Texas Association of Healthcare Facilities Management 3/31/2013

Transcription

1 Healthcare Facility : Are Yu Thinking Ahead? James S. Little, Jr., AIA, LEED AP BD+C Managing Principal SBL Tenure: 20 Years (funding principal) Wh is Jim Little? Years Experience: 34 Years Registered Architect in multiple states Educatin: Bachelr f Science, Architecture and Envirnmental Design with Distinctin, University f Oklahma, 1975 Master f Architecture, Architecture and with Distinctin, University f Oklahma, 1980 A prven histry f cmpleting prjects within time and budget cnstraints has develped many lng-term relatinships with significant clients. He pssesses a unique cmbinatin f talents which merge creative prblem slving abilities and graphic skills with management and fiscal respnsibilities. In additin t his firm management duties, Jim takes pleasure in being persnally invlved in the prjects he manages. Staying engaged in the design prcess nt nly keeps him current and vital with regard t the ever-changing challenges f the healthcare industry, but it is als persnally fulfilling. SBL Tenure: 19 Years; Principal Wh is Kellye Jhnsn? Years Experience: 29 Years Registered Architect Educatin: Bachelr f Science, Architecture (with Hnrs) University f Texas at Arlingtn, 1983 Master f Architecture (with Hnrs) University f Texas at Arlingtn, 1986 Kellye is SBL s Directr f Facilities Prgramming and. She was a member f the Rules Rewrite Cmmittee fr the Texas Department f State Health Services, and helped rewrite f the rules gverning the architectural requirements fr Title 25 f the Hspital Licensing Rules. Kellye has als been instrumental in helping a number f clients present unique ideas and issues t DSHS. Her gal is t create quality design slutins that balance the issues f image, functin and technlgy that are unique t each prject. Sterling Barnett Little, Inc. 1

2 Architecture Architectural Design 3D Mdeling and Visualizatin Cmputer Aided Design and Drafting / BIM Specificatins Cst Value Supprt Sustainability Fire and Life Safety What d they d? (at Sterling Barnett Little) Prgramming Facility Evaluatin Master Site Develpment Feasibility Studies Interir Design Interirs Standards Develpment Cmprehensive Interir Design Space Finish Selectin / Specificatins Furniture, Fixtures & Equip. (FFE) Wayfinding / Signage Systems Healthcare Facility : Are Yu Thinking Ahead? Learning Objectives Recgnize the benefits f future fcused facilities planning and knw what t d when the bss reacts negatively t the M-wrd (nt everyne believes "Masterplans" are wrthwhile) Develp a general understanding f the disciplines and tasks invlved with the prcess thrugh which a Master Facilities Plan is develped. Understand hw strategic r business planning drives facilities planning and hw a develpment team can "right size" any prject. Realize that every prject needs t be cnsidered in the cntext f a lnger range plan r visin. Cnclude that a master plan is a radmap t the future n a rute that changes ver time and, therefre, must be maintained as a living dcument (updated frequently) r it quickly becmes useless. Sterling Barnett Little, Inc. 2

3 Over Time.. Optins Diminish Cnsistent pint f reference fr infrmed decisins Better predictability regarding budgeting and planning Ptential t ptimize resurces Advantages Means t reflect cmmunity character Ptential t anticipate and shape the Institutin s future Priritize actins Budget time and dllars Imprve internal cmmunicatins Help avid building structure nw that is in the way later Establishes Gals & Objectives (Targets are identified befre planning slutins are develped) Typically evaluates multiple Scenaris ( Optins) Validates Prgram A Successful Plan: Reduces pssibility f ver design / under design (ensuring that capital prjects prperly huse PSV) Cntrls Scpe (& therefre verall cst) Imprves accuracy f Funding Request develped fr capital prjects Imprves prbability f Funding Apprval Achieves buy-in and wnership f the utcmes Recmmends pprtunities t imprve efficiency thrugh changes in space planning Incrprates f emerging delivery mdels, technlgy and service trends Sterling Barnett Little, Inc. 3

4 When they aren t supprted by business plans. Why / When d Master Plans becme Obslete? When develped withut all stakehlders invlved. When their chief supprters leave the institutin. Because f Change: Demgraphics Technlgy Reimbursements Pririties When they are nt maintained / updated t reflect changes in the strategic visin f the institutin. Failure t respnd t change. Failure t update the plan accrdingly. Peple Invlved Facility Administratin Departmental Staff Bard f Directrs Facility Engineers Crprate? Outsiders Strategic Planners Space Prgrammers Architects / Engineers Equipment Planners Special Cnsultants Cntractrs Visinary Dream Builders Facility Engineers & Administrative Team Members Strategic Planner Architects & Engineers Cntractrs & Vendrs All Team Members - Initial Visin - ROI - Demgraphics -Service Vlumes - Prcessing Data - Analyzing - Putting Ideas t Paper - Establishing Csts - Cnstructability - Evaluate Scenaris Sterling Barnett Little, Inc. 4

