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Healthcare Facility Planning Tools and Guidelines Volume 1, Number 2 |
Spring 2008
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In This Issue
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Planning a Medical Procedure Unit: Breaking Down Department Boundaries Hospital Leaders Predict Growth in Telemedicine Customer Service Centers Are Gaining Momentum in the Healthcare Industry CT Scanner in 54 Square Feet? For Specialty Physicians it is Possible |
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Feature Print (PDF) |
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Planning a Medical Procedure Unit: Breaking Down Department Boundaries BACKGROUND Historically, same-day medical procedures at Midwest Medical Center (MMC) have been provided by a variety of different departments and scattered throughout the hospital with redundant patient reception/waiting, preparation, treatment, and recovery spaces. As demand for same-day medical procedures continued to grow, the hospital leadership was concerned that outpatient satisfaction was being compromised while operational costs were increasing dramatically. Department staff were inpatient-focused and reluctant to alter pre-established protocols and processes. They were also reluctant to consider any changes to their existing “turf.” After several failed attempts at operational redesign, the serendipitous retirement of several key managers allowed MMC leadership to recruit a new manager who shared their vision. A variety of same-day medical procedures would be consolidated in an area that would function as the equivalent of the same-day surgery center and include flexible space for:
It was decided to refer to the new same-day medical service as the “medical procedure unit” or “MPU” to facilitate outpatient wayfinding. A business plan was prepared and operational processes were established and new job descriptions were developed in conjunction with facility planning. PLANNING APPROACH A detailed analysis was initially undertaken to identify the current and projected workload volumes and corresponding treatment spaces required:
Analysis of Current Workload (2007)
Projected Workload (2012) and Treatment Bay Calculation
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3 major procedure rooms (scoping procedures) 1 minor treatment/exam room (flexible, multipurpose room) 4 prep/holding bays (adjacent to the procedure rooms) 8 prep/treatment/recovery bays (three walls with curtain closure) 2 private prep/treatment/recovery rooms 6 prep/treatment/observation recliner chair bays
CONCLUSION Creation of the new MPU would not have been possible without the vision and strong leadership of the executive team and their facility planning consultant. Previous attempts by the organization to get input from individual department staff resulted in recommendations to simply maintain the status quo. Once the unit is operational for a year, hospital leadership will determine if there are other outpatient services that could potentially be incorporated into the MPU. For example, outpatient cardiac cath patients are currently transferred from the first floor to a third floor nursing unit for their recovery and outpatient chemotherapy patients receive treatment in the adjacent physician office building. back to top Cynthia Hayward, AIA, ACHA, FAAHC Principal Hayward & Associates LLC |
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In the News |
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Hospital Leaders Predict Growth in Telemedicine OVERVIEW According to Futurescan 2008: Healthcare Trends and Implications 2008-2013, telemedicine (delivery of healthcare through the Internet) will be increasingly used to manage chronic and acute care conditions through continuous monitoring, real-time consultation, and delivery of pharmacologically-based treatments. The annual report from the Society for Healthcare Strategy and Market Development is written by an expert panel supported by data from a survey of over 1,400 healthcare leaders across the country. The report highlights eight important trends ranging from healthcare policy to physician employment and discusses their implications for hospital leaders and strategic planners. However, the section on technology titled “New Technologies Demand New Business Models” should be of particular interest to healthcare facility planners. SURVEY RESULTS REGARDING TECHNOLOGY Of the survey respondents, 89 percent predicted that telemedicine will be “very likely” or “somewhat likely” to be used in their communities by 2013. In addition, the Internet will reduce variations in clinical practice by allowing the rapid diffusion of best practices according to 77 percent of the respondents. Other technical innovations are expected by 2013, but by fewer respondents. For example, 54 percent predicted that remote surgery would allow advanced care to patients irrespective of where they live. Also, 59 percent predicted that gene-based treatments would replace many traditional treatments and 54 percent predicted that nanotechnology would be used to cure disease or disability. WHAT THE EXPERTS SAY According to authors Jason Hwang, M.D., and Clayton Christensen, D.B.A., medical technology offers a seemingly endless stream of technological enablers that ought to make healthcare delivery simpler, faster, cheaper, convenient, and accessible. However, the fact that healthcare often seems to be moving in the opposite direction indicates a lack of innovative business models that incorporate the advantages of these new technologies. They cite examples of how hospitals have been intimately involved with the development of new delivery models over the years to separate standardized, rules-based care from the rest of the hospital. Examples include the creation of outpatient clinics to manage patients with chronic conditions and separation of nonurgent patients from trauma patients in the emergency room. Ironically, hospitals now find themselves lobbying against some of the newest models of healthcare delivery such as retail health clinics and specialty hospitals. These new competitors are often accused of cherry-picking only the healthiest patients even though they are using innovative business models designed to improve quality and increase profitability. The experts suggest that hospitals view business model innovation as an opportunity rather than a threat, work to fix reimbursement so that prices accurately reflect value, and create autonomous business units with their own resources, processes, and profit formulas such as seeking out-of-pocket payments or by supporting physician-provided care with nurses and physician assistants. back to top |
