national healthcare cxo summit - 2015: roi of efficient facility design

VOLUME 5:RETURN ON INVESTMENTOFFACILITY DESIGN

18 MAY 2015 | DECISION PROCESS = CLINICAL AND FINANCIAL RESULTS

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NATIONAL HEALTHCARE CXO SUMMIT MASTERCLASS | ROI OF FACILITY DESIGN | 18 MAY 2015

Introductions

TEG Efficient Design+Productive Care Clinical Procedural Platform• Overview• Platform Design Elements

TEG Efficient Design+Productive Care Decision Management Timeline

Clinical Procedural Platform Concept Benefits and ROI Impact• Clinical Volumes Comparison• Staffing Comparison• Patient Satisfaction Comparison• Financial Results Comparison

Questions from Attendees

Presentation Outline

Return on Investment ofFacility Design

1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0

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Introductions

R. Wayne EstopinalAIA, ACHA, LEED APPresidentTEG Architects

W. F. “Bud” Barrow, IIAHA Region 7 Policy Board Chair, AHA Board MemberPresident/CEOOur Lady of Lourdes Regional Medical Center

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Our Lady of Lourdes Regional Medical Center (OLOL) Lafayette, Louisiana

Process = Results

Replacement Facility Metrics

• Total Acute SF 430,400

• Number of Beds 186

• SF/Bed 2,314

• Percent Circulation 10.2%

• Site Acreage 46

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Clinical Procedural Platform

• Overview

• Platform Design Elements

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Clinical Procedural PlatformOverview

Departments Involved

• Emergency

• Imaging

• Invasive Cardiology

• Surgery

• Surgical Prep/Recovery and PACU

• Innovative Area - Flex Unit

DECONDECONDECON

EMERGENCY

IMAGING

FLEX UNIT

CYSTO

GI CATH SURGERY

CARDIOLOGY

PRE/POST OP

PACU

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Clinical Procedural PlatformDesign Elements

Circulation• Corridors Clear and Direct

• Staff Functions Without Circuitous Routes

• Reduces Travel Distances

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Departmental Adjacencies• Department Locations with Direct

Access to Other Departments

• Clinical Frequencies Determines Adjacencies


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Visibility• Staff Stations Allow Viewing of

Multiple Patient Care Areas

• Reduces Need for Staffing Observation Stations

Photo by: Will Crocker


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Expandability• Horizontal Expansion via

Exterior Walls

• Eliminates Major Disruption or Demolition of Clinical Spaces


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• Circulation

• Departmental Adjacencies

• Visibility

• Expandability

Clinical Procedural PlatformSummary

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Decision Management Timeline

1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0

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Project Decision Management Timeline Overview

Objective: Continuation of services to insure maximum value is provided to the Hospital.

8.0 CONSTRUCTION

9.0 POST CONSTRUCTION

1.0 INVESTIGATE/CONFIRM/VISION/INFORMObjective: Explore new ideas and Confirm prior decisions; Inform/Educate Hospital participants. Guiding Principles Draft One.

2.0 PROGRAMObjective: Define facility square footages driven by projected clinical utilization data./Service Lines/Programs and Departments

3.0 CONCEPTUALObjective: Create departmental level images to optimize clinical efficiency and illustrate adjacencies./Resolve Guiding Principles

4.0 SCHEMATIC DESIGNObjective: Design spatially accurate images to define the project./Initial Facility Aesthetics

5.0 DESIGN DEVELOPMENTObjective: Detail each space via clinical collaboration and multi-disciplinary input.

Objective: Deliver the facility by collaboration with Construction Team.

7.0 BIDDING/NEGOTIATIONSObjective: Price the CD Package via selected construction delivery process.

6.0 CONSTRUCTION DOCUMENTSObjective: Document the Replacement Hospital via construction level detailing and coordination.

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OLOL Collaboration Metrics• 170 Meetings between OLOL & TEG

• 105 OLOL Staff Involved

• 28 Design Team Members

• 104,051 Design Team Hours

OLOL Nurses Station

1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0


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A. Hospital .01 Leadership Team .02 Project Committee .03 Buildings/Equipment Committee .04 Board of Directors .05 Departmental Leaders .06 Physician Leaders

B. Design Team .01 Architects .02 Civil Engineering .03 Structural Engineering .04 Mechanical/Electrical Engineering .05 Code/Egress Consultant .06 Landscape Architect .07 Interior Design

Sample list of Participants

1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0

C. Construction Team .01 Construction Manager .02 Prime Sub Contractors

D. Consultants .01 Health Care Delivery Strategist .02 Program Manager .03 Equipment Planner .04 Construction Cost Estimator .05 Transition/Move Consultants .06 Security Consultant .07 Information Technology Consultant .08 Legal Counsel/Construction Specialist .09 Financial Consultant .10 Vertical Transportation Consultant .11 Traffic Consultant

OLOL Lobby Interior

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Clinical Procedural Platform Concept Benefits and ROI Impact

