons learned from recent Joint Commission changes for designing behavioral health spaces
Enhance the Patient Experience with Technology
Mike Maselli, Principal, EDI, Ltd.
Technology enables health care facilities to do more than ever to enhance the patient experience, but to capitalize on this opportunity, organizations must be prepared. Administration, facility design, construction, and information technology must know how all the pieces integrate to provide for an exceptional and pleasing experience for patients and visitors. This session will lay the framework for the programming, design, and implementation of technology integration for optimized patient engagement, entertainment, and satisfaction.
- Assess the newest device integrations available for the health care facility
- Explore ways to program technology that matches the care delivery process
- Identify the patient experiences possible with the latest technology
- Describe the organizational steps to take to implement technology effectively in programming and design
A Team’s Journey to Improve Safety, Quality, Efficiencies, and Communication
Brad Benhart, MBA, LEED, ASHE HC, Healthcare Construction Management Program Manager and Associate Professor of Practice, Purdue University; Josef Michuda, LEED AP, ASHE HC, CM-LEAN, Executive Vice President, Michuda Construction; York Chan, CHFM, CHC, SASHE, Administrator of Facilities, Advocate Health Care
This panel will focus on strategic partnerships and the evolution of a team and processes. Michuda Construction, an Advocate Healthcare partner, answered Advocate&rspuo;s challenge of zero incidents by 2020. The project required more than applying lean terminology to existing procedures. Conversations with Purdue University led to the addition of an eager graduate student, and the journey began. This presentation will be a dynamic discussion with the team and review lessons learned, best practices, new tools, and a valued partnership.
- Explain the process to implement a lean program both from an owner and contractor perspective
- Describe measurable metrics applicable for any owner and contractor
- Identify potential pitfalls in what to assess in quality improvement programs
- Assess innovative tools to improve safety and communications in health care construction projects
Implications of Recent OR Research on Standard 170
Rick Hermans, PE, HFDP, Director of Training and Advanced Applications, McQuay International
Recent research on the effectiveness of ventilation in operating rooms may have an effect on the requirements of ANSI/ASHRAE/ASHE Standard 170. Research on the total and viable particle counts in three operating rooms in three different hospitals at three different air change rates produced unexpected results regarding the effectiveness of the standard and also revealed a possible shortcoming. This presentation will review the results of the groundbreaking research and suggest possible avenues for the requirements in ASHRAE Standard.
- Discover an approach to evaluating an operating room ventilation
- Identify the parameters that are important in OR ventilation design
- Participate in the debate over how an OR ventilation system should perform
- Evaluate future designs of OR ventilation for effectiveness
Sterile Processing Department Design and HVAC Considerations
Paula Wright, RN, BSN, CIC, Project Manager, Infection Control Unit, Massachusetts General Hospital; Doug Erickson, FASHE, CHFM, HFDP, CHC, CEO, Facilty Guidelines Institute
The requirements for sterile processing facilities were significantly revised in the Facility Guidelines Institute’s 2018 Guidelines. The new hospital and outpatient facility documents provide expanded guidance for designing these areas in a manner that supports and encourages compliance with guidelines for cleaning, decontaminating, and sterilizing surgical instruments. The session will cover when a two-room sterile processing facility is required and when a single-room sterile processing facility is acceptable as well as ventilation requirements to support a dirty-to-clean workflow.
- Discuss the perspectives of infection preventionists on what architects and engineers need to know to provide the safest, most efficient environment for sterile processing
- Describe the extent to which each profession’s perspective is addressed in AORN’s Recommended Practices for a Safe Environment of Care Part 2 and FGI’s Guidelines
- Describe the design engineer’s perspectives as they approach initial planning for sterile processing environments in hospitals and outpatient surgery facilities
- Explain the latest ventilation requirements for sterile processing and the Joint HVAC Task Force’s recommendations on compliance
Improving Patient Care: The Intersection of Culture and Evidence-Based Design
Bill Sabatini, FAIA, ACHA, Principal, Dekker/Perich/Sabatini; Deswood Etsitty, Healthcare Facilities Planner, Indian Health Services; Max Parrill, ACHA, LEED AP BD+C, WELL AP, Principal, Dekker/Perich/Sabatini
The Indian Health Service has created two new health care facilities: Kayenta Health Center and Fort Yuma Health Care Center. Both facilities prioritize preventative care, contradicting the perceived hierarchy of inpatient care over outpatient and therapy services. Instead, each facility emphasizes cultural traditions and puts wellness first. This session will demonstrate how evidence-based design, a cultural understanding of wellness, and state-of-the-art health care can intersect to improve patient outcomes and support IHS’s proactive mission.
