This document outlines a 3-step approach to building a patient-centered environment. It discusses understanding healing through balance, considering the perspectives of healthy patients, teams, and projects. It also details the 3 stages of construction plans: schematic plans, design development plans, and bid & permit construction plans. Each stage is examined through the lenses of how it impacts patients, the project team, and the overall project. The presentation uses a case study of expanding a cath lab to demonstrate how the stages are applied.
5. Objectives
1. Learn 3’step integrated approach to building
a patient centered environment.
2. Define the 3 stages of construction plans.
1. What to look for when you are a member of
a patient centered project team.
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7. Agenda
3 Stages Of The Plans
• Schematic Plan
• Design Development plan
• Bid & Permit Construction plan
What To Look For 3 Perspectives and 3 Stages
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10. 3 Stages of the Plans
Stage One Schematic Plan
Stage Two Design Development Plan
Stage Three Bid & Permit Construction Plan
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11. Case Study – EP Cath Lab
Needs
• Larger Procedure & Control
Room
• Dedicated storage area
• Equipment room
• Radiology storage room
Location
• Existing Cath Lab replacing
outdated equipment
• Radiology department
behind
• Cath Lab 2 adjacent
• Clean storage and janitor
closet adjacent
• MRI waiting room adjacent
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12. Stage I – Schematic Plan
I am going to show you a SP we are going to look
at it from 3 perspectives
1. Patient and staff traffic paths.
2. What Equipment needed in the space?
3. Space reconfiguration impacts on budget
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16. Schematic Plan
Healthy Patient
1. Who is the patient?
2. Why are they using this space?
3. How does the space impact them?
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17. Schematic Plan
Healthy Team
1. Do we have everyone on the team?
2. Does everyone understand their role?
3. How will the team make decisions?
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18. Schematic Plan
Healthy Project
1. Do we have a budget?
2. Can we meet the schedule?
3. Process and rules for engagement?
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20. Definition- Stage Two
Design Development Plans
1. Contract documents phase.
2. Drawings and finish boards
3. Project estimate can be established.
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21. Design Development Plan
Healthy Patient
1. Patient Construction Phasing schedule –
something new
2. Team Storage supplies – something new
3. Equipment placement
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22. Design Development Plan
Healthy Team
1. Input from each department.
2. Hospital approval for phasing plan.
3. Communication, communication.
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23. Design Development Plan
Healthy Project
1. Behind the wall details and logistics.
2. Does the budget to include the phases?
3. Who is removing the existing equipment?
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24. Stage Three
Bid & Permit Construction Plans
1. Contract documents for construction
• Equipment
• Furniture
• Square footage
• Electrical & Technology Integration
• Structural
• Ventilation
• Water
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26. Bid & Permit Construction Plan
Healthy Patient
1. Medical equipment secrets.
2. Patient safety
3. Adjacent patient areas during construction.
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27. Bid & Permit Construction Plan
Healthy Team
1. Technology requirements coordinated with
the medical equipment installation teams.
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Coordinate
Integrate
28. Bid & Permit Construction Plan
Healthy Team
1. Are the logistics clear for construction and
delivery of all equipment
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29. Bid & Permit Construction Plan
Healthy Team
1. Where are we going to store all the existing
equipment?
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30. Bid & Permit Construction Plan
Healthy Project
1. Medical equipment and trades translated?
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31. Bid & Permit Construction Plan
Healthy Project
1. Plans include infection prevention &
phasing?
2. Team sign off and review?
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What is wrong with this picture? Is this the best environment for a patient and or staff member? Why? Does this look clean and are we sure everything is plugged in correctly?
Little better but could be a staff and patient safety issue.
Looks a bit different. This was a project that was well done. The overriding Planetree school of thought is to use the physical environment to enhance healing, health and wellbeing. The staff described this space “as like working in a theater”. They were going to be able to perform on stage. They could feel a harmony when they moved in the space using the equipment. So how do you get to this? You need an approach a way to tackle a project like this and you have to have a way to translate construction plans into a space that works for the staff and patient. Today I am going to talk to you about a 3 step approach
A 3 step approach to navigating each stage of building a patient centered environment. We are also going to define the 3 plan stages and what to look for when you are on a team working to build a patient centered environment.
Today we are going to define three step approach to building a patient centered environment. The elements within that 3 step approach.
We are going to define the 3 stages of plans that we all use as tools to communication and get a project done. The schematic plan, design development plan and the bid and permit set of plans. Then we are going to put this all together so it equals a good strategy to approaching a patient centered building project. There is so much information coming at you and we are all stretched and this will show you how to avoid problems before they hit a project. We only have 30 mines today so I cannot cover everything but I a handout for all of you that gives you symbols and abbreviations. Definitions and plans to help guide you through this very fast presentation so let’s get started.
We talked about the 3 steps to tacking a project and the 3 stages of plans let’s move forward to out the two together. Many people on the construction side of the table are very process oriented. That is a good thing. They Healthy project rings true to their ears but from my perspective when you are working on a patient centered healing environment you need to have an understanding of healing and a balance of process. I speak about this from the patient side because when I was a patient I realized that I approached projects from a process side. Needing to get this project done on time and on budget. It was all about getting it done. Since then I have concluded that you need to have both and maybe even be stronger on the side of understanding of healing. This is where the clinical side of the table needs to be strong. To think a little out of the box because now we are working in a preventative care.
