An injured soldier in a 110-degree desert. An ailing child in an emergency room. A fallen retiree in a suburban home’s bathroom. Interdisciplinary health care team members will encounter these and other real-life scenarios in the new Simulation Center at the Captain James A. Lovell Federal Health Care Center (FHCC). The FHCC set out to use innovative methodologies to enhance knowledge, validate expertise, and provide a safe, supportive learning environment for all staff. The resulting Simulation Center replicates civilian and battlefield situations requiring medical intervention so that interdisciplinary teams can provide safe patient care in both fixed and deployed settings. Hospital, medical planner, and audio-visual specialist discuss the FHCC’s decision to embrace simulation, and the challenges of refitting a dated space into a technology-rich setting that readies students for both the technical and relational challenges that they will confront in the real world.

LEARNING OBJECTIVES
1. Describe the role of simulated environments in medical professional training for civilian and military scenarios
2. Identify innovative methodologies to enhance knowledge, validate expertise, and promote safe patient outcomes while enhancing staff development
3. Resolve challenges that health care providers face when bringing new layouts and technologies into dated spaces
4. Transform obsolete facilities into centers that bridge educational and clinical programs with spaces that are realistic, adaptable, and recordable

Within the span of one year, a group of passionate industry professionals created the momentum to make a significant impact in their community. Share Our Selves is a non-profit organization which provides medical, dental, financial and counseling services to the homeless and low income populations of Orange County, California. Situated within two dilapidated buildings, the facility wished for a minor repainting. The end result was a full transformation resulting from the harmonious collaboration of industry professionals. The overwhelming response of help created wonderful challenges, including assembling donations toward a cohesive design solution, as well as allowing the clinic to remain operational throughout construction. Four key members of The SOS Project, each offering a unique perspective, invite you to bring greater change to the industry and to make the greatest possible impact - create a project that continues to give!

LEARNING OBJECTIVES:
1. Participants will learn the value of collective teamwork, aligning missions, and partnering among firms toward achieving a common goal.
2. Participants will recognize the importance of generating the why, the reason for taking action, to enable others to move into action.
3. Participants will assess the ways to keep a team on board and engaged through highlighting pivotal experiences and creating momentum and energy.
4. Through prioritizing needs, sharing results and embracing discoveries, participants will learn how to create a collaborative community project.

Using two case studies, this presentation will illustrate the application of lean design into new lean healthcare delivery methods: the Patient-Centered Medical Home practice and the Urgent Care Center. At the outset of the design process, Reliant Medical Group approached lean in a truly holistic fashion, involving expert facilitators as well as professional staff to redesign the entire patient experience. From architect and owner perspectives, we will review how using lean design and BIM led to improved layout and efficiencies for these two facilities. As a result of a comprehensive lean design process, Reliant was able to realize a 29% increase in patient volume and profitability within the same facility footprint. This presentation will illustrate how a collaborative lean design process using BIM helped build consensus and enthusiasm among community stakeholders. We will also discuss metrics illustrating effectiveness, utilization, doctor/patient reactions, and survey results.

LEARNING OBJECTIVES:
1. Learn how to involve and collaborate with clinicians, facilities professionals, and patients most effectively in a “lean” design process
2. Explore the design options available to create a clinical environment that still feels hospitable and comfortable
3. Understand the financial models of patient-centered medical home centers and urgent care centers
4. Learn how building information modeling aids the design process and promotes community collaboration in designing new healthcare delivery methods

In 2007, the University of Texas's Construction Industry Institute (CII) began working with several organizations to benchmark capital projects in the healthcare sector. The goal was to establish an external benchmarking program to capture cost, schedule, rework, change, and best practice implementation data from a range of healthcare facilities. These data are categorized by a facility framework that includes hospitals, central utility plants, medical office buildings and outpatient surgical centers, amongst others. This is the first program of its kind for healthcare projects. This session explains how the National Healthcare Facilities Benchmarking Program works and what types of analyses will be produced. Panelists will demonstrate how the information produced by the benchmarking program will improve the delivery of healthcare facilities. Panelists will also explain how participants can become involved in this landmark (and free) program and benchmark their projects.

LEARNING OBJECTIVES:
1. Describe the benefits of an external benchmarking program for the delivery of capital projects
2. Learn methods used to compare projects from different organizations and validate estimates
3. Learn how benchmarking can assist improvement initiatives
4. Explore how benchmarking can serve as a basis for facility planning

As reimbursements decline and patients wait until they are sicker to come to hospitals, designing and detailing the next generation of patient rooms to decrease falls and hospital-acquired infections (HAIs) becomes extremely significant for our healthcare systems. Since Medicare/Medicaid reimbursements are continuing to decrease, addressing the unreimbursed “never events” have become more important than ever. Focusing on patient falls and HAI prevention, this team researched the standard medical/surgical patient room design to try to solve the problem and save hospitals money in the process.

LEARNING OBJECTIVES:
1. Understand the impact of Medicare/Medicaid reimbursements for the "28 Never Events" and their effect on the Patient room
2. Understand where the greatest risk is for patient falls and HAIs and where the opportunity for improvement can be achieved
3. Review Traditional Patient Room designs to learn about what has and has not worked to mitigate risk
4. Planning and Design strategies to achieve Maximum Safety in Patient Room layouts

When it comes to facility replacements you can have any two—quality, speed, or low cost—but you usually can’t have all three. Dave Hitchcock of ASA, Charlie Walden of Walden Structures and Glenn Mitchell, retired VP of Medical Services for Mercy will discuss how Mercy Hospital Joplin benefited from all three: The quality of factory built components; the speed of site work and building construction; and a new hospital providing continuity of services and income in 8 ½ months. Looking for a facility solution following the May 2011 tornado disaster in Joplin MO, Mercy leadership flew to Calif. and toured a modular acute care hospital addition. The quality of that project, along with the opportunity to have a hospital in record time, convinced Mercy to commission an interim modular hospital of 150,000sf. Mercy Hospital Joplin's component hospital was completed in April and is the quickest hospital ever built in the U.S. to meet IBC and Joint Commission standards.

