This project consists of a 82 bed General Acute Care Hospital with a Cancer Center and Medical Office Building and Hotel in Tver, Russia. During the session we will present an overview of the road of discoveries traveled to get to the implementation phase. We will be looking back on lessons learned from the social, clinical, cultural, financial and political perspectives. The Client requested specifically an "iconic" design for this Hospital in order to set it apart from all traditional Russian hospitals in the region. This experience has introduced not only a new architecture, but more importantly, many new clinical concepts to be implemented by the medical staff. The objective was to have this hospital represent a new standard in quality of healthcare delivery in Russia. As a result, this hospital expects to be successful not only as a community hospital, but also as an international medical tourism hospital. The Hospital campus design also contributes to the surrounding community.

LEARNING OBJECTIVES:

1. Show how the Hospital design was influenced by cultural and clinical traditions
2. Show how the Hospital provides the environment to substantially improve the quality of healthcare services as compared to local hospitals.
3. Show how the campus design provides both security, yet reaches out and embraces the surrounding community.
4. Reflect on lessons learned about doing business in Russia. Managing expectations, setting goals, assigning responsibilities, contracting.

Sustainable energy solutions have gone beyond experimental technologies to become practical applications at a growing number of hospitals across the country. From simple energy conservation measures to renewable energy, we will utilize research from hospitals employing sustainable solutions to analyze practical applications, design innovations and technology advancements, and discuss true costs and quantifiable benefits. We will review lessons learned in design and operational considerations along with the challenges faced in implementing energy efficient strategies. Understanding the advantages and risks associated with multiple energy saving solutions, from modifying air handling unit controls to implementing solar systems, will help to establish a business case for investing in sustainable energy at your hospital. This session will challenge you to think beyond traditional cost-saving opportunities to invest in sustainable strategies for a truly healthier community.

LEARNING OBJECTIVES:

1. Define metrics in terms of capital costs, ancillary costs, life cycle costs, financial incentives, and cost savings of a myriad of sustainable solutions
2. Understand the various types of renewable energy systems and their performance characteristics
3. Examine how sustainable energy systems have impacted the design of hospitals
4. Understand emerging technologies that will improve energy efficient strategies and practices

Three years ago, Northwestern Memorial Hospital (NMH) issued an enterprise mandate requiring a transition to BIM/VDC technologies and processes on all projects, both new and renovation. That mandate began, “with the end in mind” and a stated goal of successful BIM-enabled FM at close out. NMH has since undertaken to put in place various infrastructure, tools and procedures necessary for successful FM handover at closeout. In this session, we will take a real-time look at several NMH project examples (2 new construction, 1 renovation) used as live laboratory investigations for optimizing BIM/VDC and transitioning to a BIM-enabled FM system. While not singular contract or tri-party agreements, each of the projects include elements of Integrated Project Delivery (IPD) behaviors and methodologies. As works-in-progress, we will share active findings, metrics and lessons learned.

LEARNING OBJECTIVES:

1. Recognize the value of integrated project delivery behaviors and methodologies on traditional contract procurements.
2. Consider the contractual clauses and technological realities required for successful BIM-FM transitions.
3. Evaluate measured metrics to-date from BIM healthcare projects and consider their true value.
4. Access the success of several BIM-FM strategies as explored and deployed on multiple projects

This session will discuss a multi-method research study that was conducted among 11 hospitals and that investigated the return on investment of sustainable building design and LEED certification. Stakeholders of hospitals expect that sustainable design will have a positive impact not only on factors such as energy use, water use and operational costs, but also on the perceptions and satisfaction of people. How do intangible human outcomes in hospitals impact the return on investment of a facility, especially with regard to sustainable design? For instance, does sustainable design impact the incidents of illness and injury in health care workers? Is the life-cycle cost of a sustainably designed hospital lower than a hospital that is not sustainably designed? In addition to discussing these types of questions, a framework will be presented for evaluating facilities in order to determine how sustainable design impacts the health and welfare of occupants and the bottom line.

LEARNING OBJECTIVES:
1. Learn how patient satisfaction impacts the return on investment of a facility within the context of current Medicare and Medicaid reimbursement policies and hospital facility environments.
2. Determine which factors of sustainable design lead to health care worker safety, satisfaction, and engagement, therefore impacting return on investment.
3. Understand the importance of life-cycle cost analysis for evaluating on-going health care facility costs and informing design decisions.
4. Implement a framework for evaluating facilities and identifying factors that positively impact occupants and return on investment.

Parkland has created a unique organizational structure, which includes clinical liaisons to be the bridge between the current hospital and the new 3 million square foot replacement campus. We will present to you how to maintain momentum and remain on schedule during organization changes and public scrutiny. Our session will be primarily focused on how the role has moved from the planning phase to the implementation phase which includes topics such as: operational readiness, equipment relocation and move activation. As the project progresses and nears completion, we have learned how to create a model which will set the standard for future construction projects to come. We will demonstrate our cost savings through our mock-up simulation and training, procurement process and tracking of change requests. The relationship between the architects, consultants and engineers continues to grow throughout the lifecycle of the project.

LEARNING OBJECTIVES:

1. Understand the journey of the Clinical Liaisons throughout project life cycle.
2. Understand how to maintain momentum for the project and challenging environment.
3. Understand how to take the floor plan into an Operational state.
4. Identify the different roles needed throughout the life of the project.

Throughout time the presence of God or faith has been at the core of the Healthcare experience. Many faith based hospitals that were founded by Nuns or other clergy struggle to maintain their identity and serve the new and diverse communities of this decade. In this session you will learn through a variety of case studies how modern day hospitals share their faith using visual art, sculptures, branding and displays, creating sacred spaces and Interfaith Chapels and how this work is becoming a component of the healing process. It is important to support the walk of Faith that every person is on; from patients, visitors to staff and employees. In this work we engage both the communities and the spiritual representatives to learn what is truly necessary to support patients on their healing journey. Healing gardens, chapels, stairwells to wellness and landmark art pathways can become inspirational tools, which often times in itself becomes a walk of faith.

LEARNING OBJECTIVES:

1. Evaluate and support the presence of faith in the institution
2. Build opportunities for inspiration into the patient experience.
3. Distinguish the values and service of the organization with visual displays , quotes and surprises
4. Transform the daily journey for employees in to a walk of Faith

With humorous, but real examples, we will look at results of misinformed design and solutions to these dilemmas. Bringing to the table understanding of disease effects, visual-spatial capabilities, treatment processes, destination hierarchy, and expected response to color and pattern in visual elements is truly necessary to properly serve your healthcare clients. Attend to hear innovative design ideas that sprang from these examples: + Dementia care unit renovation included construction of an indoor, pretend front porch with many features that failed to accommodate a dementia population + Abstract art - a red splatter-shape on white background - hung in a cancer center reminded onlookers of phlebotomy procedures + A long-term care facility's interior was left to staff to decorate and became an uncoordinated jumble of elements + A wayfinding kiosk meant to provide a high-tech map resource was not accompanied by supporting cues, resulting in a dose of frustration as well as maps.

LEARNING OBJECTIVES:

1. Describe what is meant by "toxic visual elements."
2. Identify end-user issues to consider in design and what expertise is needed on your team to fully address these.
3. Use the examples to help you look at your own projects with fresh eyes to prevent any similar faux-pas.
4. Take away "pearls" about effecting stress reduction in healthcare and how that knowledge can change designs and improve satisfaction with a facility.

The presentation reexamines an earlier case study of the planning & design of a health care campus project consisting of an 1100 car employee garage & child care center for 320 children. Presented as a post occupancy assessment, this presentation offers a candid evaluation of the process and the first year project performance by the project sponsors. Development of the concept into a business plan in support of the organization’s mission in recruitment and retention of staff, is offered to assist others contemplating similar projects. Integration of sustainable design is illustrated to demonstrate how fundamental integration of this initiative is central in achieving wider support for these projects. Also included is first year performance data of the project from green energy and sustainability perspective in this dense urban environment. Guidance is offered in a “lessons learned” format for organizations, planners and consultants considering similar projects or initiatives.

LEARNING OBJECTIVES:

1. To offer a comprehensive overview of the concept development, planning, construction & operation of a sustainable child care center & parking facility
2. Provide insight into a strategic approach to secure the broad support necessary for developing facilities to support employee recruitment & retention
3. Understand how sustainable initiatives are best realized when they are a fundamental and fully integrated goal of the project
4. Examine how a post occupancy assessment is used in evaluating attainment of a broad range of project goals from primary function to sustainability

This session is a Panel discussion of both Owners and Architects on forming better partnerships together. Many Healthcare Organizations are being pushed to find ways to deliver projects quicker and for less cost. One of the ways to do this is to form better relationships and partnerships with owners and consultants. This panel discussion will talk through common pitfalls on partnerships between Owners and Consultants and recommend ways to develop better working relationships together. Owners often hire consultants even though they may not know what they want. They are sometimes staffed with Architects/Designers/Engineers who still want to be Architects/Designers/Engineers rather than Project managers. These relationships can be trust challenged if not for the collaborative team environment of a good partnership.

