2016-2017 Program

Hirashe

Innovation in the Built Environment for Healthcare

1Recognize Recent Innovation.

2Describe Needed Innovation.

3Envision New Actionable Approaches.

Innovation we have seen

The Institute Executive Board is investing five months to identify companies and individuals who have demonstrated innovative work over the past three years.

Innovation we would like to see

Next, the Board will actively seek industry wide advice from recognized experts to describe innovations needed to materially advance the effectiveness of American healthcare facilities. The Board will collaborate with selected industry experts to develop a series of presentations that will be introduced at four National Events.

Executive Board

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Frank Aucremanne

Cleveland Clinic | Ohio

John Becker

Defense Health Agency | Maryland

Stella Fiotes

Veterans Affairs | DC

Walter B. Jones, Jr

Metro Health | Ohio

Jeffrey Land

Dignity Health | California

Robert McCoole (Retd.)

Ascension | Missouri

Robert Mitsch

Sutter Health | California

Spencer Moore

MD Anderson Cancer | Texas

Donald Orndoff

Kaiser Permanente | California

Judy Quasney

NIH | Maryland

Sid Sanders

Houston Methodist | Houston

Dr.Stephen Wooldridge

MedStar | Maryland.

Skip Smith

Catholic Health Initiatives | Colorodo.

Joe M.Powell

University Research Institute | DC.

Deliverables

Publications

HIR + ASHE will publish the work of all 16 winners in4 seperate Monographs in 2018. Our staff will work with each winner to develop an academically acceptable article describing thier work.

Presentations

Our Board will be fully engaged in the presentation of our 16 winners at the 2018 ASHE PCD Conference in front of an anticipated 3200 professional.

Get Involved

Please contact Joe Powell to discuss how to submit an abstract or how to participate with the Board in this study: Joe.Powell@HIRinstitute.org Direct: 713-444-9363


Research Project Summary

1Healthcare Resiliency in the Era of Climate Change

NBBJ Architects

Replacement hospitals for medical institutions wiped away in Hurricane Katrina have recently reopened. The design of these facilities serves as a model for hospitals in other communities that must increasingly accommodate the effects of a changing climate and rising water levels. This study examines how these hospitals provide clues to institutions in other areas prone to severe natural disasters. It also looks at how these hospitals have transformed the region into a major hub for medical care, health and wellness, and also boosted the region’s economic future.

Contact Person: Daniel Skiffington, DSkiffington@nbbj.com

2Increasing Access to Healthcare – the case for a Nano Hospital

WHR Archietects

This study explores a concept for a smaller, ergonomic patient room that uses evidence based design to provide a high quality care environment while checking unrestricted growth in size and cost. It uses quantitative program comparison against past projects to show that the essential areas necessary for clinical care and support need not be reduced to achieve a smaller more efficient footprint. The goal of the study is to provide insight into how smart design could reduce excessive construction while still providing the space for high quality care based on the principles of lean design and ergonomics in conjunction with technology.

Contact Person: Bhargav Goswami, bgoswami@whrarchitects.com

3Modular Design and Construction in Healthcare

Gresham, Smith and Partners
Turner Construction

In a 2009 report, the National Research Council of the National Academics identified prefabrication and modularization as an ”opportunity for breakthrough achievement” in the design and construction industry. This study examines how the healthcare design and construction market have embraced the opportunity for modularization and what results can be measured in terms of cost, schedule, quality and safety. It further explores these areas of design and construction delivery and provides definitive data to help guide owners, architects, and contractors on future projects.

Contact Person: Pat West, pat_west@gspnet.com

4The Perpetual Future-State Hospital

Affiliated Engineers, Inc.

Future-proofing healthcare facilities with adaptability strategies and measures correctly assume that care-model change from “present point A” to “unknown point B” is inevitable. Today’s convergence of record data, analytics, genomics, and value-based payment for services, however, is fundamentally redefining the concept of facility flexibility from assumptions of episodic change to a state of comparatively continuous change. This case study explores how the transition from fee-for-service to value-based healthcare, guided by information/data technology, drives changes in space usage, whether to the more medically-intensive, such as surgical centers, or the more consultatively-intensive, such as telehealth augmented by real-time biometric patient data. Meeting the current challenges requires fresh approaches to capital project management. Combining the best practices of integrated teams and value stream mapping offers the environment for success.