LEARNING OBJECTIVES:
1. Address the myths you’ve heard about “modular” buildings.
2. Evaluate component design/construction’s potential for healthcare facility upgrades and hospital replacement needs.
3. Assess the Mercy Hospital Joplin project.
4. Explore the possibility of using component construction. Is this the right solution for upgrading, replacing or expanding your facility?

Buildings and spaces that were once ‘state of the art’ become unused, forgotten shells. In many instances, rooms are nothing more than storage depots. Large hospitals are constantly changing their built environment to accommodate new technology, staff and processes. A series of case studies, will demonstrate how forgotten spaces can be reclaimed and provide updated, bright and functional areas. New addresses are created within the existing hospital by reclaiming real estate. Disparate functions that require adjacencies are grouped together transforming ill-used spaces into updated, functioning spaces for patients and staff. Results from three separate cases will be presented. 

LEARNING OBJECTIVES:
1. Identify barriers when working within a current infrastructure.
2. Develop a design solution to overcome the barriers and meet client needs.
3. Understand specific strategies to assist clarity throughout the design process.
4. Review and document for future reference.

Health care organizations are taking greater leadership roles when guiding community members to create healthier lives, by offering wellness and active aging courses, and providing exercise, nutrition and rehabilitation centers. Concurrently, health care facilities are transforming into arts and cultural activities centers, using tools that boost community pride. They promote regional artists through physical arts programs, create employee and community galleries, build partnerships with local museums and art associations, provide venues for concerts and performances, and engage artists to create art with patients, all while supporting their health care journey. By sharing community-based visual and performing arts program case studies on three hospitals—Cottage Health Systems, Santa Barbara, Children’s Hospitals and Clinics of Minnesota and AtlantiCare Health Systems—Annette Ridenour and Leah Goodwin will demonstrate the effectiveness and success of these cultural partnerships.

LEARNING OBJECTIVES:
1. Methods to structure and fund arts and culture programs
2. Benefits to the healthcare organization
3. Benefits to the community artists and arts organizations
4. Positive effects on patients, visitors, administrators and employees.

The continuing scientific discovery linking light to human health, disease, and wellness is one of the most exciting stories of the decade. Epigenetic Design is an emerging design practice of creating health promoting built environments that is firmly established on medically relevant knowledge of how genetic expression, physiological, neuroendocrine, and behavioral response is impacted by built environmental sensory stimuli - primarily that of LIGHT. This three-part series – delivered in the context of cultivating a generative space - bridges the gap between science, medicine, and design by presenting an advanced understanding of the human circadian system and its connection to ambient lighting conditions as primary sensory stimuli capable of direct health impact.

LEARNING OBJECTIVES:
1. Review the basics of light and color as electromagnetic stimuli capable of direct impact on health outcomes, human behavior, and bottom-line cost of care.
2. Examine ambient electric lighting and surface color stimuli known to elicit human genetic and behavioral response and discover how this can impact design practice.   
3. Assess and evaluate the current offering of electric light sources available for healthcare application and examine the known physiological and neurohormonal impacts each has on the human body and brain throughout each stage of life.
4. Develop a working knowledge of the new metrics for defining electric light and color sources to better understand how these impact the healthcare environment. 

The next five years will be the most transformational time in the history of American Healthcare. The Patient Protection & Affordable Care Act is here to stay; the courts have ruled, the budget demands, & the people will vote. Providers must embrace a new business model, reconsider service offerings, & achieve real clinical integration. Responding to a turbulent environment and uncharted waters, Sauvé frames the future of healthcare in America with uncanny accuracy and unsettling insight. A multi-media opening, frames the evolution of healthcare from 1500 to 2050. Insights from the top 15 causes of death, the impact of longevity & obesity, and the cost-benefit of unproven treatments are quantified. Key trends in obstetrics, emergency, and ambulatory services are detailed. The truth about physician compensation, employment, and team-centric care are exposed with new revelations. Frame the hard realities, board mandates, & new mindset required to realign the business of healthcare.

LEARNING OBJECTIVES:
1. Learn the practical implications of healthcare's new business model; the impact on emergency, observation, inpatient, and ambulatory services
2. Uncover the driving forces behind rising physician compensation, longevity, obesity, and the unethical practices of the pharmaceutical industry
3. Visually review the evolution of American healthcare; experience accelerating innovation, travel 50 years into the future, in a multi-media opening
4. Frame the hard realities, board mandates, and management mindsets required to realign the business of healthcare and survive the next five years

When Partners Healthcare set out to design a replacement facility for the Spaulding Rehabilitation Hospital in Boston, MA, the ownership team wanted to create a project that would serve as an international model for environmental and social sustainability. Working with an experienced design team, Partners made a critical decision to apply the principles of Universal Design to every aspect of the project, from site planning to patient room layouts. Slated to open in 2013, the design of the new hospital greatly exceeds minimum regulatory standards for accessibility, leaving behind the old paradigm of “just tell me what I have to do” and opting instead for an approach to healthcare design that is grounded in the global realities of the 21st century. During this session, senior members of the design team will share an overview of the facility and discuss key aspects of the design process, including full-scale mock-ups, staff and patient simulations, and user-expert engagement.

LEARNING OBJECTIVES:
1. Attendees will be introduced to the seven principles of Universal Design, their history, and their potential application for healthcare environments.
2. Attendees will learn the benefits of Universal Design for all users in a rehabilitative setting: in-patients, out-patients, families, and staff.
3. Attendees will learn how to integrate Universal Design principles across the disciplines of architecture, interior design, and landscape architecture.
4. Attendees will learn strategies for structuring the design team and the design process to facilitate the application Universal Design principles.