LEARNING OBJECTIVES:

1. Develop an Understanding of each other's world - From the Owner & Architect's perspectives
2. Discuss challenges projects often have and how to avoid them - From the Owner's & Architect's perspectives
3. Discuss how to complete projects with relationships intact
4. Explore the trends and future of Healthcare collaboration together

The U.S. Department of Housing and Urban Development, Federal Housing Administration (FHA)’s Office of Healthcare Programs (OHP) administers both the Section 232 Residential Care Facilities and the Section 242 Hospital Facilities Mortgage Insurance Programs. These programs allows hospitals, nursing homes, LTACs, and assisted living facilities to access low-cost capital for financing the construction, renovation, or refinancing of projects throughout the United States. Additionally, the newly launched 223(f) program for Hospitals allows the financing of acquisitions and refinancing of existing capital debt for new applicants. FHA commitment enhances a hospital’s credit-worthiness, allowing the issuance of higher rated bonds or securities with lower interest rates that reduce the long-term cost of borrowing. Recent rates have been historically low. Attendees will learn whether their projects/enterprises are a potential fit for the program, as well as how to start the process.

LEARNING OBJECTIVES:

1. Learn how FHA Mortgage Insurance can lower the cost of capital for healthcare entities looking to (re)finance construction projects or acquisitions
2. Understand the programmatic eligibility determinants
3. Establish a general understanding of what healthcare projects might be a fit for FHA programs
4. Learn how to start the process

Are you debating the shift from ward configuration to private room NICU? This presentation addresses the design process for both the design team and NICU Staff. We will explore how to engage the NICU Staff in transition planning from a ward configuration to a single room model along with design considerations. Design can affect the growth and development of the neonates by managing the amount of sound and light exposure, can facilitate breast feeding and kangaroo care by creating privacy for the family, and address infection prevalence based on the location of hand washing stations and the distance between patients and other variables. Evidence from Cleveland Clinic’s Hillcrest Hospital 33-bed Level III NICU will be used to compare prior ward configuration to actual outcomes gathered over two years since opening. We will discuss gaining NICU staff comfort level with a private room model and unique design, operational and implementation considerations.

LEARNING OBJECTIVES:

1. Review a brief history of Neonatal care from its inception to current times.
2. Identify the important staff and hospital operational considerations in shifting from a ward configuration to a single room model
3. Acquire key architectural and engineering considerations unique to the NICU
4. Compare key data of ward configuration outcomes with (2) years of data from single room configuration.

Kaiser Permanente is reshaping healthcare design through their focus on Total Cost of Ownership. The Kaiser Permanente Central San Diego Hospital project team adopted the use of LEED HC for the new 600,000 sqft building following the tool’s emergence from the USGBC’s pilot phase. The team set a goal of LEED HC Gold, a first for a California hospital using the new HC tool. To achieve a nearly 30% reduction in energy consumption over an aggressive code-compliant, ASHRAE 90.1-2007 baseline building, the team analyzed several sites for optimal climate and site orientation, and then assessed numerous first time energy and water conservation technologies for implementation into a high-performance envelope. In this presentation, members of the project team will walk through the process to explain how these technologies and design strategies contribute toward the hospital’s LEED HC rating, as well as how the project’s budget, operating cost and schedule were reconciled.

LEARNING OBJECTIVES:

1. Learn how LEED HC differs from LEED
2. See how an integrated team matters for LEED
3. Understand how your facility compares to ASHRAE 90.1-2007
4. Discover the best tools for this job

Today's economics of providing high-quality healthcare in state-of-the-art facilities, requires a funding source which goes beyond traditional financing through operational means alone. The best academic and community hospitals in the US benefit from philanthropy, and are receiving monetary gifts at an unprecedented rate, despite the economy. This is not an accident or a happy coincidence, but the result of a highly skilled and coordinated effort between the capital campaign leaders of these institutions, the community at large, and at times, the design team. This session will illustrate the benefits of a coordinated capital campaign, and the utilization of design in this process. We will explore examples of major hospital projects which would not be possible except for philanthropy, and how this integration not only creates great architecture, but enhanced funding. Your hospital may be missing a golden opportunity if you have not considered the potential of philanthropy by design.

LEARNING OBJECTIVES:

1. Learn how a coordinated effort between designers and capital campaign leadership can enhance giving.
2. Learn how to create a grass-roots capital campaign in your community which enhances giving as well as the public perception of your hospital.
3. Learn about the importance of various tools including identifying gift opportunities, and managing the recognition of your gifts in a consistent way.
4. See success stories of integrated capital campaigns, and the benefits of this approach.

Saint Mary's Health Care offers state-of-the-art surgical services for a wide range of medical conditions. Saint Mary's surgeons are board-certified and trained in the most up-to-date techniques and technology, including minimally invasive robotic procedures. Over 14,000 procedures are performed in hospital on a yearly basis. On main campus surgical services take place in the main hospital, at the LACKS cancer center and hands and plastic surgery center. Leadership dedicated to process excellence decided to conduct a LEAN operations improvement process and implementing its results into a redesign of surgical services – spatial and operational. The effort included collective participation of D&T clinicians and ancillary services, technology and process excellence departments. It resulted in creation of future optimal 7 healthcare flows; elimination of 8 waste components, creation of 5S guiding principles and detailed analyses and comparison of institution existing and future operations.

LEARNING OBJECTIVES:

1. In-depth learning of integrated Surgery operations platform and functionality: step by step; minute by minute; specialty by specialty.
2. LEAN is creating more value for customers with fewer resources. Learn how we transformed functional silos into one cohesive and efficient value stream
3. Follow the change in experience for patients, clinicians, and public. Learn medication, supplies, equipment and information LEAN flows
4. How to proactively “translate” functional and operations excellence into spatial layout, equipment, number of full and part time employees and budget

Cedars-Sinai Medical Center (CSMC) and a multidisciplinary team of experts in process improvement, human factors research, trauma and architecture are proposing to test and document the efficacy of new processes and technology in peri-operative trauma care. CSMC is creating a new open environment to facilitate interdisciplinary and creative interactions. The hybrid space allows flexible research and simulation areas, academic offices and collaborative environments. This novel design for a surgical simulation laboratory will ensure the highest performance for the CSMC’s research team and will focus on the integration of teams and technology in the operating room. The research will map trauma care environments at CSMC and their military partner hospital Madigan Army Medical Center. We will explain how technology is impacting hospital operations, and OR intelligent infrastructures. The session will outline the project evolution from inception thru completion of design and construction.

LEARNING OBJECTIVES:

1. Participants will learn how to design, construct, implement and evaluate improved process models in trauma simulation and practice
2. Learn how to test and implement research findings in a military environment and disseminate best practices to both civilian and military sectors
3. Evaluate how multi-disciplinary analysis and enhancements of integration of technology lead to measurable improvements in trauma care processes
4. Benefit from the perspective of the clinical team and facilities/ design to solve the challenges imposed by current simulation practices

In our session we will provide best practice examples from lean construction in hospital design in Europe - mainly Germany. We will outline the challenges of the hospital´s situation as well as the specific approaches we took to set up the planning process following the DFSS (design for six sigma) and lean toolbox. We will describe the planning process where we conducted more than 150 workshops with almost 100 staff involved in a 2 years process. We will provide case example data to demonstrate that it is possible to reduce investment cost while optimize medical core processes and staff work satisfaction.

LEARNING OBJECTIVES:

1. Learn about best practice examples in hospital design from abroad
2. Learn how to successfully apply DFSS and lean tools in hospital planning and design
3. Learn how to reduce investment cost while improve functionality an staff satisfaction
4. Broaden your view on hospital planning and design by learning from real case examples

Why would a design team strive for ways to avoid accessibility requirements in all patient spaces? This case study explores the challenges of an existing renovation at Aspirus Wausau Hospital and how the project acquired approval to waive ADA requirements to better meet the needs of the patients. Patients with varying levels of mobility, cognitive abilities, and ailment severity are treated within the Aspirus Hospital Wausau Inpatient Rehab unit. The hospital and its care providers strive to ensure that the space provides an additional level of healing beyond the medical practice and care. An aging unit had left rooms too cramped to accommodate more than a few people at a time which hindered the patient’s rehab progress. In order to solve this problem, it was decided that it would be in the best interest of the patients to waive some ADA requirements. This session will explain in detail the reasons behind the decision and the process required to waive the requirements.

LEARNING OBJECTIVES:

1. Learn about potential challenges of ADA requirements and how some may hinder the patient rehabilitation.
2. Understand how the collaborative design process addresses the unique needs of rehabilitation patients.
3. Assess the impact of material selection on patient, family, and staff comfort.
4. Explore implications of existing construction and how the team worked within these constraints to provide an optimal inpatient experience.

All capital projects assume risk. In healthcare, the quality of the building system’s design is critical. As technology and ease of collaboration grows, there is a relentless worldwide demand for new healthcare facilities that are more robust, more sophisticated, and more sustainable. These two realities create a marketplace that forces engineers to think smart and think fast while hedging risks and exceeding the expectations of healthcare experts around the globe. How do we manage this paradox? What are the fundamental values of healthcare design that separate the designers from the thought leaders? The University of Chicago Medicine’s Center for Care and Discovery is a $700 million, LEED Silver hospital consisting of 1.2 million square feet and is recognized as one of the nation’s most modern clinical and surgical centers dedicated to specialty care and research in areas such as cancer, orthopedics, gastrointestinal disease, neuroscience, advanced surgery, and high-tech medical imaging. This project was designed and constructed over seven years – spanning breakthrough medical developments, an economic recession, and a sustainable movement. Project delivery involved collaboration and communication between numerous and varying stakeholders, the understanding and incorporation of a multi-million square foot surrounding campus, evolving sustainability requirements, and foresight into the future demands of the healthcare industry. This facility heightens Chicago’s profile among the ranks of international healthcare destinations and resulted in distinct design challenges, innovative solutions, lessons learned, and repeatable success.