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Trendline Print (PDF) |
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Customer Service Centers Are Gaining Momentum in the Healthcare Industry BACKGROUND In the traditional healthcare facility, multiple departments and staff are involved in customer intake and “processing” activities, including reception, admitting and registration, coordination of multiple appointments, cashiering, insurance verification, and physician referrals. This typically results in fragmented customer service and complicated wayfinding. Although many of these departments are located on the first floor of the facility, only a few staff in each department actually have face-to-face interaction with visitors, patients, and their families. The question is: How can a healthcare organization better utilize both its staff and space to potentially enhance operational efficiency and improve customer service? CURRENT TREND With the continuing focus on patient-centered care and emergence of multihospital systems, information technology, and reengineering techniques, the trend is to consolidate customer intake, processing, and support services into a single operational unit. Such units are often referred to as a customer service center, patient service center, or similar designation. The term “customer” can refer to visitors, family members, employers, payers, physicians, staff, and vendors, in addition to the “patient” who is scheduled for an interview, examination, procedure, or admission. The customer service center serves as the primary patient and visitor intake, processing, and communication area for a healthare facility or campus and also includes centralized patient/visitor amenities. The customer service center should be located directly inside the primary entrance to the healthcare complex to serve as the initial access point for visitors and most scheduled patients. This area can also function as a “home base” for family members and visitors who are spending increased time at the facility as more treatments and procedures are performed on a same-day basis. KEY COMPONENTS Functional components of the customer service center typically include:
In this model, all staff work together as a team to provide quality care in an expedient manner. The staff are often cross-trained and report organizationally to a single manager, rather than to multiple department managers. Patient satisfaction generally improves as wayfinding is simplified, patient throughput is expedited, waiting times decrease, and continuity of care improves, thus reducing operational costs. Less space is needed on the first floor (i.e., prime real estate) and staff not directly involved in face-to-face customer contact are relocated. Patient processing and support services are being affected by numerous initiatives. The emergence of multihospital systems and advances in information technology are influencing the demand for, and configuration of, these services. At the same time, institutionwide reengineering is challenging traditional, inefficient organizational structures and operational systems. CONCLUSION The healthcare industry is beginning to look to the hospitality industry for solutions to ongoing customer service problems resulting from archaic organizational structures and inadequate information systems. For example, when a customer visits a hotel, he/she is met by a central reception desk and comfortable lobby immediately upon entry. At this central reception desk, the customer can receive, or be networked with, any needed services including registration, paying his/her bill, receiving/sending faxes, getting directions, making a special request regarding housekeeping services, arranging transportation, or scheduling a massage. Yet the healthcare industry requires that its customers visit multiple locations and interact with multiple staff and fragmented systems ― assuming that they first determine the appropriate access point for their needed service. The customer service center concept replicates the main reception desk or “hub” found in an upscale hotel and connects its customers to various other services or “spokes” that may be remote. back to top Cynthia Hayward, AIA, ACHA, FAAHC Principal Hayward & Associates LLC chayward@hayward-assoc.com |
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Technology |
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CT Scanner in 54 Square Feet? For Specialty Physicians it is Possible OVERVIEW
ABOUT XORAN TECHNOLOGY'S MiniCAT The Xoran Technology’s MiniCAT™ is specially designed for head and neck imaging allowing physicians to diagnose and treat their patients faster and more conveniently. It creates high-resolution, ultra-thin CT slices (0.3 mm for temporal bones), making it ideal for scanning the sinuses, skull base, and temporal bones. The availability of a limited footprint, In-office, upright CT scanner enables point-of-care imaging without the problems associated with scheduling CT scans at the hospital’s central imaging department. A scan takes only 40 seconds to get an immediate, digitally versatile CT image on a Windows PC monitor. The actual dimensions of the unit are 46” x 49” x 72” tall. Although it can be installed in a room as small as 6’ x 9’, a room that is 80 to 100 NSF is recommended, or the equivalent of the size of a standard exam room. The MiniCAT scanner emits very low radiation so that it requires little or no shielding to comply with State regulations. The manufacturer can install it in a single day since its small footprint fits through a standard door frame and it weighs only 450 pounds. The MiniCAT is compatible with most image-guided surgery systems and can also be used for surgical planning and post-operative evaluations and care. back to top |
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Note: DGSF represents the "footprint" of a department or functional area and includes the net square feet of the individual rooms as well as the space occupied by internal circulation corridors, walls/partition, and minor utility shafts; DGSF excludes common areas such as shared public corridors and lobbies, elevator banks, stairwells, major mechanical spaces, and the space occupied by the building's exterior wall. Source: SpaceMed Guide (Second Edition). |
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Copyright ©2008 SpaceMed. All rights reserved. |
Imagine a computed
tomography (CT) scanner that can be installed in a room as small as six by
nine feet, weighs 450 pounds, and plugs into a standard electrical outlet.
Well, for eye, ear, nose, and throat physicians it is possible to provide
point-of-care CT imaging in a clinic or an operating room.