Humber will be North America’s first LEAN, green & fully digital hospital, incorporating technology into virtually every aspect of healthcare delivery. A P3 delivery method, procurement approach & contracting for this project were critical to the design solution that was adopted. The RFP allowed the hospital to choose from 3 totally different designs, each developed and submitted by the bidders based on the hospital’s output specifications. Dr. Devlin will articulate the Humber vision & Barb Collins will speak to the value of P3 in delivering the right facility & the right partner to meet the hospital’s long-term needs. The session will allow participants to explore the applicability & benefits of the P3 model for their capital renewal & expansion projects. It will also highlight specific considerations to be addressed by hospital administrators in the planning phase, including long-term contracting & implementation performance guarantees.

LEARNING OBJECTIVES:
1. Learn how the P3 delivery method, procurement approach & contract ensure Humber has superior asset management & predictable O&M costs over 30 years
2. Transform conventional thinking about hospital design by planning ahead 30 years and partnering for long-term accountability and performance
3. Share benefits, lessons learned and P3 best practices which can be implemented in future hospital projects
4. Explore Humber River Regional Hospital’s pioneering use of LEAN, GREEN DESIGN & DIGITAL TECHNOLOGY in North America’s first fully digital hospital

Funding for a study to program and plan a joint use medical facility (JMF) was provided to the Department of Veteran’s Affairs. The objective was to develop a plan for a new medical center to be used jointly by the Department of Defense, primarily those stationed at Ft. Leavenworth, and the Department of Veteran’s Affairs. Efficiently serving the needs of veterans and active duty military personnel and efficient use of resources were determined to be essential criteria. Both the VA and the Army have aging hospital in Leavenworth, Kansas. Consolidation and repurposing of current assets was defined as essential to the viability of the contract. Implementing these primary goals in the planning process was accomplished through a series of programming/planning meetings with representatives of both agencies.

LEARNING OBJECTIVES:
1. Learn how long term operating efficiency is obtained by combining key functions of two aging hospitals into a single destination with better service.
2. Learn how facility design accommodates cross training Department of Defense and VA medical staff, increasing exposure to wider range of treatments.
3. Learn how combined facility design intends to improve medical services to active duty military personnel as well as veterans.
4. Learn how facility design responds to need for psychiatric services in close proximity to demographic needs.

This session will be a case study on the Lutheran Fifth Floor Vertical Expansion project. The project involved the design and construction of a new floor to the existing four-story hospital building to add 96 new private patient rooms, enabling a new Cardiac Intensive Care Unit and three new Telemetry Medical Surgical Units to be brought on-line. The early strategic planning process will be high-lighted when the design and construction team carefully analyzed pros and cons of expanding vertically versus horizontally. The vertical expansion of an active hospital presents many challenges. How the team was able to overcome the challenges and complete the project without shutting down any fourth floor patient units will be featured, including unique solutions developed by the design and construction team. The project is a relevant case study for any facility faced with maximizing their existing assets while providing excellent patient care today and into the future.

LEARNING OBJECTIVES:
1. Review of early analysis of vertical versus horizontal expansion, including impact on hospital revenue, and patient safety during construction.
2. Presentation on challenges faced by team in creating an expansion above a hospital and features were added to allow minimal impact on the facility.
3.  Discussion on unique challenges faced by the construction team in building vertically above an active hospital.
4. Best Practices in Construction Safety and impact of design on construction and hospital personnel safety.

Cost overruns, impaired image quality, equipment conflicts, lack of coordination, reduced functionality; more often then not this seems to the story line associated with major radiology projects. This session will take a critical look at the root cause of imaging suite failures and how to avoid them. This presentation will provide case studies of imaging suite designs that undermine the essential value of imaging for patient care, both in minor and major ways. You will have the rare opportunity to learn from others’ mistakes and how, sometimes, design and construction teams expect radiology departments to cover shortcomings in the building with increased staffing or decreased throughput.

LEARNING OBJECTIVES:
1. Learn through real-world examples of imaging designs that have failed how to avoid the most common mistakes that impact quality, cost and schedule.
2. Learn where responsibility for design shifts from the equipment vendor to the design team, and how to avoid having items fall through the cracks.
3. Learn how to protect themselves and their clients from design failures.
4. Learn to be more cognizant of potential failures in existing facilities.

In today's environment there are increasing pressures on Emergency departments everywhere. Volumes are up, space is at a premium, budgets are tight. Healthcare Reform, and aging populations only add to the pressure. The emphasis is therefore on doing more with what you have while improving patient care, improving wait times, and reducing patients left without being seen. The answer can't be found in facilities alone. In truth, the best solutions reside in how well you can implement lean principles into your process, taking no tasks for granted. Join us as we look at two case studies within the same system where we will look at data results from process and design improvements. The first is on how they transformed a 125,000 visit trauma ED into one that reduced LOS up to 45 minutes in many categories. The second is how they incorporated lean principles into a new Freestanding FED. In both cases, we will share process and techniques for improving emergency medicine design.

LEARNING OBJECTIVES:
1. Learn about the STEEP approach, and the importance of continuous improvement.
2. Learn about reducing waste in the system and eliminating process variation, including use of Supertrack, results waiting and carefully placed staff.
3. Learn how software can help your lean initiative, including the benefits and essentials of passive patient/results tracking versus active tracking.
4. Learn how to build lean from the ground up in Freestanding Emergency Departments, maximizing for throughput.