DISCUSSION POINTS:

- High Performance = True Sustainability
- Engineering Design fundamentals that should be applied for repeatable success.
- Guiding Stakeholders through forward-thinking ideas.
- Lessons learned and complex design solutions for mission critical buildings. 

LEARNING OBJECTIVES:

1. Sustainable buildings are a result of sound engineering design, with or without LEED
2. Long-term success is directly related to reliability, flexibility, and adaptability
3. Items to consider when predicting the future of an industry
4. Alternative approaches to multi-faceted design challenges

With the help of Purdue University, BSA LifeStructures is using Lean design principles to put a focus on functionality and operational efficiencies in the design of healthcare facilities. The use of these principles has enabled the firm to implement designs free of non-value adding steps. Using a Lean philosophy, the firm’s designers have helped healthcare clients manage their resources to reduce costs and improve quality. This presentation will highlight their Lean journey and dissect projects that use Lean methods, a required step to earn yellow belt certification. Representatives from Purdue University’s Healthcare Advisors program and designers from BSA LifeStructures will highlight and expose how they used Lean on the new Simon Family Tower at Riley Hospital for Children and how Lean was applied to the firm’s programming phase during design.

LEARNING OBJECTIVES:

1. Define the five key Lean concepts for healthcare: identify value, eliminate waste, create flow, establish pull and seek perfection.
2. Identify methods and strategies that other organizations can use to implement Lean procedures.
3. Describe real-life lessons learned from the use of Lean on healthcare facilities.
4. Evaluate the effectiveness and impact of Lean design processes on two healthcare projects.

This presentation will review the major NFPA 101 changes that will impact the design and operations of a new or existing health care facility. The 2012 edition changes are not the only ones that are changed by this update. NFPA 101 was revised in 2003, 2006 and 2009 in addition to the 2012 update. All of these editions have changes that affect the health care setting in both new and existing facilities.

LEARNING OBJECTIVES:

1. Identify the major NFPA 101 changes related to healthcare occupancies.
2. Describe the security criteria allowed by newer editions of NFPA 101
3. Understand the changes in the corridor clutter issues and allowances in an 8 foot corridor
4. Understanding the CMS schedule for adoption of the 2012 edition of NFPA 101

Medical technology is reshaping how we deliver care, but the rapidly advancing scanners are also changing the very fabric of our healthcare buildings. This presentation offers a rare look at an inter-firm collaboration in the development of design standards and space planning criteria for radiology, nuclear medicine, and radiation therapy. This session will begin with the development of the US Department of Veterans Affairs Design Guides, and describe industry, technological and clinical changes in imaging and device-driven therapy, and the 2013 efforts to revise and redevelop the Department of Defense Space Planning Criteria for these rapidly evolving practice areas. The presentation will also identify those imaging and therapy technologies still changing too fast to effectively build prescriptive design criteria.

LEARNING OBJECTIVES:

1. Summarize how advances medical imaging technologies have outpaced standard designs for imaging facilities, and how to catch up.
2. Understand how changes in both technology and clinical practice were captured at both device and department level for the VA Imaging Series Guides.
3. Observe as imaging and therapy area design standards are updated for the DoD's Space Planning Criteria.
4. Identify the latest technologies and clinical practice which - while in practice - were too new to make it into even this most recent standard.

As the healthcare landscape in the U.S. continues to evolve as a result of the Affordable Care Act and a slow rise in the economy, public and private hospital leaders are preparing for the shift in their business model to face limited access to capital markets, even for construction projects deemed necessary. An alternate funding option that has not been closely examined in the U.S. is public-private partnerships (P3). The Barts and Royal London Hospital in London, England, recently named as one of the world’s best projects by finance firm KPMG, is one successful example of what can be achieved utilizing the P3 delivery method. The Barts and Royal London was delivered by a single entity team and carried out to the highest standards. This presentation will explore the relationship with the hospital and the benefits achieved through P3. Presenters will also discuss possibilities for using this model in the U.S. to help address the current funding issues.

LEARNING OBJECTIVES:

1. Gain a better understanding of the P3 delivery model
2. Understand when P3 is the right delivery model and the strategies for development
3. Understand both the short and long benefits PPP provide hospitals owners
4. Analyze the project to understand the organization of a P3 as well as the benefits, challenges, cost ramifications and lessons learned

We will present on the emerging role of prefabrication in healthcare design and construction. The project is a 360-bed, 830,000SF replacement hospital with an aggressive construction schedule. With the goals of operational efficiency, improved quality and compressed schedule in mind, the team worked collaboratively to identify the elements for prefabrication, which include wall panels, toilets, headwalls and multi-trade above-ceiling racks. Adaptations were required to the typical work sequence. Innovative tools and approaches were employed to meet the modified work sequence and aggressive schedule, including digital mockups, 3D mockups, and real-time collaboration. The integration of these approaches with BIM, virtual design and construction efforts drove intense collaboration efforts to finalize details earlier, allowing the team to get ahead of the construction schedule and deliver best in class innovative solutions.

LEARNING OBJECTIVES:

1. Learn elements that can be standardized and prefabricated for the benefit of all and how to evaluate and select the best candidates for prefabrication
2. Understand how to adapt the standard design process and construction schedule to ensure standardization and prefabrication yield success and ROI.
3. Learn how to reap the benefits of IPD while working under standard contract types, and how we built and sustained a collaborative OAC team.
4. Discover how to use cloud-based collaboration tools and BIM to meet aggressive schedules and eliminate duplication of effort.

Within the climate of healthcare accountability, general lighting must now be considered as a cost effective means for delivering patient safety thru early detection of life threatening conditions. With an emphasis on reducing clinician errors and limiting patient readmissions, design knowledge regarding the specification of ambient light sources is now critical. Long established for delivering effective clinician performance and improved patient safety, light sources which pass the Australian standard for early detection of cyanosis have been utilized worldwide. This session will explain the COI standard and provide examples of where general lighting compliant to the standard would also be of benefit for improving clinician visual acuity within senior living, medical imagining, physician offices, and walk-in clinic environments where this type of lighting has the potential to thwart occupant discomfort and negate unwanted visual impacts.

LEARNING OBJECTIVES:

1. Explore ambient general lighting conditions for enhancing clinician visual assessment of skin indicative of life threatening conditions.
2. Review lighting condition negative impacts on visual acuity when color saturated exterior glazing options are installed.
3. Review health care environments where international code compliant light sources are beneficial for reducing clinician errors and saving lives.
4. Acquire lighting specification skills targeting enhanced visual acuity of surface color specifications, skin observation, and facial features.

In 2004, the VA had not built a new medical campus in 15 years and greatly needed to expand its facility base to support our growing veteran population. In 2005, the joint venture of RTKL/JMA was engaged to master plan and design a new, 1 million square foot medical campus north of Las Vegas, for this growing region. The panel will discuss the approach taken to programming, budget reconciliation and the design, as the team developed a new hospital for the 21st century while examining lessons learned from the RED BOOK. The team will discuss the planning of this multi-use campus, which includes significant inpatient and outpatient services, VBA benefits, mental health care, long-term care and community ER services. The master plan discussion will include the thinking behind the "spine concept" and its 100-year plan for expansion. The building's sustainable features will also be highlighted including the off-grid reserves, solar generation and high-performance, recycled skin.

LEARNING OBJECTIVES:

1. Discuss the master plan for the complex, outlining our methodology concept development and our interpretation of the client’s goals.
2. Discuss transforming an existing systems approach (RED BOOK) into a model for the 21st century, learning from both the present and the past.
3. Discuss the strategy for medical planning and incorporation of the patient experience/wayfinding system into such an overwhelming environment.
4. Discuss the research and approach used to ensure this complex is as sustainable as possible through a value-driven scorecard.

Healthcare facility managers throughout the nation are continually reminded of the perpetual nightmare of fire-stopping deficiencies throughout their facilities. The looming threat of the Joint Commission continual preparedness, electronic SOC™ (Statement of Conditions) and online Requirements for Improvement (RFI) reporting; negate the age-old approach to avoiding the hidden holes in the walls. Joint Commission Standard LS.02.01.40 (Health Care) states that “The organization provides and maintains special features to protect individuals from the hazards of fire and smoke”. What historically had been “out of sight, out of mind” is a now a focus of the Joint Commission life safety surveyors, CMS surveyors, fire marshals and city inspectors alike.

LEARNING OBJECTIVES:

1. Provide insight as to managing Barriers in facilities.
2. Provide insight as to the processes needed to insure compliance.
3. Provide insight as to the processes needed to insure compliance.
4. Show how a sustainable barrier management approach can cut cost associated with managing barriers.

The design of the Douglas and Nancy Barnhart Cancer Center was approached from the experience of the patient, visitors, and staff in order to reduce the stress and anxiety level of all. Residential scale, a soothing color palette, connection to nature through multiple fountains/gardens, and a unique Linear Accelerator vault that is open to the sky help to soften the clinical environment and create a less intimidating space. This session will enable attendees to: Understand how art, scale and the experience are as important to patient care as medical equipment. Learn how the entire project team has been affected by cancer and how they played a key role in the process of healing design. Recognize that illness causes uncertainty and by making patients more comfortable and confident you can help them overcome challenges and aid in their healing. Realize that patients and staff need guidance for coping with Cancer and that a facility should provide space, amenities and privacy for them.