- Describe Indian Health Service’s health care initiative
- Evaluate how services are accommodated in each facility and how they are improving outcomes
- Assess how each facility responds to the culture of the tribes served
- Explore ancient health care and wellness traditions and how they coincide with current thinking about wellness
10:40 – 10:50 a.m. | Networking Break
10:50 – 11:50 a.m. | Concurrent Sessions VIII
Cracking the Code: Deciphering Workplace Stress for RNs
Molly Scanlon, PhD, FAIA, FACHA, Research Scientist, University of Arizona
This session will demonstrate an occupational stress risk assessment identifying nursing stress risk factors, as well as the relationships between stress and health-promoting behaviors. Nurses are exposed to seven common stress factors including workload, death and dying, inadequate preparation for role, lack of staff support, uncertainty concerning treatment, communication with physicians, and communication with nurses. This study will report findings on the relationship between nursing stress and RNs’ health and wellness, as well as its effect on patient care.
- Identify the challenges and risk factors for workplace stress in nurses, stress’s effect on patient care, and cyclical impacts to nursing shortages
- Describe and assess the process of an occupational stress risk assessment and how to objectively measure for it within any health care organization
- List a ranking of nursing stress risk factors and differences by gender, ethnicity, and race
- Describe and report outcomes concerning health promoting behaviors and perceived nature contact in nursing personnel to reduce occupational stress
Amazon’s Convenience Culture Impacting the Health Care Environment
Carrie Condry, Senior Technology Consultant, Mazzetti+GBA; Josh Kelly, RCDD, Senior Technology Consultant, Mazzetti+GBA
Amazon has forever changed the way we shop; health care is next. The consumer’s expectation of convenience will push health care systems to create new and repurposed physical and digital environments. These changes will transform delivery processes and incorporate diverse services and products. The impact to the built environment will be substantial: call centers, wellness centers, and more telehealth capability. This session will explore how a customized, coordinated, analytics-driven, personalized, single-click health care experience might be achieved.
- Identify the ways the consumer experience and expectations have been changed by Amazon’s innovations
- Contrast current health care workflow and operations with those of a convenience culture
- Explore a range of technologies to support these new approaches
- Evaluate the efffect of “Amazon-like health care” and other innovations to the built environment
The Future of Building Automation and IoT Integration in Health Care
Frank Shadpour, PE, CxA, LEED AP, CPD, ASHRAE Fellow, ASHRAE HFDP, President, SC Engineers, Inc.; Daniel Farrow, BSB, MHA, AVP Hospitality and Facilities, Palomar Health; Robert Betz, Executive Vice President, San Diego, McCarthy Building Companies, Inc.
The Internet of Things (IoT) has been gaining momentum in many industries to make machines smarter, enabling them to communicate and coordinate with one other. As these devices and the staggering quantity of associated data continues to grow, the new challenge becomes connecting data silos in a managed and secure method to derive value from the data. Our distinguished panel of designers, contractors, and owners will cover the latest technology in smart hospital systems as well as review real-world applications.
- Classify building automation systems into four levels
- Describe the essential elements to consider when selecting dashboard software
- Identify why Smart Metering technology is vital to ongoing energy performance of sustainable buildings
- Discover how remote monitoring of building energy use can be used for retrocommissioning existing buildings
Who’s on First? Person-Centered Focus Promotes Sustainable Communities
Addie Abushousheh, PhD, EDAC, Assoc. AIA, Gerontologist, Researcher & Consultant; Charles Schlegel, Director, Pennsylvania Dept. of Health, Division of Safety Inspection; Jane Rohde, AIA, FIIDA, ACHA, CHID, LEED-AP, Principal, JSR Associates, Inc.
One of the barriers to creating built environments that support person-centered care has been outdated or obsolete regulations, standards, and codes. The minimum requirements in the Facility Guidelines Institute’s Guidelines for Design and Construction of Residential Health, Care, and Support Facilities have been updated for the 2018 edition to reflect a shift in the industry toward provision of person-centered care in a more home-like environment. This session explores the 2018 FGI revisions to support and promote the provision of person-centered care.
- Describe how long-term care facilities that support person-centered care result in better resident and staff experiences
- Navigate the barriers to creating person-centered environments in long-term care settings
- Explain the processes required to develop person-centered environments that support viable long-term care settings
- Apply the 2018 Guidelines requirements during predesign and programming to maximize project success
1 – 2 p.m. | Certified Healthcare Constructor (CHC) Exam Check−in
2 – 4 p.m. | Certified Healthcare Constructor (CHC) Exam