Contact Person: Khris House, khouse@aeieng.com

5Non Traditional Means of Delivering Healthcare

DGA

With communities and consumers seeking better care and greater convenience, non-traditional outlets of care are growing in terms of popularity and capability. Some direct examples of this include government programs providing outreach to underserved communities and those below the federal poverty level; telemedicine and retail clinics are also part of the non-traditional delivery of care. This case study explores: mobile medical units, back pack medicine, wellness home check nursing, telemedicine and wearable devices and Workplace Clinics / Urgent Care Centers / Retail Clinics. This work illustrates the impact of the real people and teams that are currently providing this care and the lessons learned from their experiences.

Contact Persons: Khris House, Melinda Lin, mlin@dga-sf.com , Charles Aunger, charles@aunger.com

6Using Predictive Analytics and Big Data to drive Ambulatory Care Transformation

Hoar Construction, Real Estate Strategies (RES), and HGA Architects

Health providers acknowledge that ambulatory networks are the key to providing convenient, accessible services for patients while also ensuring future market share growth for health systems. Hoar, Real Estate Strategies, and HGA architects joined forces and developed an innovative approach to assist health systems in the creation and rapid implementation of successful ambulatory network strategies. This case study utilizes predictive analytics and interactive mapping to identify unsaturated market areas full of unmet patient demand, overlay ideal payer mix projections, and forecasting future financial success of new locations long before real estate has even been identified. By combining proven tools and techniques from vast experience in the retail and financial services industries with healthcare specific Big Data, health providers can now create predictive, visually compelling, neighborhood level strategic plans for expansion or optimization of urgent care centers, freestanding EDs, primary & specialty care practices and even micro-hospital locations.

Contact Persons: Coker Barton, cbarton@hoar.com Craig Beam, craig.beam@restrategies.com Charles Black, charles.black@restrategies.com Stan Chiu, SChiu@hga.com

7Technology Driven Solutions in Preparedness Reporting for Life Safety Management

JLL

The U.S. healthcare industry continues on a path of perpetual transformation as patient demands and government regulations evolve the care environment and begin to define a renewed operating model for the Nation’s top health systems. Requisite attention to margins, newfound potential in operational efficiencies, increased competition, and a proliferation of M&A activity, are all contributing factors to the ever increasingly complex task of managing a modern health system. This work examines the use of new technologies to ensure compliance preparedness, benchmarking, and reporting around three important areas: construction risk, life safety, and environment of care.

Contact Persons: Ted Pappas, Theodore.Pappas@am.jll.com Roger Herritz, Roger.Herritz@am.jll.com

8Making a Virtual Statement – Mercy Facility Delivers New Frontier of Care Delivery

Forum Studio

Mercy’s Virtual Care Center in Chesterfield, Missouri, has no waiting rooms, hospital beds, or patients. Instead Mercy Virtual, which opened last winter, houses more than 500 full-time employees who sit in front of computer displays, watching over the care of patients within several health systems, including 38 hospitals in six states. This case study illustrates that by integrating care management with primary care, home telemonitoring, and online and telephone support, Mercy has made a remarkable impact on utilization and clinical outcomes for individual clients.

Contact Person: Gary Collins, collinsg@forumstudio.com

9Achieving Integrated Team Success

Clark Construction Group

Success on today’s projects comes from delivery methods/contracts that allow the design and construction team to collaborate from the early stages of project inception. Studies show that this early engagement, at all levels, increases collaboration and leads to better outcomes. This presentation explores: 1) the ideal phase of the project (programming, conceptualization, schematic, etc.) during which to bring together the team to achieve the maximum benefit, 2) characteristics of a successful project team/culture, 3) project delivery options that maximize collaboration and manage proper risk allocation of the team and 4) best practices on past projects that exemplify the definition of successful team integration

Contact Person: Barbara Wagner, barbara.wagner@clarkconstruction.com

10Entropy and the Exploding Hospital

CRGA Design

The United States has begun moving to a new model of care that emphasizes healthy lifestyles to avoid unnecessary and/or avoidable inpatient admissions. When care is required, it is delivered in the most appropriate environment from a cost, quality and patient experience perspective. There will always be very sick patients requiring high-acuity care spaces—but there are so many alternatives to delivering high quality care across the continuum. This study explores a future of healthcare being dispersed from the public realm of institutional space to the scattered private realm of personal space—a space defined not by bricks and mortar, but rather by social connections. Such innovation could very well point to a future of (most) healthcare being delivered without dedicated buildings. The irony is the wider the dispersion, the more personalized care becomes.