LEARNING OBJECTIVES:

1. Understand that all of us - not just doctors and nurses - but architects, contractors, owners and visitors are part of the healing process.
2. Recognize that it is up to each of us to do everything we can to improve the experience for the patient, visitors and staff.
3. Learn how our team transformed an intimidating and uncomfortable concrete bunker space into a light airy room with natural daylight and a garden view.
4. Research shows increased healing when the patient is connected to nature and art. Learn how this project integrated both throughout the facility.

Spectrum Health, a non-profit, award-winning US Top 10 Health System is in the midst of creating outpatient healthcare facilities to support the expanding Spectrum Health Medical Group (SHMG) physician network. These facilities are designed to respond to market volatility, express the SHMG mission and establish a new standard for programmability. They must also nurture and support efficient, effective, patient-centered care. With one facility operating, another one in design, and several more in the early planning stage, it is imperative that each new facility utilize lessons learned from previous projects, providing improvements in efficiencies for health care providers, patients and the built environment. Key team members will share their work in measuring effectiveness, post occupancy, in the clinical outpatient environment, and how that translates to the delivery of healthcare and the design of outpatient facilities.

LEARNING OBJECTIVES:

1. Define team-based care, team-based care cell and its applications
2. Illustrate the difference between simple facility assessment and the post-occupancy scorecard
3. Share the process used to develop metrics that supports continuous refinement and how to involve process engineers in the effort
4. Next steps. Communicate how team translates results into design and operations of next generation facilities

The speakers bring extensive knowledge of healthcare delivery trends which they are deploying jointly to develop a new hospital supported by an integrated multidisciplinary team care delivery model. The care delivery model adopted by the Health Region for their new hospital supports a Patient First Mandate and the vision to incorporate Lean innovation to optimize health care delivery in the Province of Saskatchewan. The planning approach has utilized integrated care teams focused on pulling value to patients. Effective, consensus driven changes in healthcare delivery will reduce operating costs, cut patient care cycle-times, and improve patient safety and satisfaction. The clinical operations team is working in conjunction with the design team to structure the operational processes for the new hospital to eliminate waste, duplication, and waiting while adding value and efficiency to the patient experience.

LEARNING OBJECTIVES:

1. Provide real life examples of how Lean works and what is involved in implementing Lean in Healthcare
2. Understand the lean management principles most applicable to the design of the building and the design of operational processes for the new hospital.
3. Provide specific examples of how lean tools helped to inform the design of the building.
4. Summarize the significant Do’s and Don’ts of lean integrated project delivery.

The Intensive Care Unit with its many patients, beds, staff members, visitors, devices, advanced informatics systems, data and alarms and infections has a propensity to be in perpetual disarray. In this session, we will explore design approaches to minimize the "mess" by focusing on the patient room and visitor areas, patient privacy, logistics, translation systems, “rounding” techniques, integration of ICU devices into a unified medical and ICU information system with complete "smart" data and alarm management, bidirectional data flow into devices and the electronic flow sheets, local and remote e-ICU telemedicine applications, time synchronization and task based and vender neutral servers and gateways. We will investigate the installation and use of Real Time Locating Systems and Solutions (RTLS) for asset, staff, patient and environmental management. Finally, we will go through the hidden troubles of upgrading ICU high tech equipment.

LEARNING OBJECTIVES:

1. Understand the inherent disarray of the complex Intensive Care Unit environment.
2. Learn how to create "smart" data and alarm management systems.
3. Comprehend Real Time Locating Systems and Solutions (RTLS)
4. Look at the hidden challenges of upgrading ICU technology

Patient satisfaction is a top goal of hospitals throughout the US and the physical environment can be a major factor in enhancing the patient experience. In the 2012 HealthLeaders Media Patient Experience Survey nearly 84% of top-level US healthcare executives said that patient experience is among their top three priorities, and 24% say it is their top priority. Can we build a case that the physical environment can improve the quality of experience for patients and family? What aspects of hospital design and planning can support a positive patient experience? Studies have shown that though clinical care was almost identical, it is perceived superior in a new facility. This session will feature six new designed facilities that scored well above the national average in HCAHPS scoring and share what aspects of the built environment were proven to enhance the patient and family experience through post occupancy studies, including what decisions gave the best value for money spent.

LEARNING OBJECTIVES:

1. Learn the five proven elements for enhancing patient satisfaction
2. Explore current research on how the physical environment affects the patient experience
3. Review physical improvements that most cost effectively raise HCAHPS scores
4. Identify key services that designers can market to improve patient experience

The Star Trek Medical Tricorder is here! 
Having the world of medical diagnostics in the palm of your hand is no longer science fiction. Through the use of tablets and smartphones, medical diagnostic tools are becoming more mobile and more available to doctors and patients. With each day, more manufacturers are creating apps and medical products that can safely and securely turn your mobile devices into medical diagnostic tools. What is the future of this technology, and what does it mean to the future of patient care?

LEARNING OBJECTIVES:
1. Learn about current technology and anticipated future advancements.
2. Discuss the potential limitations (user limitations, legal limitations, etc)
3. Discuss the impact on electronic medical records
4. Discuss patient versus physician responsibilities with this technology

During this time of rapid transformation and innovation within the healthcare industry, costs and efficiencies have become increasingly significant benchmarks for facilities. The design team, hospital staff, and all involved in the delivery of healthcare will need to place a greater focus on value creation and opportunities for more efficient design and operational strategies. How do we do more with less on projects? The implementation of modular design, reuse and repurposing, interchangeable finishes and spaces, and future planning for technology advancements are some of the solutions to be discussed. With a new commitment to improved healthcare for all, facilities and design teams in the healthcare industry have tremendous opportunity in achieving objectives to improve the patient experience and to contribute significant value to the advancement of healthcare.

LEARNING OBJECTIVES:

1. RECOGNIZE the benefits of value-driven design
2. EXPLORE design elements to improve the experience of care and reduce per capital healthcare costs
3. CONCEPTUALIZE the strategies to streamline the design and construction process to minimize the cost of design and construction
4. DISCOVER ways to facilitate discussions between the Hospital and the design team in order to generate more successful and cost efficient outcomes

Many organizations have difficulty committing to sustainability because of the tremendous number of competing resource demands within healthcare. This session illustrates the business case for sustainability using a triple bottom line methodology (people, planet, profit), with specific focus on the intersection of sustainability and facilities management. An approach to assessment, gap analysis, structure, accountability, culture, improvement process, targeted initiatives and measurement will be reviewed. Throughout the presentation, specific case study examples will be provided by Spectrum Health to illustrate the need for, and benefits of, incorporating a balanced approach to sustainability. Organizational readiness and sustainability process tools, resources and strategies will be reviewed, as well as leveraging sustainability measurement to show success and hold the gains. Numerous tools and visuals will be incorporated into the presentation and available for use by the audience.

LEARNING OBJECTIVES:

1. Describe the importance of incorporating a balanced approach of the Triple Bottom Line (TBL) into the organizations sustainability strategy.
2. Define a strategic approach to building a business case for sustainability that aligns organizational priorities and drives measurable value.
3. List the elements of an improvement process that develops internal capacity and hardwires sustainability into the cultural fabric of the organization.
4. Learn how to develop a measurement and reporting system that shows progress and holds the gains.

This session will focus on the emerging need for the effective integration of healthcare and retail development solutions that will provide patients with dignified and convenient care. Recognizing that the world is changing, a growing demand exists for elegant healthcare solutions that will last over time. Though a move toward clinic-based models is not new, physicians and hospital administrators have been slow to truly embrace this approach. This session will explore the challenges of clinic-based models and the added dimension of appropriately integrating health-related and convenience-based retail to the mix. Insights concerning the business case including the necessity of developing inventive proformas and new thinking about real estate services will be shared. We will look ahead to the emergence of the multi-disciplinary clinic as an anchor to vibrant community centers and the impact such demands might have on these financially constrained developments.

LEARNING OBJECTIVES:

1. Participants will gain insights into the complexity of market condition impacts on retail and MOB real estate “deals”. 2. Participants will learn techniques for leveraging low cost outpatient settings into dignified and integrated developments.
3. Participants will explore the opportunities and challenges of clinic-based models and the lease agreements that drive successful developments.
4. Participants will gain a deeper understanding of the interdependency of proformas for integrated retail and healthcare developments.

Ann & Robert H. Lurie Children’s Hospital of Chicago is a new 1.25 million square foot, 24-story, 288-bed children’s hospital in the heart of downtown Chicago. Planning for this replacement hospital project began in 2006, construction broke ground in 2008, and the facility opened on June 9, 2012. During that 6 year span, thousands of people worked diligently to design, build, and activate the best state-of-the-art facility for the patients, families, and caregivers, and the final product was and is a success by all accounts. But with a project of this size and scope, there were many challenges along the way, some expected, others not so. And there were many solutions crafted to these overcome these challenges, some incredibly effective, efficient, and quick, while others missed the mark. One thing is certain, with the experience gained and the lessons learned from working on the Lurie Children’s project, things will be a whole lot easier THE NEXT TIME WE DO THIS…

LEARNING OBJECTIVES:

1. Build the right team and structure • Assemble the appropriate personnel • Schedule effective meetings • Establish key info links between colleagues
2. Understand operations when making decisions • Begin with the end in mind • Organize details • Beware the pitfalls of value engineering
3. Manage Change • Execute an integrated training program • Update corporate and organizational brand
4. Cultivate Readiness • Plan for patient move day • Activate and integrate technology systems • Test doors and card readers

Imagine having over a dozen US News and World Report-ranked hospitals within a 50-mile radius of your hospital. How does a community hospital with aging infrastructure compete with world-class Academic Medical Centers and specialty hospitals only an hour’s drive away? We all know that improving payer mix, attracting new patients and recruiting best-in-class clinical talent is much easier if you have state-of-the-art facilities. But how do you accomplish this in a depressed economy with scarce capital dollars?