• Clinical Volumes Comparison

• Staffing Comparison

• Patient Satisfaction Comparison

• Financial Results Comparison

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Clinical Volume ComparisonFY 2011 vs. FY 2014

FY 2011: 29,096

FY 2014: 36,081

FY 2011: 6,549

FY 2014: 6,757

FY 2011: 52,246

FY 2014: 75,175

24%Increase

3.17%Increase*

43.88%Increase

* Surgical Volumes are reduced due to joint venture with adjoining surgical hospital on campus

Emergency Department Visits

Surgical Department Procedures

Imaging Department Procedures

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Staffing to Clinical Volume Comparison

Emergency Department

Old Campus

43.1 FTEUtilization: 675 Visits/FTE

New Campus

49.4 FTEUtilization: 730 Visits/FTE

Surgical Department

Old Campus

45.9 FTEUtilization: 143 Procedures/FTE

New Campus

52.2 FTE*Utilization: 130 Procedures/FTE

Imaging Department

Old Campus

25.8 FTEUtilization: 2,025 Procedures/FTE

New Campus

34.2 FTEUtilization: 2,199 Procedures/FTE

14.61%Staffing Increase

13.72%Staffing Increase*


*Actual staffing increases were minimal given the percentage of procedure increases documented.

Surgery procedures did not increase significantly due to the surgical hospital joint venture with physicians.

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Goals

• Not Reduce Staffing

• Create Facility that Attracts Greater Market Share

• Improves Outcomes and Access to Care

• Department Size Based on Need

• Staff Productivity Improved

• Financial Results Improved

Staffing to Clinical Volume Comparison

3.17%*Procedure Increase


24%Visit Increase


43.88%Procedure Increase


*Actual staffing increases were minimal given the percentage of procedure increases documented.

Surgery procedures did not increase significantly due to the surgical hospital joint venture with physicians.

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Patient Satisfaction Comparison

Press Ganey Guardian of Excellence AwardOLOL named a Guardian of Excellence Award winner by Press Ganey Associates, Inc in 2013 and 2014

86thPercentile of Scoring Population

Press Ganey Mean Scores: Old Campus VS. New Campus Comparison

60thPercentile of Scoring Population

86.7

Old Campus

Press Ganey Mean Score

89.7

New Campus

Press Ganey Mean Score

43.3%Increase in Percentile

OLOL Patient RoomPhoto by: Will Crocker

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OLOL Overall Facility Performance

FY 2011: $155,818,000

FY 2014: $192,540,000

23.57%Increase

Net Patient Service Revenue 2011 vs. 2014

OLOL Hybrid OR

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Financial ResultsEmergency Department

$2,160,314Increase

FY 2011: $(71,912)

FY 2014: $2,088,402

Net Profit

8%Decrease

FY 2014: $3,310,259

FY 2011: $3,605,999

Total Salaries/Wages/Benefits

DECON

Total GrossRevenue

89%Increase

NetRevenue

71%Increase

EMERGENCY

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NetRevenue

49%Increase

Total Gross Revenue

58%Increase

$1,495,340Increase

FY 2011: $(1,288,514)

FY 2014: $206,826

Net Profit

6%Decrease

FY 2014: $3,314,931

FY 2011: $3,532,222


SURGICAL

Financial ResultsSurgical Department

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$2,634,602Increase

FY 2011: $3,674,925

FY 2014: $6,309,527

Net Profit

17%Increase

FY 2014: $2,439,680

FY 2011: $2,085,806


Total GrossRevenue

73%Increase

NetRevenue

43%Increase

IMAGING

Financial ResultsImaging Department

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Series

Volume III

Masterplanning

Aligned Planning Strategies & Collaborative Visioning

Volume II

ED Examples

Emergency Departments:Highly Efficient Facility Design

Volume I

ED Efficiency

Emergency Departments:Facility Metrics with Time & Motion Considerations

2012 | VOLUME. 03 | A PrOcEss OF highLy EFFiciEnt FAciLity dEsign

EFFICIENT DESIGNPRODUCTIVE CARE

ALIGNED PLANNING STRATEGIES AND COLLABORATIVE VISIONING

2011 | VOLUME. 02 | A CASE STUDY OF HIGHLY EFFICIENT FACILITY DESIGN

EFFICIENT DESIGNPRODUCTIVE CARE

DESIGNING EMERGENCY DEPARTMENTS THAT IMPROVE STAFF PRODUCTIVITY

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Efficient Design Productive CareDesigning Emergency Departments that Improve Staff Productivity

A case study of facility metrics with time and motion considerations.

2010

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VOLUME 5:RETURN ON INVESTMENTOFFACILITY DESIGN

2015 | VOLUME .05 | DECISION PROCESS = CLINICAL AND FINANCIAL RESULTS

Volume IV

Nursing Units

High Performance Nursing Units & Patient Room Innovation

Volume V

ROI of Facility Design

Decision process =Clinical and Financial results

TEG Architectswww.teg123.com

Questions?

national healthcare cxo summit - 2015: roi of efficient facility design

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