2 texas childrens hospital. tch conversion $6.6m initial construction budget (10% contingency...
DESCRIPTION
Computer SimulationTRANSCRIPT
2TEXAS CHILDREN’S HOSPITAL
TCH Conversion
$6.6M – Initial Construction Budget (10% Contingency Included)$6.6M – Actual Construction Budget
$13 M – Overall Approved Project Budget$12.6M – Actual Total Commitment To Project
Building Relationships with Community – Metro, Local Council
Managing non-TCH tenants (Dental) – infrastructure heavy & delayed opening timing
Computer Simulation
Overview Of Simulation Modeling
ARRIVAL AT MEDICAL HOME
PT TO SUB WAITING FOR NAVIGATOR
GATHERS ANY SIGNITURES AND
REVIEWS NECESSARY DOCUMENTS
CHECK-IN KIOSKS FOR ESTABLISHED
PATIENTS? 3-5 MINS
SICK CHILDWELL VISITNEW VISIT
%$ WELL VS. SICK
SICK VISIT
WELL VISIT
NEW VISIT
PT TAKEN TO EXAM ROOM
VITALS TAKEN ON WAY LAB
DRAW AR VITALS IF REQ
3-5 MINS
PT TAKEN TO EXAM ROOM
VITALS TAKEN ON WAY 3-5 MINS
PT TAKEN TO EXAM ROOM
VITALS TAKEN ON WAY 3-5 MINS
EXAM VISIT HISTORY & PHYSICAL
TIME BASED ON ESTABLISHED PT
HISTORICAL DISTRIBUTION
5-40 MINS
EXAM VISIT HISTORY & PHYSICAL
TIME BASED ON ESTABLISHED PT
HISTORICAL DISTRIBUTION
5-40 MINS
EXAM VISIT HISTORY & PHYSICAL
TIME BASED ON ESTABLISHED PT
HISTORICAL DISTRIBUTION
10-60 MINS
DISCOVERY OF ISSUE
DISCOVERY OF ISSUE
DISCHARGE IN EXAM ROOM
UNLESS COMPLEX DISCHARD NEEDED 3-10 MINS
TO COMPLEX DISCHARGE AREA FOR
SCHEDULING DIAG OR
TREATMENT10-20 MINS
DISCHARGE IN EXAM ROOM
UNLESS COMPLEX DISCHARD NEEDED 3-10 MINS
TO COMPLEX DISCHARGE AREA FOR
SCHEDULING DIAG OR
TREATMENT10-20 MINS
TO TREATMENT ROOM
20-90 MINS
PATIENT LEAVE MEDICAL HOME
PATIENT LEAVE MEDICAL HOME
THIS SIMPLIFIED FLOW DIAGRAM IS USEFUL TO LOOK AT THE NUMBER OF EXAM ROOMS IN A STANDARD CARE TRACK. HOW WITH THIS FLOW DIFFER FOR PED PATIENTS IN A CENTERING
CONCEPT? WHAT % OF PATIENTS COULD THIS BE?
DID WE WANT TO MODEL PATIENTS HAVING THEIR PERSCRIPTIONS BROUGHT TO THEM IN THE EXAM ROOM, OR
WAITING IN A SUB-WAITING AREA?
TCH MEDICAL HOME PEDI PATIENT PROCESSMODEL - 01/30/2012
Medical Home – Space Program SummaryTotal Area
50,458 sf Quantity of Rooms
Public Area 3,528 sfPediatric Service Module 8,338 sf 25 Exam Rooms, 2 Consult RoomsOB Service Module 4,726 sf 11 Exam Rooms, 4 Consult RoomsCentering Module 2,030 sf 2 Centering RoomsService Module Support 1,972 sfDiagnostics 5,340 sf 1 Gen Rad, 2 UltrasoundPharmacy 3,074 sfEye Clinic 5,733 sf 4 Exam RoomsDental Clinic 3,560 sf 9 OperatoriesSpecialty Clinic 2,160 sf 4 Observation RoomsMember Education 2,849 sfAdministration 4,874 sfSupport 2,273 sf
Site Selection
Reflects Pilot Program Preferred Area
-Membership Density-Proximity To Potential Partner Hospitals-Near Major Freeways
site
TMC
CBD
Vehicular Access- Site Along Beltway Feeder Road- Can Be Approached From Multiple Directions
N
I 45
B 8
Existing BuildingTCH Medical Home
Site OrganizationParking1.1=Patient & Public Parking
2.Staff Parking3.Patient Flow from Bus Stop
4.Main Entry5.Public Retail Entry
6.Staff Entry
4
3
65
6
N
1
2
1 2
Public Areas
1.Main Entry/Drop-Off
2.Public Retail Entry- North/East Natural Light
3.Waiting/Circulation
4.Retail Corridor
3
1a
a
42
3
Program Plan
3 1a
a
2
Public/Retail/EDU/Admin1.Main Entry/Drop-Off2.Public Retail Entry3.Waiting/Circulation4.Retail Corridor5.Pharmacy6.Dental7.Optometry8.Education9.AdministrationStaff10.Staff Work AreaOB Program Space11.OB Clinic12.CenteringPeds Program Space13.Primary Care Clinic14.Specialty Clinic15.Diagnostics
13
14
15
10
12
1111
89106
57
4
ReceptionTCH Medical Home
WaitingTCH Medical Home
Team WorkstationsTCH Medical Home
ReceptionTCH Medical Home
3Lessons Learned
POE Methodology
(to be provided at learning session)
POE Results
(to be provided at learning session)
Common Takeaways – Conversion “Pros”
- Large, open footplate- Opportunity for various ceiling heights / high ceilings- Potential for second floor / mezzanine- Opportunity for skylights- Potential for separate front-of-house and back-of-house - Good visibility from major thoroughfares- Ample parking- Economical investment- Places care directly in the target community - Create a feeder system to or away from hospital campus
Common Takeaways - Conversion “Cons”
- Inappropriate column spacing - Undersized / shared utilities with adjoining tenants- Usually no emergency generators- Inappropriate / unusable mechanical systems- Low-budget original construction- Poorly documented building alterations over time- Undocumented / undiscoverable existing conditions- Potential limitations to exterior façade changes- Significant saw-cutting for under-floor plumbing- High roof: ceiling-mounted equipment challenging- Security
Dianna Prachyl [email protected]
Allison Muth [email protected]
Diane Osan [email protected]
Lance Winn [email protected]