LEARNING OBJECTIVES:
1. Discover facility improvement strategies for becoming the provider of choice in a highly competitive market.
2. Understand the process required to obtain HUD-insured financing for facility projects.
3. Identify how including a retail approach in your hospital can drive revenue growth.
4. Explore how patient-focused design contributes to an enhanced patient experience and improved HCAPHS scores.

Dutch hospitals are drastically changing the work environments, and thus the nature of work, for medical staff. Individual offices are sacrificed and changed into knowledge centers in order to optimize work flow, optimize use of space, better accommodate patients, and to create work environments within buildings that have infrastructures and structures that fully support change. Where does this leave staff? Do they embrace the new work environments? What are the critical success criteria for implementing shared office spaces in hospitals? How to avoid design solutions that are neither individual offices nor innovative knowledge centers? This session will share how several examples of the newest Dutch hospitals did away with individual offices and got away with it!

LEARNING OBJECTIVES:

1. Learn how one of the Dutch newest hospitals did away with individual offices and got away with it!
2. Learn about the critical success criteria for implementing shared office spaces in hospitals.
3. Understand the challenges when implementing a new work environment and a new way of working.
4. Learn about the benefits and pitfalls of shared office spaces in hospitals.

Mazzetti is working on various projects in the developing world. Our work in Haiti, for instance, blends the best in international thinking in healthcare with the Haitian reality. As such, the solutions we are developing are radically different from those in the US. Moreover, the developing world is not so constrained with overly detailed and all-embracing and slow to evolve regulation, allowing much more creative solution development. And, the lessons we are learning there are helping us to figure out how we can do better buildings in the US, using a process similar to Reverse Innovation. This session will explore some of the projects we are working on in the developing world, and some of the ideas that they are inspiring.

LEARNING OBJECTIVES:

1. Learn about the innovative financing method to improve energy infrastructure in the developing world.
2. Get acquainted with the lessons learned in improving healthcare in the developing world.
3. Learn what principles were put to practice in the remote village in Haiti.
4. Learn about the various co-benefits that will be published by the World Health Organization.

Few institutions have the opportunity to invent a hospital environment exclusively dedicated to children of all ages and their families. Beyond the mere introduction of “kid-friendly” decorative elements in their facilities, over the past decade children’s hospitals have started to utilize comprehensive design strategies in the design of new or renovated facilities. We call these “Integrating Theming.” The process to develop and implement this approach is fundamentally different than the conventional design process, as it affects basic programming, design and management decisions throughout the process. Starting with an overview of recent trends and approaches to Theming in children’s hospitals, presenters will offer different perspectives on the application of Integrated Theming through a case study of a major new children’s hospital in Pennsylvania.

LEARNING OBJECTIVES:

1. Discuss operational and staffing implications of an integrated Theming program
2. Analyze the process and people involved in the theme development and implementation and how it is being received by the users
3. Learn the elements and steps involved in the implementation of a Theming program
4. Situate the issue of Theming within the larger context of children's health care, nationally and internationally

In 2000 planning for a new Hospital in Hagerstown , MD started. After a variety of delays & challenges, it finally opened in December 2010. During that long gestation period electronic medical records were piloted and integration across the health system was deepened. Key decision makers retired. Five new businesses now required space within the hospital. After being open for 2 ½ years none of the directors or managers who participated during the visioning of the project remain in the hospital. The clinical construction coordinator moved onto process improvement. We visited the hospital to see how the systems that were designed fared. What changed and why? What worked and why? How well did the facility respond to the changes in process & systems? What criteria did process improvement apply? Working with the process improvement teams and interviews with managers of key departments we explore how to create a more responsive and flexible building.

LEARNING OBJECTIVES:

1. Assess the planning elements which helped lead to flexibility.
2. Interpret how to apply process improvement methodology when occupying new facilities.
3. Understand the value of a clinical construction coordinator in smoothing the transition into a new building.
4. Recognize the affect macro planning and micro planning had on the productive use of a new facility.

Need new emergency exam space while not closing your existing ED or being able to construct the project in a new location? You can “go internal.” That was the strategy for UPMC Mercy Hospital in Pittsburgh, PA. As a Level 1 Trauma center, decreasing the number of patient care examination rooms was never an option for construction phasing. Therefore the design had to allow for the addition of rooms in an area that would create a more positive than negative bed count through each phase. The resulting 37 bay ED and 10 bed observation unit was designed to facilitate the sharing of knowledge between basic diagnostic and clinical care, improve disease diagnosis and treatment, and to attract leading physicians and nursing staff. The total design plan required a 6 phase construction sequence allowing for a net gain of 4 additional rooms per phase (on average).The facility added more than 23 clinical examination rooms and associated support areas to their existing 14 bay ED.

LEARNING OBJECTIVES:

1. Learn techniques hospital facilities, MEP, and architects can employ to manage life safety and infection control needs in complex multi-phase projects
2. Discuss strategies for phasing and selecting the optimal number of phases to maximize space for operations
3. Identify the phasing “tipping point” to balance operational needs with construction costs and duration
4. Discover ways to integrate phasing into the early parts of the design process

Compliance is the ever-present foundation guiding hospital operations and helping maintain the environment of care. All-inclusive, it includes testing, evaluation and maintenance of critical equipment, building systems and life-safety programs. Compliance—and non-compliance—has great, far-reaching implications on quality of care, patient safety and satisfaction and a hospital’s long-term success. Developing and maintaining a rigorous protocol/practice can’t be overlooked, especially given the serious health, financial and branding consequences associated with non-compliance. An effective compliance program is the blueprint to create/sustain a safe environment, minimize hospital risk profiles, and ensure an optimal patient experience. This session will show effective compliance and facility maintenance operations go hand-in-hand, and demonstrate that an effective compliance program can ensure that their programs meet the requirements of the accredited bodies and regulatory agencies.

LEARNING OBJECTIVES:

1. Understand what a superior compliance program looks like and the best practice approaches that demonstrate the effectiveness of a proactive program
2. Create triggers and dashboard mechanisms to be alerted to weaknesses and deficiencies in a comprehensive compliance program
3. Identify the operational and philosophical pitfalls in the development, execution and maintenance of an all-encompassing compliance program
4. Demonstrate how KPIs and other standardized evaluation tactics can be used to modify existing compliance programs

Our world is enriched with new knowledge about the brain. This knowledge and the tools that cultivate our understanding of the brain can be applied to healthcare design to generate insights into effective environments for clinical and research uses. This session assimilates the dual perspectives of a neuroscientist and an architect in a novel approach to understanding and experiencing healthcare architecture. Using brain structure and function as a metaphor for buildings and their use will serve as a breeding ground for novel ideas in design.

In particular, the following will be examined:

- New knowledge about brain function in health and disease 
- A neuroscientist's observations of parallels between brains and buildings
- An architect's observations of scientific processes as design tools
- Ways to apply our understanding of the brain in order to reshape our healthcare facilities

LEARNING OBJECTIVES:

1. Observe how neuroscience is changing healthcare and clinical research.
2. Evaluate how scientific tools can be applied to facility design
3. Explore creative synergies between the art and science of design
4. Experience a new vision of health facility design through a neuroscience lens

After creating the Maria Fareri Children's Hospital, in Westchester, NY, the major donor and father of Maria joined forces with the Project Executive to create another very unique facility on the grounds of the hospital, dedicated to keeping children healthy. This "one of a kind experience" focuses on the top ten reasons that create illness or death in children and then tries to influence their behavior through powerful exhibits to improve their health. The design team is in the process of being selected through a unique design competition that will be complete by the time of the presentation. The project will also be part of a Medical Science Village that will include an ambulatory surgery / cancer center, 350 units of resident and fellow housing, a 100,000 sq. ft of retail, a hotel, medical school offices and research and development space.

LEARNING OBJECTIVES:

1. Learn how a parent, not only created a hospital in her name but went on to create a new facility dedicated to keeping kids out of the hospital.
2. Learn how a unique competition was used to select a "museum designer" to bring the project to life.
3. Understand the importance of philanthropy to not only create the hospital but the Living Science Center.
4. Learn how both the hospital and Living Science Center are part of a new concept in healthcare real estate - "The Medical Science Village".

Adolescent behavior health and substance addiction treatment centers are evolving with a more holistic approach to treatment, emphasizing patients’ emotional, psychological and physical well-being. This session will look at two residential adolescent treatment centers that are re-imagining treatment methods by incorporating non-institutional, homelike features that offer patients a stronger sense of dignity and personal accountability. The Adolescent Treatment Center of Winnebago and Hazelden Center for Youth and Families both suggest a retreat rather than an “institutional” healthcare center. Each blends seamlessly into its surroundings, and each offers a range of amenities that promote individual, communal and family-focused activities and treatments. We will detail how each healthcare organization identified growing market needs to develop facilities that uniquely serve their patient base with individualized approaches to substance abuse treatment.