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. We will also explore how ‘Health Design Leadership’ is the first step along this continuous journey. A case study will be presented highlighting 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 better integrate both together.
2. Learn to distinguish ‘leading’ and ‘organizing’, and how to use this distinction to produce more effective outcomes.
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.

Case Study for Integrated Delivery of the Ann & Robert H. Lurie Children's Hospital of Chicago, a $1 billion, 1.2 million square feet replacement hospital located in the Streeterville community in the City of Chicago. The new replacement hosital includes 288 single occupancy rooms with capacity to expand to 313 rooms. The new hospital is located in a concentrated urban site located within the Northwestern Memorial Hospital's Medical Campus. Discussions will focus on the benefits of integrated project delivery, early team collaborations, challanges and associated examples. Also, benefits during construction / transition planning / operations will be discussed as well as project successes.

LEARNING OBJECTIVES:
1. If administration is considering potentially spending the largest investment in its history, define what success is and how it will be measured.
2. _______ of key team member selection. ________ not only of company but individual people.
3. Development of budget and contract. Make sure that project stays within a realistic budget and schedule.
4. Importance of program management, design, construction manager, and consultant selection. Importance not only of company but individual people.

Healthcare organizations increasingly are shifting from the traditional construction delivery methods consisting of negotiated work, design-bid-build process and the design-build process to other options such as engaging a developer who will ultimately own the property and lease it back to the healthcare organization. No single structure is best for every situation, and many financial and operational factors go into the decision to own or lease properties. In this session, two knowledgeable healthcare decision makers and a leading development manager and advisor discuss the factors influencing the financial conditions and the pros and cons of each structure, and engage audience members to share their experiences. Points for discussion will include: Advantages/ disadvantages of different structures, pros and cons of ownership and leasing, financial, design and operational considerations.

LEARNING OBJECTIVES:
1. Pros and cons of various traditional structures as well as development leaseback structures
2. Choosing the right developer / owner - pitfalls to consider
3. Financial considerations such as cap rates on leaseback deals, cost of capital and returns on investment for all parties
4. Design and operation considerations from an owners perspective

In 2010, Saint Alphonsus Health System (SAHS) identified key strategic goals intended to evolve SAHS into a patient-centered, integrated health delivery system. One such goal was to advance a comprehensive ambulatory strategy throughout the region vis-a-vis an Integrated Physician Delivery Network (IPDN). The IPDN is the cornerstone of a clinical integration strategy intended to position SAHS for success in the future environment of outpatient-focused accountable care and value-based performance payment. After a series of hospital and clinic acquisitions, SAHS conducted a comprehensive network ambulatory master plan to provide multi-year direction to the development of ambulatory-focused services, providers, and facilities. This session will explore the master planning methodology, output, and lessons learned.

LEARNING OBJECTIVES:
1. Review and discuss the methodology used to master plan a comprehensive network of outpatient services.
2. Identify and understand the key drivers underpinning the master planning effort.
3. Explore the implications of healthcare reform and how they shaped the plan
4. Discuss lessons learned throughout the process

The design of the built environment in healthcare facilities has a measurable impact on publicly reported hospital inpatient quality metrics. Everything from a macro-environment construct (hospital site selection) to a micro-environment construct (cardiac cath lab location) can adversely impact quality metrics significantly handicapping facilities with a poor design. For example, the U.S. Department of Health & Human Services reports the percentage of time that a given hospital performs percutaneus cardiac intervention within 90 minutes of arrival and reports this against state and national average (“door to balloon time”). A survey of six eastern Virginia healthcare facilities revealed that the door to balloon distance ranges from a short 224 feet to 987 feet adding at least 3 minutes to the door to balloon time for this facility. This difference resulted in a 5% difference in the reported percentage of patients who received PCI within 90 minutes at one facility.

LEARNING OBJECTIVES:
1. Recognize the role of the built environment and facility design in hospital inpatient quality measures.
2. Assess those elements of a facility design that, if modified, could improve reported hospital inpatient quality metrics.
3. Summarize all of the currently reported hospital inpatient quality measures that are impacted by hospital design.
4. Distinguish between quality metrics that are partially explained by hospital design from those that are independent of hospital design.

Information Technology plays a critical role in any business, and the healthcare industry is not indifferent to this. Lack of quality communications between Facilities and IT can create gaps within the schedule as well as budget. This session focuses on specific examples on how the Facilities/Construction, IT Department, and SM&W worked together and built a 620k sq. ft. medical facility – Orange Regional Medical Center. ORMC combined two existing hospitals into a new main campus and implemented over 50 discrete systems. The technology implementations did not come easy. Due to the considerable flux in new work flow and processes, the clinical staff and administration’s resources were stretched thin. The design team resolved infrastructure and Medical IT Systems design issues and provided the coordination and communication links between Facilities and IT.

LEARNING OBJECTIVES:
1. Learn to be an effective design team member and breakdown barriers between Facilities and IT departments.
2. Key roles that both IT staffs and Facilities staff play in a hospital construction project.
3. Technologies that can improve operational efficiencies and improve quality of patient care.
4. Coordinating multiple groups to integrate discrete systems is critical to the overall success of the project.

The INSTITUTE OF HEALTHCARE IMPROVEMENT (IHI)-was established in 1991 with the mission to lead the improvement of healthcare throughout the world. It focuses on motivating and building the will for change; identifying and testing new models of care in partnership with both patients and health care professionals; and ensuring the broadest possible adoption of best practices and effective innovations. This presentation is a case study illustrating the innovative strategies being used to design and construct Temecula Valley Hospital and how it aligns with the tenants of the IHI.

LEARNING OBJECTIVES:
1. Outline current initiative by the IHI in relationship to design and construction.
2. Describe value by means of positive patient outcomes, cost efficiency, elimination of waste and improved outcomes.
3. Illustrate through this study how the IHI suggested five ways to add value, changing behavior, beliefs, creating discerning consumers.
4. Discuss why Integrated Project Delivery (IPD) is a critical success factor.