This is the mother ship the 3 step approach to a patient centered project. If you keep your eye on all three of these you will end up with a patient centered healing environment.
First and foremost you have your healthy patient. The patient is the reason why you are spending all this money, spending all this time together as a team, and really becoming engaged and present as a member of this team. Giving it you all. Because it matters this is all connected. Take it from me one day you or a loved one can become a patient and you don’t want to be sitting in that hospital bed thinking that the facility or project manager who built this place was thinking just about the budget and schedule. So let’s focus on who is this patient, Why are they here and how does the space impact them. Today’s patient is better educated on their health, uses the internet to learn and or chat with similar interest groups. Wants to find alternative modalities to healing and has a higher expectation for their medical professionals to educate and formulate a relationship with them by using their own information they have tracked with a personal monitor on blood pressure, blood sugar, activity and caloric intake. The Healthy Team is a group of professionals with a diverse background with different specialties that can share their wisdom, experience and expertise with the team be able the feel that what they have to say is important to the project. They are on this team from the beginning to the end of the project. The healthy project gives all of this structure. Teams work better whey they have structure, a process and rules to play by. They need to have a method to organize and document all the information that goes into getting a project done. The weekly project meetings notes, plans and specifications, budgets, schedules, reports to management to name a few. When a process is in place the team feels confident that they know what is going on and have less fear that things are falling through the cracks. The 5 steps are listed in your handout for more information.
Schematic plans – this is the beginning when define the scope and the program. Rough draft of your ideas for what you need in the space along with the space identified for the renovation or new building location. Design development drawings this is where you have signed off on the Schematic plan in concept, and need to move on to the details, what will live in the space and what is going on behind the walls to support it. Electrical data etc. and these plans are a part of the contract set that means that changes that you make to the concepts may impact the budget and schedule. The bid and permit construction plans are where all the details, logistics infection prevention and any other details are included on the plans so that you can get accurate pricing and a very good time line or schedule for the project construction. These plans become a part of the construction contract as all activities, pricing and schedule will dictate how well everyone will perform.
An architect or engineer puts a set of plans together based on a scope. This is the scope we are going to work with today. This is what we are going to do. We are looking at three stages and this is an appr
What is important at this stage? Figure out what is needed, how will the patient, staff travel in and out of the space. What impacts our planning, do we need more space, do we need to repurpose space? What kinds of mechanicals are in the space, for example do I have enough power, ventilation? What is critical now for me to move forward to the next stage.
1 What is needed equipment and support space 2. what is the patient and staff path in and out of the space. 3. What will impact the project that we need to communicate.
1 What is needed equipment and support space 2. what is the patient and staff path in and out of the space. 3. What will impact the project that we need to communicate.
1 What is needed equipment and support space 2. what is the patient and staff path in and out of the space. 3. What will impact the project that we need to communicate.
A patient that has filiation in their heart. This physician that works on them is the electrician for the heart. Changes the electrical currents to help the heart beat on a regular basis. The patient gets put under while they are in this room but they still need some privacy so we put in an obscured glass. They are using this space for a delicate procedure so the ventilation requirements were Class B surgery room. Matter of life and death. Really understanding the staff needs and working habits is very important for this patient.
Phasing depicted Phase 1B and 1C, Storage and 3 is Equipment placement.
1.Does all the medical equipment have electric and data. 2. Are the patient safety zones labeled 3. Where are you going to store all of your equipment when you close down this room are your logistics in order?
The project team needs to start the project identifying what technology will reside in the space and throughout the project keep gathering information so that you can integrate the technology and coordinate everyone of those vendors so that all the equipment and technology work in harmony.
Is there someone on the team responsible to make sure that equipment delivery and construction shut downs have been scheduled and communicated to the hospital or practice. Surprises are costly and cause much stress.
Tagging and making a inventory list as well as finding a location to store equipment that resides in the space that is going under construction is very important. Should have three tags. 1. Stays on site and is used in other rooms. 2. Can go offsite for storage. 3. Dispose.
Check all pages of the plans to confirm that all the equipment has electrical, data, mechanical, and structural depicted on the plans. This could be a costly mistake if some things are left out. This also causes much finger pointing. It is always better to have the team check each page of the plans to check on this coordination
Can you see that the infection prevention requirements are depicted on the plans as well as the phasing because this has a cost associated with it. As I spoke about in the last slide having a review of all the pages of the plans confirms you have caught everything. Always make sure the whole team signs off on the plans.
This is a patient centered environment that was well done. A place that enhances healing, health and wellbeing. It feels like a place where the medical team can perform, a place that really matters. In closing I would like to leave you with this question if you were the patient on that table would you want to be in a EP Cath lab like this? Let me help you get there, let’s do it together. Write on the back of your business card what your biggest project problem is and leave it with me. Also if you want to download 5 things that drive you nuts on a project and how to avoid them please go to my website and use the promo code planetree. Thank you and may all your projects be done well.