LEARNING OBJECTIVES:

1. Learn how architecture is supporting clinical innovations in adolescent behavior health and substance addiction treatment.
2. Learn how facility design can remove the “stigma” attached to teen addiction by creating facilities that support shared accountability and safety.
3. Compare programs to understand how different healthcare providers are implementing holistic approaches to adolescent substance addiction treatment.
4. Examine post-occupancy data to trace operational success of these new-model, patient-focused treatment centers.

Healthcare reform will eventually require all health systems to improve the quality and efficiency of patient care, while reducing costs. Health systems across the country are anticipating these demands by planning off-campus outpatient centers that integrate services into a single, high quality, efficiently designed facility located close to where people live. This new product type—“Big Box” centers in retail quality locations—is expected to play a crucial role in helping systems expand and maintain their patient base. NexCore Group recently collaborated with United Health Services, the largest provider of healthcare-related services in New York’s Southern Tier, to develop an 85,500 SF integrated outpatient center in an underserved market. Since opening in Sep. 2012, the facility's volumes have exceeded projections. The project team will discuss lessons learned during the planning, programming and construction of the UHS facility, as well as challenges, innovations and outcomes.

LEARNING OBJECTIVES:

1. Assemble a collaborative project team with expert skills in planning, programming and design to deliver a successful integrated outpatient facility.
2. Implement best practices related to physician practice patterns and patient flow to eliminate excess space, reduce costs and enhance delivery of care.
3. Improve branding to effectively convey the health system’s commitment to improving access to healthcare delivery in the community.
4. Transform underutilized or brownfield sites into premier healthcare destinations.

Long before most people had ever heard of “physician integration” or “accountable care organizations,” university-affiliated teaching hospitals and medical centers recognized a process to support collaboration of medicine, research and education, as well as across specialties, with the ultimate goal to provide consistent, coordinated, positive patient outcomes. Using detailed case studies involving Loyola, Northwestern and Vanderbilt, this session will explore the strategies and techniques these academic medical centers used to successfully design for collaborative care. We will examine Loyola’s groundbreaking Burr Ridge Outpatient Center, Northwestern’s Comprehensive Center on Obesity (NCCO) and Vanderbilt’s new Critical Care Tower. Most importantly, we will explain how the design best practices of these successful projects can be applied to the need for greater collaboration and integration in other health providers’ projects.

LEARNING OBJECTIVES:

1. Learn the fundamental characteristics of design that supports collaborative care.
2. Find out how academic medical centers have been ahead of their time in terms of designing for collaborative care. 3. Examine three detailed case studies involving successful design for collaborative care by Loyola, Northwestern and Vanderbilt universities.
4. Come away with practical, actionable design ideas that can help you to enhance collaborative care in your next healthcare project.

On May 22, 2011, a deadly tornado struck Joplin, MO with Mercy Hospital Joplin directly in its path. Mercy pledged they would rebuild, committing to break ground on the new $449 million, 875,000 sf facility in January 2012 and open in early 2015. This session illustrates how the project team worked together to overcome challenges to meet this aggressive schedule. Mercy Hospital Joplin reflects the latest trends in the AEC industry like using co-location to overcome the distance barrier between team members and bringing design-assist MEP subcontractors on board early. As a result of a truly collaborative approach, the team was able to get from initial design to breaking ground in just five months. The presenters include key members of the owner, designer, engineer, contractor, and mechanical and electrical subcontractors.The new hospital is scheduled to open 45 months after the tornado hit Joplin; pushing the traditional limits of hospital PD&C in response to the community’s need.

LEARNING OBJECTIVES:

1. Recognize the elements and conditions of the cohesive relationship among the team members that lead to a successful project.
2. Identify the lean construction techniques that were used to deliver the project on time and on budget.
3. Investigate how alternate delivery methods including design-assist and co-location can be successful.
4. Discuss the importance of disaster planning and how the new facility has been designed to withstand future storms.

In 1999 Catholic Health System in Buffalo, NY merged two hospitals due to close proximity, declining inpatient volume and overall declining population. The community was promised that Catholic Health would find a suitable reuse for the Our Lady of Victory (OLV) Hospital campus, -the result, the OLV Senior Neighborhood. Over the course of more than a decade of focused effort, the following mixed-use solution was built & operationalized: Senior Housing (74 apartments),Skilled Nursing (84 residents within 4 households containing 21 private bedrooms each), Program of All-inclusive Care for the Elderly (PACE), “Main Street” Concourse (Chapel, Community Rooms, History Museum, Food-court, Blood Lab Patient Service Center, Outdoor Terrace), Tier III Co-location data center, health system emergency and archive storage centers. This session will focus upon detailed communication of each major project component developed, especially the newest and final venture, -a state-of-the-art Tier III+ colocation data center!

LEARNING OBJECTIVES:

1. Understanding how to harness the potential that exists within the infrastructure of a closed hospital
2. How to implement an adaptive re-use solution that sustains itself with ordinary and creative new (Tier III+ co-location data center) revenue sources.
3. How to ‘frame a project’ to maximize public exposure, funding and on-going operational revenues
4. Measuring the impact of dedicated focus, doing the right thing to serve elders in need and learning from mistakes

Healthcare in the United States is currently undergoing the most extreme transformational paradigm shift in over a century. As a technical builder of some of the nation’s most advanced healthcare facilities, DPR Construction conducted a research initiative to better understand the long-term trends that its healthcare customers will have to manage in the coming decade and asked owners, designers and management consultants. 42 healthcare leaders shared their insights into what the future holds for the healthcare industry and for their own systems. It should be no surprise that everyone agrees that uncertainty is one of the biggest challenges facing the healthcare industry today. While the healthcare industry is constantly tasked with change and doing more for less, there is an underlying optimism in the new focus on wellness, integration and community embeddedness. This session will focus on what was learned and where the industry is heading.

LEARNING OBJECTIVES:

1. Gain a better understanding of where the healthcare industry is heading over the next 10 years. What outside forces will affect the industry?
2. Gain an understanding on how healthcare will be delivered in the next 10 years.
3. Gain an understanding of future delivery methods that will affect the design and construction industry.
4. How will healthcare design and construction be different in the next 10 years and what might the physical market look like?

Northwestern Memorial Hospital was challenged to update its 10-year old bed tower to reflect new patient care models, to replace existing finishes with a standardized finish selection, and to better align interiors to meet brand and capital expenditure requirements over a 20-year improvement cycle. Three million square feet were evaluated based on standards established by contributors across patient, clinical, facilities and staff. This evaluation allowed the team to create a master-plan for refurbishment. Implementing the plan allowed the team to prioritize across multiple competing projects and select those that had the most impact to patient satisfaction, as well as aligned with business requirements involved in running the top rated hospital in the Chicago metropolitan area. Post construction, patient satisfaction improvement, as measured by Press Ganney surveys, increased by almost 30 percent.

LEARNING OBJECTIVES:

1. How to prioritize multiple “do now” projects, to maximize budget, patient satisfaction and clinician requirements.
2. When to use standards versus Guidelines to create continuity among projects and streamline budgeting and the design process.
3. How to budget for multiple phased projects with varying scopes and time constraints.
4. Demonstrate how renovations moved themetrics in patient satisfaction scores.

It’s anything but “business as usual” in an OR environment where surgeons, cardiologists, nurses, and radiologists work side-by-side and all staff members practice the same perioperative standards of care for all procedural patients. As technology advances to improve minimally invasive approaches to care, Providence Regional Medical Center's state-of-the-art new facility (with two floors of twenty-four operating and imaging rooms that function as one perioperative environment), and changes to operational practices have decreased the need for duplication and raised care to the highest standard. The project is the culmination of four years of research, planning, testing, educating and collaborating with a team of more than forty healthcare professionals, medical planners, architects and vendors. Perspectives from the hospital and medical planner will reveal best practices for integrating new technology, and improving efficiency in a facility that is six times larger and more complex.

LEARNING OBJECTIVES:

1. Identify tools the design team can provide to assist organizations in decision-making around planning and designing an integrated surgical platform.
2. Explore strategies to successfully integrate (surgical and imaging) services and apply lessons learned in your organization.
3. Describe the impacts of imaging technology to improve efficiency within a hybrid OR that successfully navigates impacts to staff and their roles.
4. Create a plan that specifically addresses the anticipated benefits for integrating these services.

Project risk, real or implied, plays a significant role in the pricing of a project. The IPD delivery process promises higher value at a lower cost in significantly less time yet many people believe that this is the result of the Owner accepting more risk. We will explore the topic of risk and how it is viewed from an Owner's, a Contractors and a Lawyers perspective for both conventionally delivered and IPD projects.

LEARNING OBJECTIVES:

1. Understand how project risk is viewed by the Owner, the Contractor and the Lawyer in the different project delivery types.
2. Understand ways that project risk is transferred or mitigated in each of the delivery methods.
3. Recognize how risk and responsibility are interconnected.
4. Discover if IPD project are more of a risk for Owner's than conventionally delivered projects.

The Baystate Medical Center Hospital of the Future has been open for 18 months. Baystate Medical Center has recently completed a formal Post Occupancy Evaluation. Lesson learned from the Post Occupancy Evaluation and 18 months of occupancy are being applied to the next phase of the project - a 96-bed new build out. This session will review the process, post occupancy evaluation results, and detail how the lessons learned impacted the next phase of the project.