St. Josephs Healthcare Hamilton is a premier academic and research healthcare organization, committed to making a difference in peoples lives, through integrated health services and internationally recognized programs. The hospital is currently constructing a new Mental Health and Addiction facility complete with a major ambulatory medical clinic and a diagnostic imaging centre and will house McMaster University's Department of Behavioural Neuroscience. Construction started in ealry 2011 and substantial completion is scheduled for December 2013. We are committed to developing a new centre that will transform how mental health care is perceived, through its seamless integration of research, teaching and clinical care, to serve as an innovative model internationally for how design can advance the care of those who suffer from mental illness. Our session will describe how the design of our new building supports the hospitals vision for delivery of mental health care.

LEARNING OBJECTIVES:
1. Learn how the design of a facility can integrate mental health care with traditional medical treatment, recognizing the co-morbidities that exist between them
2. Understand how the development of an institution supports the normalization and de-stigmatization of mental illness and provides for  greater community engagement
3. Explore how the fusion of mental healthcare, education, medical care and research into a single facility can drive translational research
4. Assess how the integration of security along with competing needs of privacy, infection control and flexibility have been accommodated within the best thinking of evidence based design.

Mt. Washington Pediatric Hospital’s $9.2 million renovation of its largest patient unit provides premature infants and their families with a warm and friendly—yet highly functional—place to transition from acute care to their home. Participants will learn how the Hospital and designer created a unit to improve patient safety and security while increasing nursing staff efficiency and morale. The renovation creates a bold method of distributed nursing. The patient floor will have no central nurse station, instead 16 nursing alcoves are located directly outside of patient rooms, creating a highly effective structure for observation of patients. The alcoves replace a central nurse station as well as nurse “desks” previously located inside the patient rooms. Additionally, the model more quickly brings clinical support tools such as medications, formula, and supplies to the patient. The renovation also added family-oriented amenities to encourage greater involvement in patient care.

LEARNNG OBJECTIVES:
1. To understand how the needs of post-acute, long-term infant care drives a distributed staffing model.
2. To learn how specialized design elements, such as distributing core functions, provided necessary configurations for the patient care model.
3.  To evaluate how design elements improved patient safety and security through better visibility and infection control.
4. To assess how this unique method of distributed nursing increased staff morale and efficiency.

This presentation will use a case study of Baystate Health’s new Hospital of the Future to examine the planning considerations and outcomes in building healthcare facilities today that will meet the demands of the future. The $260 million Hospital of the Future, completed in January 2012, consists of a new seven-story addition to the existing hospital and creates 600,000 gsf of new construction. During the master planning, a broad-based and extensive process was endorsed by senior leadership involving over 150 clinicians and managers to review clinical trends, identify key clinical areas of focus and develop program components reflecting projected technological and operational advances into the future. Particular attention was focused on future operational models of care, implications of new technology, and opportunities for improving effectiveness related to patient safety and access.

LEARNING OBJECTIVES:
1. Learn how to integrate hospital staff in the master planning process.
2. Understand architectural and engineering considerations when planning facilities for the future.
3. Explore new ideas in MEP design that can impact healthcare facilities planning.
4. Identify key steps in designing a healthcare facility that will meet the demands of the future, from master planning through

How can you use Design Psychology to create healthcare, community and even home settings that enhance healing? Through hands-on exercises, this talk illustrates how to determine the personal, nurturing associations we have with color, fabrics, furniture, and special objects. Case studies provide insights into ways to translate such associations into a “Design Psychology Blueprint” for designers, healthcare professionals and patients seeking to create a healing oasis by design. Healthcare design examples will show how: • Results of Design Psychology focus groups with staff/caregivers led to the oasis-like design of the Ken Hamilton Caregiver Center at Northern Westchester Hospital. • During her treatment for breast cancer, speaker Toby Israel used principles of Design Psychology and psychoneuroimmunology to design her therapeutic bedroom. • Kimono-like radiation gowns designed as “wearable,” “hangable” art unite hospitals and community via online and in-person support networks.

LEARNING OBJECTIVES:
1. Participants will be able to define Design Psychology and explain its application to healthcare design.
2. Participants will complete Design Psychology exercises enabling them to explore and identify their own experience of healing oases.
3. Participants will be able to summarize the importance of involving users in selecting color, texture, layouts and objects to create healing places.
4. Participants will recognize how Design Psychology exercises can be incorporated into their own programming process to create healing environments.

For many years designers have made pilgrimages to Europe to learn lessons from them about how to design and operate greener buildings. And, we North Americans and Europeans have taken it upon ourselves to define the parameters for what makes a building, especially a healthcare building, green and sustainable. But, there is another world of healthcare delivery that must provide care with extremely limited resources. Indeed, much of the world’s experience is that, by necessity, healthcare must be provided with a minimum of resources as their only other option is no healthcare. Green healthcare practitioners from the developed world have much to learn from healthcare practitioners in low-resourced settings. Two recent efforts, one by the World Healthcare Organization and Healthcare Without Harm begin to collect these lessons and formulate them into cohesive prescriptions for sustainable healthcare models that span a wide range of low-resourced to highly-resourced organizations.

LEARNING OBJECTIVES:
1. Learn about the WHO’s Healthcare in the Green Economy; Prescription for the Global Healthcare Sector.
2. Learn about the Heath Care Without Harm’s Seven Elements of a Healthy Hospital.
3. Learn about ways that low-resourced countries provide healthcare.
4. Learn new ideas for Sustainable Healthcare Delivery, based on experience of low-resourced countries.