5 1: Wrk Plan Develpment 2: Existing Facilities Tasks Invlved 3: Strategic Plan 4: Business Initiatives & Prjectins 5: Initial f Facility Needs / Slutins 6: Utilizatin (n Prjected Service Vlumes) 7: Functinal / Space Prgram 8: Master Site and Facility Optins 9: Capital Requirements f the Strategic Plan 10: and Recmmendatins Flw UA ALL Critical Task Wrk Flw Owner & Cnsultants Cst Estimating Equipment Furniture V/D/NC/S Owner Input Owner Input Owner Input Owner Input Strategic Prjected Service Vlumes Utilizatin Space Prgram Gaming Single Line Flr Plans Flr Areas Cnfirme d Prject Cst Estimate Prject / Capital Apprval Scenari Preliminary Estimate Cnstructin Cst Owner's Prfrma Setting Pririties Facilities t be Develped ASAP Phase 1 Prject Identify Pririties Facilities t be Develped fr Occupancy in 36 t 60 Mnths Phase 2 Prject Facilities t be Develped fr Occupancy in the Future Phase 3 Prject Sterling Barnett Little, Inc. 5

6 Utilizatin : Service Vlume Driven Mdel Final U.A. Rules f Thumb Result 1 Prjected Service Vlumes Overall PSV's Result 2 Wrklad Assumptins PSV's by Prcedure Type/Level Result 3 Issues t Cnsider Utilizatin Why run utilizatin calculatins? T identify the number f prcedure rms r beds t meet the prjected service vlumes since these will ultimately drive the space prgram which, in turn, will drive the prject csts. T help right size any expansin / renvatin prject (avid underbuilding r verbuilding). T make preliminary decisins prir t prceeding with mre detailed analysis. What are the 'drivers'? Are existing services expanding due t lcal demgraphics? Are new services being added t the business plan? Are the lengths f prcedures changing based n technlgy? Are the wrklad assumptins changing in respnse t these issues? Issues t Cnsider Space Prgram Key Pints: Must be matched t PSV's, thrugh the Utilizatin. Is first step (nt final) in establishing prject scpe, because: Operating requirements affect planning cncept, and Cncept affects actual space required The 'drivers': The number f prcedure rms required (by the PSV's) Cde minimums State Health Department Agency(ies) dealing with handicapped accessibility (which smetimes exceed state minimums) Technlgy based minimums (which smetimes exceed cde minimums). Equipment and Furniture / Furnishings Sterling Barnett Little, Inc. 6

7 Setting Pririties Detailed UA and Prgramming fr Pririties Single Line Flr Plans Evaluate All Org Elements Establish Pririties f Balance Departmental Blck Diagrams Issues t Cnsider Establishing Capital Requirements Nt all General Cntractrs are gd 'Cnceptual Estimatrs' Departmental Unit Csts fr Cnstructin Estimate Rule f Thumb factrs nt accurate 'by Department (unless all space is New Cnstructin --- Scpe f Wrk varies t much) Use a Cmpsite Unit Cst ($ / sf) generated fr each prject, based n: New Cnstructin Majr Renvatin Minr Renvatin (walls / drs, but n impact n M/E/P Systems) Refinish Infrastructure (Building Systems / Central Plant) Cst f Central Plant expansin can match general cnstructin in sme cases 'Rules f Thumb' fr M/E/P Systems Cst (sf driven) slve the prblem Medical Equipment / FF&E Equipment cst can match cnstructin cst in sme cases Rules f Thumb' (rm driven) create 'budget' BUT dn't slve the prblem (utside cnsultant is recmmended fr accuracy) Prcess and Wrk Prducts Initial Assessment Review Scenari Review Scpe Cnfirmatin Review Final Adjustment Final The entire prcess is driven by Prjected Service Vlumes (PSV) Strategic Utilizatin Facility needs Business Plan initiatives Questinnaires Prjected Service Vlumes Initial Utilizatin Final Utilizatin Activity related t 5 tracks ccur simultaneusly Space Prgramming First Draft Space Prgram Final Space Prgram Facility Existing Facility Departmental tur Base Plans Departments cnfirmed Blck cncepts Single lines (Phase I) Facility analysis Finalize single lines Financial Order f Magnitude Csts Ttal Cst Prfrma Initial prject schedule Finalize csts and schedule Sterling Barnett Little, Inc. 7

8 Typical Prject Cntrl Schedule The Tasks are nt sequential. Questins / Decisins that affect Scpe: Are Prjected Service Vlumes (PSV s) available? Have PSV s been blessed by Administratin and/r the BOD? Establishing Scpe f Services Required Is a full Existing Facilities warranted / needed? Are existing Base Plans available? Has an ADA survey been cmpleted? Is a Central Plant (Building Systems) capacity reprt available? Hw much f the facility will be impacted by any prpsed prjects? Hw many departments are t be addressed in detail? (UA / Space Prgram / Cncept) Hw many departments are t be addressed in general? (Blck Cncepts / later phase(s) f Lng Range Facilities Plan) Hw many Scenaris are t be studied? (general and/r detail) Thinking () Ahead Sterling Barnett Little, Inc. 8

9 Thinking () Ahead Study Study Future Plan Master : Call it what yu want Cnceptual Visin Plan f Attack Scheme 5-Year Plan Game Plan Facilities Develpment Plan Lng Range Facilities Plan Cnclusin While it is nt a crystal ball, a master plan answers questins: Hw much future space will the Hspital need fr future grwth? Where shuld functins be lcated t maximize grwth and flexibility as needs change? A Master Plan anticipates current & future facility needs, in additin t ppulatin grwth, infrastructure and utility requirements. A Master Plan incrprates the best qualities that already exist n the Hspital campus and enhances them. Abve all, this dcument generates an ver-arching cnceptual visin fr the lng-term develpment f the Hspital campus t match architectural needs with Hspital bjectives. The Master Plan becmes a living dcument fr grwth f a successful facility and must be fed. Sterling Barnett Little, Inc. 9