LEARNING OBJECTIVES:

1. How to integrate hospital staff into a post occupancy evaluation process and planning process for phased project development.
2. Understand architectural and engineering considerations when planning facilities for phased development.
3. Explore advantages of phase implementation of MEP infrastructure development.
4. Identify key steps in designing a healthcare facility that will meet the demands of the future, from master planning through phased implementation.

The Accountable Care Organization (ACO), with its flat per-life-covered payment, demands efficiency. The primary hospital will serve as the mother ship, interconnecting clinics, physicians, offices, tertiary facilities and their patients. This model impacts the clinician’s workflow, the patient experience, technologies and interoperability required and ultimately, the built environment.

LEARNING OBJECTIVES:

1. Provide overview of the ACO model
2. Explore the change in patient and caregiver interaction
3. Identify technologies needed to provide care in the ACO framework
4. Assess potential design impact of the technology supporting ACOs

What happened to New York City, Monday, October 29, 2012, is commonly referred to as Hurricane Sandy.  Nicknamed ‘the storm of the century’ Sandy forever advanced the way New York Presbyterian (NYP) supports NYC. As many hospitals in lower Manhattan were unable to sustain patient care and facility operations, and as evacuations ensued and power failure extended through lower Manhattan, the response evidenced a culture resolved to meet the needs of patients against all odds, and many lessons were learned. These lessons were collected and analyzed to create a Hazard Vulnerability Mitigation Plan (HVMP) to enhance disaster recovery capability and minimize impacts. The concept was to go beyond a Joint Commission-mandated recovery plan to examine what steps might prevent effects of disasters, from scenarios that include 20 potential technological events and 10 natural disasters. The initiative balanced the logistics and cost of various strategies against the anticipated frequency and potential impact of disasters to ensure that the plan is effective, feasible, and within budget constraints. Panelists from hospital operations, engineering, and capital planning teams will relay the story of what happened, how the hospital responded, and how to develop a mitigation plan for any healthcare facility.

LEARNING OBJECTIVES:

1. What happened to the City and NYP
2. How did we respond and come to the aid of the City
3. How the City came to our aid
4. Impact to future planning
5. Creating a Hazard Vulnerability Mitigation Plan -

• Discover the process and steps involved in developing and implementing a comprehensive hazard vulnerability mitigation program.
• Review survey questions designed to prioritize technological and natural disaster threats and critical functions that must remain operational.
• Learn how to conduct cost/benefit analyses that accounts for feasibility and effects on hospital operations.
• Discuss examples of disaster prevention and mitigation strategies considered and why they were or were not implemented

With traditional delivery methods, designers and contractors often focus on their areas of expertise, with less consideration for the impact on the entire project. Integrated Project Delivery breaks down traditional silos, connecting each team member to the entire building process. The resulting perspective creates better collaboration, information sharing and decision making – motivated by the sharing of risks and rewards. McCarthy, H+L Architecture, and their JV partners completed Children’s Hospital CO in 2007. The same team was asked to renovate and expand the hospital under a tri-party IPD contract. This presentation will examine IPD and the results achieved and compare these results to the traditional contracting method used to construct the original hospital only a few years earlier with the same team.

LEARNING OBJECTIVES:

1. Recognize the elements and conditions of the cohesive relationship among the team members that lead to a successful project.
2. Identify the lean construction techniques that were used to deliver the project on time and on budget.
3. Investigate how alternate subcontracting methods (design-assist) can be successful.
4. Identify the nuances of the Tri-Party contract, review items that can be challenging, and clarify through contract language that is agreeable to all.

In this presentation, the cohesive team of both owner and designer will share the value of performing an unbiased, comprehensive facility environmental assessment and then using that tool as a guideline for planning and prioritizing capital projects. We will also explain some of the tools developed to create a data driven look at real estate condition by interweaving patient satisfaction metrics and utilization to help guide decisions. We will share proven tools and techniques that will help you discover potential areas of improvement and unbiased ranking systems to prioritize future facility upgrades, and then explain the roll out of this tool into a facility master plan. We will explain benefits of in-house and external resourcing and share case studies from both perspectives. Participants will leave this session with new strategies to implement a cohesive, patient focused environment in a planning, prioritized and financially manageable manner.

LEARNING OBJECTIVES:

1. Describe the tools and rating techniques derived from the assessment process
2. Identify the benefits of in house and external resourcing
3. Learn how to apply the results to create a workable implementation plan
4. Explore case study examples of both approaches

Next year, 2014 will be the tipping point in the transformation of American Healthcare. The most significant components of the Patient Protection and ACA will be initiated over the next 12 months. This presentation will preview the year on a month by month healthcare calendar, with milestone dates and strategic implications. As the insurance exchanges open their doors and all states expand their Medicaid programs, a new set of rules drive success. Providers must embrace new business models and a team-centric continuum of care to manage the health of their population. The real drivers of rising healthcare costs are exposed with a new round of revelations, from congressional corridors to corporate board rooms. Sauvé frames the future of healthcare with uncanny accuracy and unsettling insight. Updated insights from the top 15 causes of death shed light on the American lifestyle and the challenges ahead. New rules frame the hard realities, board mandates, and management mindsets required.

LEARNING OBJECTIVES:
1. Gain insight into the historical significance of 2014; as a tipping point in the ACA and a transformational period in American healthcare.
2. Explore the mega trends and strategic implications for orthopedics, emergency, obstetrics, and observation services under the new rules of healthcare.
3. Dateline the major 2014 Patient Protection & Affordable Care Act initiatives and management implications on a month by month calendar rollout review.
4. Identify the hard realities, board mandates, and management mindsets required to realign the business of healthcare; as well as, the biggest mistake.

The healthcare design field has seen a decided shift in the last several years as LEED® certification has become a standard for many healthcare organizations. Concurrently, the ongoing global recession has put an even greater emphasis on cost control and reducing what may be perceived as “unnecessary” capital costs. With this potentially conflicting market dynamic, questions remain concerning the capital cost for hospitals to achieve LEED certification. Despite an increasing number of completed projects, no consolidated survey of market data has focused on these issues since 2008. The authors of that original study will answer these pertinent questions with a recently completed update representing 15 LEED-certified hospitals completed between 2010 and 2012. It expands the 2008 research to understand how capital cost premiums have evolved, reasons that hospitals’ decisions to pursue LEED, and what future trends and expectations are on the horizon for the industry.

LEARNING OBJECTIVES:

1. Understand the current state of capital cost green premiums of LEED certified hospitals based on empirical research from recently completed projects.
2. Identify the design and construction factors that influence the capital cost green premium for a hospital, and how it's perceived by the design team.
3. Explore the drivers that influence hospitals to pursue LEED certification, and the benefits they anticipate realizing in the completed facility.
4. Understand the changes in the market sector since 2008, and learn what trends leading healthcare firms see in future LEED hospital construction.

The Princess Margaret Cancer Centre, Canada's largest comprehensive cancer research centre, has an ongoing capital equipment replacement and upgrade program. For the past decade, significant capital dollars have been invested in leading-edge medical imaging, radiation therapy treatment planning and delivery equipment and associated infrastructure. Innovative solutions to overcome the challenges of introducing new technologies into existing buildings and allow the integration of these technologies while meeting radiation safety, MRI Safety, and other regulations will be discussed. Several examples of complex projects that combine multi-modality first-of-its-kind cancer diagnosis and treatment equipment will be presented. These case studies will demonstrate the challenges of creating highly technical cancer treatment spaces that are patient-centred and meet latest design standards, while providing safe and efficient working spaces. This session will discuss lessons learned from these projects.

LEARNING OBJECTIVES:

1. Understand complexities of managing capital equipment projects in a large publicly-funded Canadian cancer centre, while maintaining full operations
2. Learn the technical challenges of integration of first-of-their-kind multi-modality technologies into existing buildings and identify novel solutions
3. Explore a spectrum of materials, equipment and finishes that meet and exceed latest standards.
4. Explore lessons learned on designing and building highly technical treatment areas that enhance the patient experience and improve staff satisfaction

Since the invention of electric lighting, architects and designers have pondered the role of light for building interiors, day and night. But until the 1940’s, the limits of electric lighting continued to demand daylight as the principal source of illumination by day, with the less powerful incandescent light sources allowing activity in the evening and night hours at far lower light levels. Then, the nearly concurrent inventions of air conditioning and fluorescent lighting made large windowless buildings possible. No longer confined by the night, interior space could be illuminated to resemble daylight at any time. The result is a society that works 24 hours a day, with the unfortunate side effects of sleep disorders, Vitamin D deficiency and other struggles to maintain the pace. Interior architecture and design have responded strongly to the practical challenge with decades of inventive and often artful solutions integrating electric lighting into interior spaces, making ever more massive structures possible. But over time, the growing problems of energy cost and global warming have conspired to drive interior lighting to levels well below the threshold of biological darkness. With people spending over 90% of their lives enclosed in buildings, Nature’s circadian systems struggle to find correct zeitgebers, the signals needed by all living beings to properly manage the systems and routines of biological life. Oddly, we have learned to provide indoor plants with a certain amount and type of light every day, but we have fail to do the same with people. It is time to add the benefits of light to the mere appearance and utility of light. Generative space is a new movement in architecture in which the design seeks to: “…encourage, support, and reinforce increasing (human) performance effectiveness in health, healthcare, and/or quality of life.” All aspects of human performance require proper doses of light and of darkness. Regardless of the artfulness of lighting “design” in interior architecture, it only stands to reason that without proper doses of light and dark, any design will ultimately fail to achieve its generative goals. Moreover, light is one zeitgeber and others, including temperature and food intake, must be conducted in harmony and must be carried on by occupants even when they leave the generative space. This two-part presentation will address the role of light and lighting in generative space through the designing of daylighting and electric lighting.

