4 Critical Points to Streamline and Simplify Healthcare Building Renovation
This article was written by Coker Barton, Senior Vice President and National Healthcare Director, Hoar Construction, LLC.
In today's economy and with the evolving state of health services, healthcare facility renovations are on the rise. Increasing healthcare costs, the Affordable Care Act (in whatever form it ultimately takes), changing demographics, constricted capital, and other trends put pressure on existing facilities, encouraging owners to repurpose facilities while also maintaining standards of care.
A philosophy that accommodates both continuous improvement and constant change —while maintaining commitment to expected levels of excellence — is especially critical when undertaking a renovation project. Interestingly, when it comes to healthcare, renovations are far more challenging than new buildings. Construction in operational facilities impacts every employee, patient and guest. Communication, planning and technology are critical influencers across every step of the process, and each carries the burden of project success or failure.
Recently, Hoar Construction's most experienced healthcare superintendents sat down to look closely at several healthcare projects to identify elements that generate success. They developed a set of best practices in planning and executing healthcare renovations that include the following:
1. Focusing first on patient satisfaction;
2. Planning from the start for a successful conclusion;
3. Leveraging technology to enhance processes and outcomes; and
4. Implementing extensive infection control safeguards.
A review of each item offers a roadmap for improving bottom line performance in healthcare renovation.
Focus first on patient safety & satisfaction
Ensuring patient satisfaction begins in the planning process. Since patient satisfaction ratings are often tied to reimbursement, providing excellence in the patient experience is not only the right thing to do, it can also influence the healthcare facility's bottom line and reputation. If contractors don't pay attention to the items that impact the owner's potential reimbursement, they are costing the owner money.
Here are five items that help healthcare facility stakeholders and owners' representatives stay focused on patient satisfaction:
1. Build a well-qualified and reliable team. Only hire design and construction professionals with directly relevant experience: You are trusting them with the very lives of your facility users. Make sure to see the quality assurance plan from every general contractor or construction manager you consider hiring. It should be healthcare-specific, rather than a general program.
2. Ensure your construction team pre-qualifies all subcontractors and subconsultants. This process takes time, but helps to ensure you have team members who embody integrity and have the appropriate expertise to make your project run smoothly.
3. Engage with the project superintendent outside of formal meetings. Regularly walk the construction site with the project superintendent to review project status and explain what's being done and why, so you can assess the impact of construction decisions on facility operations. The ability to speak honestly and openly can have a huge impact on decisions that have far-reaching impacts on budget and schedule.
4. Encourage on-site mentorship. If your facilities management team can gain knowledge and expertise by working alongside your construction professionals, bring them into the mix. Let the seasoned professionals mentor them. Each renovation offers an education in itself. Mentoring offers on-the-job training that can change lives, build careers and increase the value of your facility staff.
5. Implement a broad-based stakeholder management program for patients and staff. Make sure your message is complete, consistent and creative. Think about your staff and how they are projecting the impact of construction to patients and guests. The more positive the staff experience, the more enthusiastically they’ll serve as ambassadors for the project to the public.
Plan from the a for a successful conclusion
Scheduling, sequencing, phasing, and coordinating moves — these all involve make-or-break activities that can influence project success. Below are some important ways to ensure these elements are managed effectively to help streamline construction.
1. Delegate appropriate responsibility. An owner's primary contact person should have the knowledge and authority to make decisions and approve expenses. The seemingly routine decision of who the client puts in charge is actually a very important consideration with abundant financial and schedule ramifications.
2. Time your construction phases in relation to historical census data. Then, the most disruptive work can be completed when it will impact the fewest people. This critical element is often overlooked, but can bring maximum return on investment.
3. Develop a robust scheduling and phasing strategy. Working together on such a plan allows all key team members to collaborate, brainstorm and clearly understand how critical each of their roles is for achieving on-time delivery.
4. Build safety and quality pre-planning into the project. Time invested in proper planning to ensure safety and quality is like money in the bank. The cost of upfront due diligence is always a sound investment.
5. Plan for the unexpected. Every project offers opportunities to upset even the best phasing and sequencing plans. Always be mindful of what existing conditions or Mother Nature might throw your way so you minimize schedule impacts when issues arise.
6. Establish smart processes for utility tie-ins and shutdowns. There is arguably no bigger problem in a healthcare environment than an unexpected utility shutdown. Therefore, make sure your contractor has identified every potential scenario before construction begins.
Leveraging technology to enhance processes and outcomes
Technology continues to advance the state of construction and design. The following items offer you a glimpse of some of the best-practice uses of technology, based on application of these systems in real-world settings.
1. Use a BIM-neutral platform. This platform should allow multiple types of models to be published, synthesized, and augmented with cost and schedule information. This helps coordinate activity across the full design and construction team.
2. Incorporate laser scans. The laser scans should come with cloud point analysis, building information modeling and in-situ photography to create a comprehensive, digital, as-built record. This improves the project and also provides time-saving facility management data that will serve the building for decades to come.
3. Evaluate existing building systems and conditions to mitigate cost and schedule risks. The greatest threat to maintaining cost and time expectations in renovations comes from running into unknown conditions within the core of a building, such as items behind walls and in ceilings.
4. Integrate electronic barrier management systems with BIM. This maps building penetrations and provides complete bar code labeling and online documentation for all barriers, including their construction type and rating.
Implement extensive infection control safeguards
Patient experience and patient satisfaction are huge issues, not only from a health and safety perspective but also from perceptions users form based on how construction activities are implemented, and how clearly contractors demonstrate health and safety as a driving concern.
1. Require that superintendents carry particle counters to monitor air quality throughout the construction site.
2. Make sure the contractor has healthcare-specific infection control policies and procedures that are well documented within their quality assurance program.
3. Only hire construction firms that employ a quality assurance director and staff who will regularly visit your construction site to verify the requirements of the program are met by all members of the team.
Healthcare organizations can benefit greatly from implementing the strategies outlined above. Your focus on patient satisfaction, planning, technology, and infection control can truly streamline and simplify building renovation processes.
Learn more about Hoar Construction.
Related Articles on Surgery Center Transactions & Valuation:
St. Louis Hospitals Continue to Protest Surgery Center With Overnight Stay
New Mexico's Gila Regional Medical Center Expands Surgery Center
Minnesota's Sanford Health Adds Hysterectomies as Outpatient Procedure
© Copyright ASC COMMUNICATIONS 2012. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.
- House Votes to Repeal the PPACA — for 37th Time
- 6 Statistics on Concierge and Direct Pay Physician Practices
- Best Practices: Documentation and Reporting for Post-Operative Pain Management Procedures in Anesthesia
- 5 Things to Know About Medical Office Visits in 2012
- Medical Facilities Corporation Reports Higher Revenue After Arkansas Surgical Hospital Acquisition