June 2016 — Health Care Properties Quarterly —
Page 15
and renovating for these new tech-
nologies, we have identified strategies
that can significantly improve project
success. First, it’s essential to under-
stand the project goals and intended
use of the space to identify the risks
and minimize the impacts of construc-
tion to the facility. Getting the facility
back into use quickly, safely and with-
out interruption to daily operations is
the ultimate goal. Accomplishing this
starts with pre-planning. Understand-
ing patient and staff flow from pre-op
to recovery, the red line protocol and
the function of patient and sterile cor-
ridors will allow for the creation of the
Infection Control Risk Assessment and
Interim Life Safety Measures plans.The
contractor should develop these plans
with the facility managers of safety,
infection prevention, construction and
plant operations.
Meticulous scheduling is key to get-
ting the facility operational quickly.
In a recent renovation our company
completed for a robotic operating room,
there were modifications to the quanti-
ty and locations of monitors, power and
medical gas outlets, and light fixtures.
Increased boom sizes required a greater
load, necessitating enhancement or full
replacement of the existing structural
support. Complete modifications to the
existing MEP and med gas systems and
the upsizing of the isolation panels also
were required. Having completed many
preconstruction program and design
reviews, we were able to identify the
work scope in advance and properly
time the construction.
Often new equipment increases
requirements for cooling or air
exchanges, leading to potential for
enhancement or replacement of the
air-handling unit. In the surgical suite,
there are strict infection prevention
guidelines as to how the air-handling
unit is tested and started, which
increases the time for commissioning.
Therefore, it is important to coordinate
this with the infection prevention staff
early as it eventually will tie into equip-
ment installation, test and balance, and
turnover.
In another example, a renovation to
create a hybrid OR, the facility com-
bined two individual operating rooms
into a single, larger room. In this design,
the center point of the new patient
table shifted to the space that was
previously between the two rooms. In
operating room suite design, the space
between the ORs is designed to house
the main infrastructure feeding the
operating rooms while the center of
each room is reserved for the critical
locations of lights, diffusers and equip-
ment booms. In order to clear space for
the center of the new hybrid OR, main
duct, electrical and steam lines had to
relocate.
In every project, several critical steps
should be taken to ensure success. First
is getting above the ceiling to review
existing conditions and validate as-
builts. It is worth the cost of off-hours
investigation to identify conflicts before
construction starts than to be delayed
due to unforeseen existing conditions.
The second step is to pay attention to
owner equipment coordination. Con-
stant communication with the vendor
is critical from receipt of template for
layout, to coordination with subcon-
tractors, electrical box walks, room turn
over, final connections and inspections.
Tie the vendor activities, installation
and training to the construction sched-
ule.The third critical step is managing
the state inspection process. Due to
long review times, it is important for
the design team to submit for permit
early. The contractor, in concert with
the owner and architect, should sched-
ule site inspections throughout to avoid
surprises at the end that can add unan-
ticipated time to the schedule.
Construction projects for modern
surgical suites requires an understand-
ing of the precision required for these
facilities, the preplanning for ICRA and
ILSM, and the proper coordination of
equipment vendors, inspecting agen-
cies and mechanical and electrical
system installation. Communication is
key, along with recognition that every
project teammember must be involved
from start to finish.Today’s modern
ORs are complex, involve many tech-
nologies and many disciplines. A suc-
cessful project requires collaboration
between the designers, builders, ven-
dors, hospital staff, physicians and IT as
each plays an important role in timely
project completion to provide medically
advanced procedures for patients.
s
Inspiring
Better Buildings
Where People Thrive
45 +
Hospitals & Medical
Office Buildings Projects
6
Healthcare projects that
earned LEED certification
1.5 billion
in Construction Costs
5.7million
Square Feet
According to the Healthcare
Sustainability Initiative, ”$34,000 is
the potential annual energy savings
for the average100,000 square foot
hospital through commissioning
alone. Improved energy efficiency
not only reduces environmental
impact but can also improve comfort
and infection control.”
HEALTH + WELLNESS BY THE NUMBERS
303-861-2070
primary care practitioners for ease
and speed, and going to urgent care
clinics because they can get in and
out quickly,” explained Lou Posada,
health care principal at Hord Coplan
Macht. “Some health systems are
playing catch up now and in some
cases are starting to align themselves
with retailers to capture the follow-up
care or referral. They also have the
opportunity to integrate the electronic
medical records so the provider at
the urgent care can see ongoing or
previous treatment of the patient and
avoid missed-steps in medication and
care. It allows the primary care pro-
vider to understand what happened
at the encounter.”
Population health.
Five key leaders of
Colorado health care systems recently
discussed their vision for the next
five years and population health was
a part of each of their strategic plans.
All of these leaders agreed that the
interpretation of the term “population
health” is highly subjective and lacks
a conventional definition.
In the context of this article, popula-
tion health is defined as an approach
of improving health outcomes by pro-
viding health care services on a com-
munity, rather than individual, scale.
This comprehensive approach incor-
porates mitigation and prevention of
chronic diseases, as well as the overall
holistic health measures. According
to the 2016 survey by Health Facilities
Management/ASHE, outpatient com-
munity-based initiatives to address
population health are on the rise: 38
percent increase in medical office
building and a 32 percent increase in
urgent care and ER facilities are antici-
pated in the near future.
“As health care continues to prog-
ress and adapt, Centura Health is
working to improve the connectivity
between health care and you. For our
communities to achieve an optimal
level of wellness, our presence must
move into all parts of the neighbor-
hoods we serve,” said Thomas Gessel,
CEO and president of Mercy Regional
Medical Center in Durango.
Adapting to the new approach to
health care, development projects
have evolved significantly over the
past five years. New building designs
are emerging, addressing the vast
changes in the health care delivery
model. Health systems are prioritiz-
ing their needs and developers are
fulfilling them through innovative
projects.
s
Consumer
Modernization