There is a growing acceptance of nature images in healthcare design today- but a focus on nature imagery alone can be limiting for designers and art consultants. In this presentation we propose that art depicting people (figurative), when carefully chosen, can also be appropriate for some health settings. In 2011, an art preference survey was conducted with inpatients in a neuro/oncology unit asking patients to select their favorite and least favorite images within the following categories: landscape, waterscape, floral, and figurative. Qualitative comments were recorded. Data analysis showed a high rating for figurative art depicting families, and children playing. A closer look at the specific elements of the images provided an understanding of the type of figurative art appropriate for cancer patients. Most importantly the study showed the importance of human connection for patients, and the value of having figurative images that are positively reinforcing in oncology settings.

LEARNING OBJECTIVES:
1. To understand the state of current research in evidence-based art for cancer patients
2. To explore the unique role figurative art in the design of cancer centers
3. To share findings from a research study with oncology patients comparing nature and figurative art.
4. Discuss implications for future art programs and gaps in the research that still need to be explored.

The attendees will learn the process of the” Four Pillars” needed for ensuring successful outcomes for healthcare retail. This will include in depth education on feasibility studies that will drive the design towards more rapid and substantive ROI’s. They will discover methods and processes that are used to encourage valued engineering in design and finishes. Attendees will be shown how venue and product selections have direct impacts on both staff and patient satisfactions. They will hear how to integrate the retail space into a “Vertical Mindset” to further impact HCAHPS. Additionally, there will be community impact benefits that we will introduce to their considerations. Our presentation will include models for effective management, POS and Staff operations. This will be a complete programming presentation with proven outcomes to show.

LEARNING OBJECTIVES:
1. Strong research methods that will produce realistic recommendations and ROI: -What is the potential -Who is the customer -What is the need -etc
2. Concepts for designs, FF&E and “flow” that work for retail in healthcare: -Valued engineering (ugly out before wears out) -Maintenance issues -etc
3. Get the customers served and registers ringing: -Time is money -Creating the "buzz" -Internal marketing concepts -etc
4. Success comes with sustainable planning: -Staff training modules -POS -Rewards programs -Clinical integrations -etc

Advancing professional education for medical professionals is critical in today’s quality-driven, competitive healthcare environment. Medical learning environments that develop the most technically skilled and interpersonally savvy practitioners are in high demand. Two case studies showcase successful built environment strategies that support modern approaches to medical education. At North Park University, a Nursing Simulation Lab based on real healthcare healing environments offers a sophisticated, dynamic new learning environment that has advanced student’s ability to develop and expanded enrollment. Scheduled to open in 2013, LSU’s Medical Education Building has been designed to integrate new methods for improved competency testing in the ABIM’s six core competencies: patient care, medical knowledge, professionalism, interpersonal and communication skills, systems-based practice and practice-based learning and improvement.

LEARNING OBJECTIVES:
1. Participants will learn how the built environment can support training in the integrated healthcare delivery model and effective collaborative teams
2. Participants will receive a historical overview of medical education as a platform for future advances in the treatment of patients as individuals
3. Participants will learn the critical elements, from vision to construction, in designing a successful Simulation Center
4. Participants will explore the importance of narrative medicine and relational autonomy and their impact on medical education environments.

The Lean process positively challenges teams to work collectively to make quantitative and qualitative decisions. The new multi-specialty Everett Clinic at Smokey Point serves as an informative Lean case study. Following principles of Lean, the team conducted a series of integrated design events (IDE) over the accelerated course of seven months. IDE outcomes focused on defining value in patient terms, identifying processes that enhance and add value, eliminating all non-value added steps and space, making the remaining value-added steps and space flow smoothly, and pursuing perfection by continuous improvement. The team will outline a prototype for new operational models that address the processes undertaken to set and alter project expectations. Participants will identify areas of greatest efficiency to focus outcomes, accomplish project goals, prepare for future needs of the space, and meet timelines for completion while implementing large-scale operational and cultural changes.

LEARNING OBJECTIVES:
1. Navigate strategies to develop Lean solutions that provide efficient and cost effective solutions while pursuing enhanced environmental facilities.
2. Understand Lean processes and tools used in pre-event planning, and how to implement assessment for healthcare events based on scope of the work.
3. Establish expectations about team dynamic, focusing on how to drive team interaction based on project data and objectives.
4. Identify how to balance Lean design and flexible design objectives.

Architects who design healthcare projects must learn to navigate the complex waters of hospital building projects. But what about the other side of the equation? How can physicians and other hospital staff adjust to a design process that changes the ecology of their healing environment? What should they expect out of their relationship with their architect? This session will discuss the five principles of organizational development that should guide the relationship between a hospital and their architect and will examine the issue from the perspective of both the physician and designer. We will look at the mediating role an architect plays in leading the resolution of conflicting ideas, preferences and agendas that arise in a diverse hospital community, as well as how a hospital can put together the most effective building committee. Finally, this session will give hospitals an idea of what to look for and demand in their relationship with their architecture firm.

LEARNING OBJECTIVES:
1. Understand from a physician’s perspective the impact of the architectural engagement and design process on hospital culture and function.
2. Discover the importance of reconciling the diverse goals of a hospital community.
3. Learn 5 guiding principles to optimize engagement: learn the client, communicate clearly, drive clarity, collaborate and prepare for change.
4. Recognize how to use the 5 principles to cultivate a positive relationship between physicians and architects.   

Health care design is growing more sensitive to the needs of patients, nurses, doctors and staff in various specialties. Today's hospitals must meet all stakeholder's needs. Each unit has its own requirements for space, design, furnishings and equipment. The goal is to improve the patient outcome, but are we? This presentation is not just the perspective of an experienced healthcare architect. It's also the perspective of a husband and family care giver who encountered dozens of design flaws throughout his wife's three-month in-patient orthopedic treatment and over a year of outpatient Rehabilitation. Design details that, before then, had not been given a second thought.