Contact Person: Rolf Haarstad, rhaarstad@crgadesign.com Stephen Wooldridge, Stephen.C.Wooldridge@medstar.net

11ConX System for Healthcare Infrastructure: A Platform for Continuous Improvement

ConXtech

The ConX System is an innovative structural steel platform that major healthcare owners are leveraging to advance the effectiveness of their healthcare facilities. Healthcare owners are in a unique position to benefit the most by delivering more standardized facilities. This presentation examines the role of systemization in creating a Platform for Continuous Improvement. The desired outcome is to design and deliver healthcare facilities faster, better and more safely by breaking the cycle of continuous re-creation.

Contact Person: Rolf Haarstad, rhaarstad@crgadesign.com Stephen Wooldridge, Stephen.C.Wooldridge@medstar.net

12The Impacts of Population Health Analytics on Hospital and Outpatient Clinic Designs

GE Healthcare

The United States has begun moving to a new model of care that emphasizes healthy lifestyles to avoid unnecessary and/or avoidable inpatient admissions. When care is required, it is delivered in the most appropriate environment from a cost, quality and patient experience perspective. There will always be very sick patients requiring high-acuity care spaces—but there are so many alternatives to delivering high quality care across the continuum. This study explores a future of healthcare being dispersed from the public realm of institutional space to the scattered private realm of personal space—a space defined not by bricks and mortar, but rather by social connections. Such innovation could very well point to a future of (most) healthcare being delivered without dedicated buildings. The irony is the wider the dispersion, the more personalized care becomes.

Contact Person: Christine Chadwick, christine.chadwick@ge.com Dan Zikovitz

13Patient Experience Enhanced by Mobile Wayfinding

Gozio Health

Gozio Health’s mobile wayfinding application delivers a personalized patient experience that takes patients from their home, to the right parking garage and on to their point of care inside a healthcare system’s facilities. This study demonstrates that hospitals recognize that a smartphone-based, navigation platform for their organization, represents the next generation of mobile health and patients experience, putting location-based information at patients families’ and visitors’ fingertips. With 75% of adults relying on smartphones for location-based information and directions, a hospital- branded app that offers step- by-step navigation meets an expressed users need and provides an enticing reason for patients to down- load and engage.

Contact Person: Carolyn Van Winkle, carolyn.vanwinkle@gmail.com Barb Kragor, barb@goziohealth.com

14 Designing Tomorrow’s Hospital

TLC Engineering for Architecture

This presentation explores what we can expect from the hospital of the future and examines elements that can be implemented with today’s technology such as mobile care and remote diagnostics, crowdsourcing and patient education, group thinking and innovation and perpetual analytics. Perpetual analytics focuses on staff status, response times, energy usage and predictive maintenance. This case study that patients want to know how they are doing, and to know that their choice of facility and physician is the best choice.

Contact Person: Rania Sadrack, Rania.Sadrack@tlc-eng.com

15 Space Condition Management

JLL

Hospitals need a well-defined methodology for evaluating the condition of all spaces and assets, assessing cost and true timelines for repair or replacement, and determining which capital investments have priority in keeping conditions above standard. This presentation explores JLL/ATG’s Space Condition Management solution, designed in collaboration with some of the healthcare industry’s leading hospitals, which creates accurate digital architectural layouts of the entire hospital campus - to the room level. The goal is to utilize technology to gain consistency, quantify functionality and aesthetic value, and produce accurate data that better informs capital budgeting. Space Condition Management’s mobile inspection apps, real-time analytics, and email alert system provide the ability to assess conditions and correct problems—before their impact is felt.

Contact Person: Ted Pappas, Theodore.Pappas@amjll.com Roger Herritz, Roger.Herritz@am.jll.com

16 MR-Linac in Cancer Treatment

HOK

Oncologist teams face many challenges in accurately tracking tumor position during radiation treatment. Very recently, Elekta along with Philips Healthcare launched a hightech solution, the MR Linac.MR-Linac is the world’s first treatment delivery system which provides MR-guided external beam radiation therapy; it enables the therapist to have a closer look at the patient’s internal anatomy, improving the radiation treatment. This case study illustrates the challenges faced during pre-design, design, construction, and post construction. It also highlights how these challenges were resolved by the owner, architect, and engineers with the hope it will benefit other medical facilities contemplating the planning of MR-linac in an existing vault.

Contact Person: Yvonne Nagy, yvonne.nagy@hok.com Nupur Gupta, nupur.gupta@hok.com

Alternates

Three alternate winners have been selected in case any of the 16 decide not to have their work published in an ASHE Monograph.

The Life Integration Project and Health Hub

HDR Architects

What is the Value of a Failure That Never Happens?

Facility Health, Inc.

Aultman Hospital HVAC Optimization

Optimum Energy

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