Planning in Health Care Facilities - Five Planning Dynamics to Consider

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 When planning a new health care facility, in today’s changing health care environment, there are five dynamic factors that can potentially make or break a project.  In the ‘new normal’, created by the current reform and economy, Providers are expected to deliver and provide greater patient quality outcomes for less financial reimbursement.   This creates major challenges for Providers; however well executed planning can mitigate these challenges.   Proper planning, executed at the earliest stages of facility consideration, will provide the least expensive solutions while offering the most profound impact on facility development.

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“LEAN” PLANNING IS THE KEY   FOR HEALTH CARE DEVELOPMENT EFFICIENCY & COST SAVINGS   5 Strategies for Health Care Providers Every healthcare provider is faced with the challenges of a health care system in turmoil.  There are physician shortages, reduced reimbursement and funding, increased regulatory challenges, demands for higher patient care quality and a general uneasiness about healthcare reform.  If higher quality care is going to be required, but reimbursement for the services is going to be reduced: then new sources of efficiency and cost savings will need to be identified and implemented. A significant key to higher efficiencies and cost savings is the process of Planning in the early stages of a project.  This is a comprehensive Planning of all aspects of development prior to any design activities.  Strong planning efforts establish the road map to guide future design and avoid inefficient redesign.  By establishing “Lean” planning efforts it sets the stage for a Lean delivery process though out the life of the project. The following chart illustrates the facility development process and the declining opportunity to influence costs as the process unfolds.  Even the best of teams have to be wary of impatience and the desire to design the facility too soon; resulting in a stifling of the crucial planning process. A new awareness and appreciation for the value of “Planning and Programming” is emerging during this recent paradigm shift in healthcare delivery.  This activity should include the following five essential components: 1   Conduct a strategic evaluation of the anticipated development.  Sometimes an organization’s mission, philosophy and vision evolve and morph without interim redirection or planning.  Should they be analyzed and realigned with new market forces and delivery expectations? Are your Board and Senior Management responding to current operations in a coordinated and cooperative manner that supports success?  Will the anticipated development fit your organizational goals and build upon its strengths? 2   Develop a detailed development program. Programming is a planning tool that studies a future facility’s use and quantifies its potential contents based upon that use.  It is more than a list of spaces and areas.  Programming is an analytical process that matches health care services strategy with functional uses that support that strategy.   The methodology should remove personal opinions and replace them with logical, business based analyses.  Any programming discussions that contain the phrase “I like…” indicates a personalization of the efforts and lack of strategic focus. 3   Develop a functional relationships study based upon strategy.  The physical relationship of one space to another has a major impact on the functionality and efficiency of a new development.  For example, if part of a health care provider’s strategy is patient-centered delivery; should a physician’s personal preference for arranging examination rooms around their personal office prevail at the expense of patient convenience? 4  Establish evidence based best practices that match health care outcomes to design responses.  Part of a health care provider’s strategic planning should be the determination of the quality of health care outcomes expected from the new development.  Reduction of patient falls, increased staff efficiency, reduction of infections, increased revenue, etc. are all strategic health care outcomes that should be identified and paired with programmatic design responses to support the intended outcomes.  5  Test the anticipated costs and financial impact of the projected development.  As the planning process takes form, realistic preliminary budgeting of the development should be created based upon prior experience and empirical data rather than ill-defined or uncategorized “safe” amounts that might be padded to satisfy personal agendas.  Budgeting should include a comprehensive consideration of all hard and soft development costs that the project will incur from start to finish.  A preliminary pro forma model should then be developed as a viability tool to measure the financial impact of the project as it progresses though the design process. The assistance of an experienced health care facility developer during the planning phase is an invaluable asset to an organization’s success in determining the best cost-controlled solution to meet intended strategic goals.  Please feel free to contact me to discuss how strategic facility planning can contribute to your organization’s success.  I can be reached at Wtaylor@pdcmidwest.com.
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“LEAN” PLANNING IS THE KEY  

FOR HEALTH CARE DEVELOPMENT EFFICIENCY & COST SAVINGS

pdc logo 

5 Strategies for Health Care Providers

Every healthcare provider is faced with the challenges of a health care system in turmoil.  There are physician shortages, reduced reimbursement and funding, increased regulatory challenges, demands for higher patient care quality and a general uneasiness about healthcare reform.  If higher quality care is going to be required, but reimbursement for the services is going to be reduced: then new sources of efficiency and cost savings will need to be identified and implemented.

A significant key to higher efficiencies and cost savings is the process of Planning in the early stages of a project.  This is a comprehensive Planning of all aspects of development prior to any design activities.  Strong planning efforts establish the road map to guide future design and avoid inefficient redesign.  By establishing “Lean” planning efforts it sets the stage for a Lean delivery process though out the life of the project.

The following chart illustrates the facility development process and the declining opportunity to influence costs as the process unfolds.  Even the best of teams have to be wary of impatience and the desire to design the facility too soon; resulting in a stifling of the crucial planning process.

A new awareness and appreciation for the value of “Planning and Programming” is emerging during this recent paradigm shift in healthcare delivery.  This activity should include the following five essential components:

1   Conduct a strategic evaluation of the anticipated development. 

Sometimes an organization’s mission, philosophy and vision evolve and morph without interim redirection or planning.  Should they be analyzed and realigned with new market forces and delivery expectations? Are your Board and Senior Management responding to current operations in a coordinated and cooperative manner that supports success?  Will the anticipated development fit your organizational goals and build upon its strengths?

2   Develop a detailed development program.

Programming is a planning tool that studies a future facility’s use and quantifies its potential contents based upon that use.  It is more than a list of spaces and areas.  Programming is an analytical process that matches health care services strategy with functional uses that support that strategy.   The methodology should remove personal opinions and replace them with logical, business based analyses.  Any programming discussions that contain the phrase “I like…” indicates a personalization of the efforts and lack of strategic focus.

3   Develop a functional relationships study based upon strategy. 

The physical relationship of one space to another has a major impact on the functionality and efficiency of a new development.  For example, if part of a health care provider’s strategy is patient-centered delivery; should a physician’s personal preference for arranging examination rooms around their personal office prevail at the expense of patient convenience?

4  Establish evidence based best practices that match health care outcomes to design responses. 

Part of a health care provider’s strategic planning should be the determination of the quality of health care outcomes expected from the new development.  Reduction of patient falls, increased staff efficiency, reduction of infections, increased revenue, etc. are all strategic health care outcomes that should be identified and paired with programmatic design responses to support the intended outcomes. 

5  Test the anticipated costs and financial impact of the projected development. 

As the planning process takes form, realistic preliminary budgeting of the development should be created based upon prior experience and empirical data rather than ill-defined or uncategorized “safe” amounts that might be padded to satisfy personal agendas.  Budgeting should include a comprehensive consideration of all hard and soft development costs that the project will incur from start to finish.  A preliminary pro forma model should then be developed as a viability tool to measure the financial impact of the project as it progresses though the design process.

The assistance of an experienced health care facility developer during the planning phase is an invaluable asset to an organization’s success in determining the best cost-controlled solution to meet intended strategic goals.  Please feel free to contact me to discuss how strategic facility planning can contribute to your organization’s success.  I can be reached at Wtaylor@pdcmidwest.com.