LEARNING OBJECTIVES:
1. Observations relating to hospital space allocation as it relates to care giving. Where do you get the most return on your investment.
2. Evaluate the affect of material selections on patient comfort and safety.
3. How equipment selection can improve the patient's mobility, and control of their environment and at the same time make the nurses job easier.
4. Increase the designers senstivity and awarness of how the built environment can affect overall outcomes and patient satisfaction.

Surgery spaces are big energy offenders. Codes allow for setback however they require that pressurization be maintained during turndown. Commercial VAV boxes have shown to be incapable of accurately reducing airflow and maintaining proper set-points over time. Consequently, facility managers are reluctant to turndown critical care areas due to life safety, infection control and health concerns. Explore innovative technologies that will reduce energy consumption and get introduced “Optimizer” a modeling software (free) that will allow you to calculate surgical ventilation costs. We will run multiple scenarios, to help you discover your best energy/monetary savings. Payback and financial analysis will show areas in which to improve energy efficiency, reduce waste and improve Life Cycle Costing so that you may obtain buy-in from your design teams and hospital executives.

LEARNING OBJECTIVES:
1. Overcome Problem Surgical, OR and Ambulatory Spaces That Waste Energy
2. Understand Existing Guidelines Regarding Energy Reduction and Safety
3. Explore Alternative Design Selection Options and Study Case Examples
4. Practice Using Energy Modeling Software To Uncover Waste Reduction Options

A landmark study in patient experience conducted by The Beryl Institute in 2011 showed that hospital noise reduction is the highest patient experience priority in the minds of healthcare executives. However, the study did not ask why noise reduction was such a priority or how hospitals are approaching it. More recently, a subsequent study named The Hospital Noise Project, dove deeper into hospital noise reduction by interviewing leaders from 241 US hospitals via an online survey. They described their approach to noise reduction and reported their level of success. The authors review the study’s results and discuss themes found within the success stories and lessons learned. Participants may undergo a paradigm shift as they realize that the highest level of success was achieved by hospitals that took a holistic approach, used a well-formulated and executed plan and viewed noise reduction as an on-going initiative as opposed to a tactical checklist being addressed as resources permit.

LEARNING OBJECTIVES:
1. Learn how hospitals are approaching noise reduction.
2. Gain valuable insights into hospital noise reduction through success stories and lessons learned.
3. Realize what differentiates those experiencing ‘poor’ success from those experiencing ‘good/great’ success with their noise reduction efforts.
4. Gain a perspective that will make your noise reduction efforts more likely to succeed.

The continuing scientific discovery linking light to human health, disease, and wellness is one of the most exciting stories of the decade. Epigenetic Design is an emerging design practice of creating health promoting built environments that is firmly established on medically relevant knowledge of how genetic expression, physiological, neuro-endocrine, and behavioral response is impacted by built environmental sensory stimuli - primarily that of LIGHT. This three-part series – delivered in the context of cultivating a generative space - bridges the gap between science, medicine, and design by presenting an advanced understanding of the human circadian system and its connection to ambient lighting conditions as primary sensory stimuli capable of direct health impact.

LEARNING OBJECTIVES:
1. Examine the human visual system from the perspective of circadian system response and learn how to differentiate between environmental visual and non-visual stimuli.
2. Discuss how sleep is understood to be linked with our most relevant health concerns and patient co-morbidities and evaluate this knowledge from a design perspective.
3. Discover the design link between ambient environmental conditions and the growing epidemic of obesity, heart disease, depression, and neurodegenerative disease.
4. Evaluate scientific research as to how memory is formulated, processed, consolidated, and stored while uncovering how the design of a space can enhance or hinder this.   

This year, we will talk about how the role continues to evolve as the project moves forward and we will get deeper into the return on investment of the Clinical Liaison role in the project. Since we last spoke, we have started working on the design of the outpatient clinic and logistics buildings, focusing on the future operational workflows. The procurement process has begun, focusing initially on pieces of equipment that have direct impact on the new building construction. The Clinical Liaisons play a central role in specification definition, selection of committee representatives, and serve on some of the evaluation teams. We are in the early stages of preparing for Operational Readiness and we have become deeply involved in various research projects. The Liaison role continues to expand and our responsibilities morph as the program progresses through the construction life cycle. We will continue to share lessons learned along our journey.

LEARNING OBJECTIVES:
1. Understand the role of the Clinical Liaisons
2. Understand role development throughout project life cycle
3. Identify concrete examples of project savings
4. Identify lessons learned

St. Elizabeth’s no-wait Emergency Department represents a new approach to meeting healthcare needs. The ED is integral to Affinity’s patient centered care model, in which its Kaizen team collaborates with architects and contractors to integrate Evidence Based Design, Sustainable Design and Lean Design into every project. The ED includes 48 private rooms, a four-bay infusion suite, and two hyperbaric oxygen chambers. A key component is the Universal Care Platform, in which centrally located flex rooms function as Emergency Department or Surgery Procedure Area depending on scheduling and needs. This presentation looks at Affinity’s integrated project delivery strategy to introduce one of the first Universal Care Platforms nationally. We’ll examine how the team focused on key metrics to achieve increased patient outcome. We’ll specifically examine data from four post-occupancy studies to track success—and offer insight into future approaches to the evolving Universal Care Platform.

LEARNING OBJECTIVES:
1. Learn how a cultural commitment to patient centered care, Lean operations, and sustainability influenced the development of a flexible no-wait ED.
2. Assess how a Universal Care Platform in a no-wait ED maximizes space efficiencies to promote optimal care and streamline processes
3. Evaluate how to build an “IPD-light” team in which the stakeholders share goals for innovation and patient service.
4. Review results from post-occupancy studies to evaluate impact of Evidence Based Design on healthcare planning and patient outcomes.