Learning Outcomes:

1. How to define and design human light needs and doses.
2. How to distinguish and design for nature’s and human’s cycles.
3. How to use generative Lighting design to inform decisions for daylighting design, electric lighting design, and designing controls and scheduling.
4. How to access relevant references and resources for generative lighting design.

Since the invention of electric lighting, architects and designers have pondered the role of light for building interiors, day and night. But until the 1940’s, the limits of electric lighting continued to demand daylight as the principal source of illumination by day, with the less powerful incandescent light sources allowing activity in the evening and night hours at far lower light levels. Then, the nearly concurrent inventions of air conditioning and fluorescent lighting made large windowless buildings possible. No longer confined by the night, interior space could be illuminated to resemble daylight at any time. The result is a society that works 24 hours a day, with the unfortunate side effects of sleep disorders, Vitamin D deficiency and other struggles to maintain the pace. Interior architecture and design have responded strongly to the practical challenge with decades of inventive and often artful solutions integrating electric lighting into interior spaces, making ever more massive structures possible. But over time, the growing problems of energy cost and global warming have conspired to drive interior lighting to levels well below the threshold of biological darkness. With people spending over 90% of their lives enclosed in buildings, Nature’s circadian systems struggle to find correct zeitgebers, the signals needed by all living beings to properly manage the systems and routines of biological life. Oddly, we have learned to provide indoor plants with a certain amount and type of light every day, but we have fail to do the same with people. It is time to add the benefits of light to the mere appearance and utility of light. Generative space is a new movement in architecture in which the design seeks to: “…encourage, support, and reinforce increasing (human) performance effectiveness in health, healthcare, and/or quality of life.” All aspects of human performance require proper doses of light and of darkness. Regardless of the artfulness of lighting “design” in interior architecture, it only stands to reason that without proper doses of light and dark, any design will ultimately fail to achieve its generative goals. Moreover, light is one zeitgeber and others, including temperature and food intake, must be conducted in harmony and must be carried on by occupants even when they leave the generative space. This two-part presentation will address the role of light and lighting in generative space through the designing of daylighting and electric lighting.

Learning Outcomes:

1. How to define and design human light needs and doses.
2. How to distinguish and design for nature’s and human’s cycles.
3. How to use generative Lighting design to inform decisions for daylighting design, electric lighting design, and designing controls and scheduling.
4. How to access relevant references and resources for generative lighting design.

Generative space is the new design frontier for improving individual lives, organizational performance, and overall community wellbeing. This discussion – facilitated by Heather Fennimore, a leading generative space practitioner – will introduce several other practitioners who will be presenting their detailed work in the Generative Space Track. Attendees will have the opportunity to critically question, challenge, and engage these presenters as a means to develop a generative space overview.

LEARNING OBJECTIVES:

1. Why generative space is the new design frontier.
2. How improvements can be made with generative space.
3. How to measure generative space improvements.
4. How both systemic and sustainable improvements are made with generative space.

This presentation provides the opportunity for attendees to see themselves in a new light, and to ‘try on’ a new form of leadership that can transform their organization – irrespective of their role. We will examine how leadership is the key component to cultivating generative space in the built environment, starting with ‘designing’ the social environment, which can only be designed by individuals, and – unless it is designed as generative – it, most likely, won’t be. It takes an individual to cultivate generative spaces with other individuals, before it is possible to have an impact on a building becoming generative; one cannot happen without the other. In this session, we will explore how Health Design Leadership is the first step along this continuous journey. A case study will be presented that highlights this personal and continuous journey, as well as the evidence that has been gathered on the transformative outcomes that have occurred as a result.

LEARNING OBJECTIVES:

1. Learn how to distinguish social and physical space, and how to integrate both together.
2. Learn the distinction between being a leader and an “organizer”, and the benefits being an “organizer” provides to those individuals you are trying to support.
3. Learn how identifying the simplest “gap” can be the first step in leadership transformation.
4. Learn how to maintain consistent leadership quality in the face of any challenge.

Growing concern over the potential hazards of increased computer usage and the adoption of electronic medical records (EMR) in healthcare settings has prompted a recent and increased emphasis on improving workplace design with advanced ergonomic concepts. According to the U.S. Bureau of Labor Statistics, nurses are 200% more likely to suffer from job-related injuries than construction workers or farmers. Conventional efforts to improve workplace user interface outcomes in healthcare settings have focused primarily on increased product-related adjustability. Recent research, however, suggests that adjustability alone may not be sufficient to affect postural improvements and reduce injury rates. This session engages the attendee to personally explore and experience emerging advanced ergonomic design concepts for healthcare settings. Documented case study examples of successful design installations, and their associated health impact, will also be presented and discussed.

LEARNING OJECTIVES:

1. Identify high-risk areas for musculoskeletal injury in healthcare settings.
2. Understand how workplace design can improve or decrease caregiver health.
3. Learn how to apply advanced ergonomic concepts to improve health.
4. Gain new knowledge of ergonomic health improvement strategies through hands-on personal experience of actual workplace products.

Meet the recipients of the 2013 ‘Generative Space Award’ (to be announced). See their submittals; learn from their presentations; engage with these leading pioneers in a discussion about how both systemic and sustainable improvements to health, healthcare, and wellbeing can be made through the design of the environment; and then plan your own strategy for submitting your pioneering projects to the 2014 ‘Generative Space Award’ in June 2014.

LEARNING OBJECTIVES:

1. Learn how ‘action research’ can be applied to healthcare design projects.
2. Learn how to make systemic and sustainable improvements with generative space.
3. Learn how generative space can improve lives, organizations, and communities.
4. Learn how to make an award-winning submittal to the ‘Generative Space Award’.

Hospitals are the only places where patients are relegated to performing all their activities of daily living in bed; and rarely by medical necessity or patient choice. Patients are designed into their beds by the paradigmatic assumptions made by architects, medical device designers, and hospital managers. Despite best-intentioned efforts to create mobility by all concerned stakeholders, these efforts are unsuccessful - resulting in minimal benefit, if any, for the patient. In this participatory workshop session, we will explore designing a more generative patient room with its conventional bed as a ‘murphy style bed’, apply lean concepts to eliminate waste, and articulate the conditions of a new future state that will become the vision for a new hospital planning and design reality.

LEARNING OBJECTIVES:

1. Understand the concept of mobility and its benefits in recovery and health.
2. Debunk the myths and traditions prevalent in hospital design and examine the true needs of the patient..
3. Apply generative space design and lean concepts to our re-imagining process
4. Create a mobility checklist for universal application to patient room design.

A follow up to the 2011 presentation at the Symposium, this session looks at the new ED which saw its first patients in the fall of 2012, and answers the question: ‘How is it really working?’ Sparked by the challenge to create an “environment that staff would want to come to on their day off”, the new ED at Nanaimo in Canada may be the first in the world to include nature imbued courtyards within actual patient treatment zones. The pre-design programming phase established design goals and objectives as well as sustainability strategies to achieve a LEED Gold solution around the four values of: Timely, Respectful, Quality of Care, and A Place People Would Want to Come to Work. The most important considerations informing the design were: improved patient flow, functionality, privacy/confidentiality, safety, and an abundance of natural daylight. Stantec Principal Bruce Raber is a participant in The Leading by Design research project. Guided by the Generative Space principles, the Stantec team and clinicians led by Suzanne Fox, Director for Emergency Services and Trauma Care, believed the new ED environment could be designed to systemically and sustainably improve health and healthcare. Together they worked to not only create innovative design concepts based on research, sustainability, and lessons learned from European hospitals, but demonstrated at every stage of design the cost-benefit of increased day lighting on overall productivity gain. This presentation will address the question of: ‘how has it actually turned out?’ and ‘what is the “evidence” really showing?’ ‘Is it, in fact, “A Place where People are Flourishing”?’

LEARNING OBJECTIVES:

1. Learn the steps from “community” engagement through to documented evidence that can improve health and performance for project participants.
2. See first-hand how an integrated design process incorporating, sustainability, research-informed design, and full clinical involvement can produce “a place to flourish”®.
3. Learn how to apply cost-benefit analyses to “sell” Generative Space, sustainability, and design excellence.
4. Discover whether the research and evidence that has been gathered over the first 12 months actually supports the goals established during the design process.

This presentation will describe how colors - on surfaces, in light, or combined in patterns - can be used to support improved user experiences in generative spaces. It will provide research-based guidance for designers, so that - as they are choosing color, they can use science-based knowledge to consider how hue, saturation, and brightness - as well as users' culture and personal factors - influence the effects of color on the wellbeing of the individual users. Since, in actual practice, surface colors are rarely experienced in isolation, the ramifications of color combinations and visual patterns will also be addressed.

LEARNING OBJECTIVES:

1. Understand how hue, saturation, and brightness can influence human wellbeing.
2. Learn how personal factors, such as age and mental health, can influence wellbeing-related implications of color selections on individuals.
3. Learn how to effectively access and use information on culture during the hue selection process to improve overall health-related outcomes.
4. Identify reliable sources of information on colored surfaces, colored lights, and patterns to scientifically inform color-related design decisions.