Hospital design continues to evolve to meet the higher standards of patient centered care, lean operations, and sustainability. This presentation, will cover the design process and strategies that test best practices in hospital design largely accepted by the HC design community today. The presentation will follow the design of the Rust Medical Center, a 96 bed phase 1, Master Planned for 300 bed, full service acute care hospital from visioning to completion and one year of operation. We will summarize the client’s goals and ideas learned through visits of recent, innovative hospitals, review the specific strategies ultimately employed in the hospital design, and evaluate how the ideas are working to meet the client's vision. A key focus will be on the design and performance of the patient care unit where our analysis shows the patent care unit strategy saves a nurse over 150 miles per year of walking resulting in a significant increase in face to face time with patients.

LEARNING OBJECTIVES:
1. Learn what evidence based design strategies were used to improve the healing process, reduce staff stress, and improve patient satisfaction
2. Learn about tools and methods for user input and evaluation of design alternatives
3. Learn about specific hospital design solutions in the improvement of health care outcomes
4. Lean about the issues in the design of operationally efficient and flexible patient care units

P3’s (Public Private Partnerships) are coming to a project near you! They are seeing increased use in the delivery of infrastructure including Healthcare facilities in Canada and around the world. They have existed for years as PFI’s in the UK & Australia, and are starting to appear in the USA. They often include the maintenance and operation of the facility for 30 years after construction. This discussion forum will be led by 4 key participants in any P3 project; owner, architect, financial advisor and design-builder. They will share experience gained on the $472 million P3 project for the Interior Health Authority in Kelowna and Vernon, BC Canada. Raber of Stantec Architecture, Malanowich of Interior Health, Corcoran of Graham Construction and Prokhoroff of PWC will talk about the opportunities and challenges, benefits and risks related to P3s, and suggest why a P3 model, properly executed could be a viable alternative to more conventional project delivery models for successfully delivering your next project.

LEARNING OBJECTIVES:
1. Learn about P3’s (Public Private Partnerships) as a project delivery model, and why they are becoming the choice on many capital projects.
2. Discuss the new roles that owners, healthcare providers, architects and design-builders have to play in this delivery model.
3. Discuss your fears and the unknown around  the pros and cons to decide if a P3 is in your future.
4. Hear first-hand some of the cost benefits that can come with P3’s.  

Three years ago, Holy Cross Hospital in Silver Spring, Maryland, was in the process of developing a Certificate of Need (CON) for a new patient tower on its existing campus. At the same time, they also decided to pursue CON for a brand new hospital in Germantown, Maryland, an under-served market 20 miles away. The project team was developing a building concept that met the system’s needs when the economy crashed and plans for the new hospital stalled; yet the team, determined to move forward, stayed on track. Working for two years, this extreme team identified a way to leverage buying power, reduce the budget and right-size the project to produce a design that far exceeded the client’s new vision for a highest value–lowest cost hospital. In spite of a weakening economy, a CON battle and an uncertain outcome, the team pulled out all the stops and was able to develop a great plan that was efficient and affordable.

LEARNING OBJECTIVES:
1. Learn how a team focused on flexibility and speed to market switched gears midstream to deliver highest value for lowest cost.
2. Understand how collaboration and determination can be capitalized to reduce waste, streamline design and produce efficiency.
3. Explore how to leverage buying power to reduce capital cost.
4. Evaluate lessons learned from committing two years to resuscitate a project.

All healthcare facility managers are faced with the problem of reduced capital, unfunded government mandates, and diminished funds. But while the availability of funding has been reduced, the need for maintenance and keeping systems in prime condition has not decreased. An Existing Building Commissioning (EBCx) Program can bring quick wins for the facility to improve energy and facility performance on a relatively small budget. An interactive discussion guided by a facility manager and two nationally recognized commissioning professionals will focus on physical, practical, and financial aspects of EBCx for energy savings and optimal operation. A synopsis presentation of the Building Commissioning Association (BCA) EBCx roadmap will be presented along with examples from recent projects that show how a methodical process can bring quick wins. The speakers will walk through how to create the best ROI model to obtain capital and provide tips and tricks and pitfalls to avoid.

LEARNING OBJECTIVES:
1. Learn how and see examples of how to build a viable roadmap in your facility for EBCx and sell it to the C-Suite.
2. Gain an understanding of the BCA EBCx process.
3. Learn how to create the right EBCx team to forge sustainable success.
4. Learn how to generate your EBCx story so that it has high impact to the CFO.

Hackensack University Medical Center, Cipher Systems and Health Risk Technologies, Inc. have teamed up to create a fleet of mobile rapid response vehicles designed to respond to mass casualty incidents. This session focuses on challenges and lessons learned in designing, building, operationalizing, and sustaining advanced mobile response capabilities for the purposes of disaster response and emergency preparedness. The New Jersey – Mobile Satellite Emergency Department (NJ-MSED) is made up of two state-of-the-art mobile emergency rooms, an advanced mobile surgical unit, and novel communications capabilities that extend hospital level readiness and increase field-level mobility and expediency. In addition to the disaster response, these assets are perfectly suited for extending advanced care to rural communities, relieving hospital surge, short-term and long-term supplemental ER/OR space during hospital renovations, and preplanned events such as concerts, sporting events, etc.

LEARNING OBJECTIVES:
1. Building a state-of-the-art medical operation to rapidly respond to regional disasters
2. How new communication technologies can transform and elevate a mobile hospital
3. Training and staffing the New Jersey – Mobile Satellite Emergency Department (NJ-MSED)
4. Bringing a Mobile Rapid Response Program on the road: case studies and future plans.

Creating ‘A Place to Flourish’ is an aspiration of all good and effective companies. It is a specific challenge to all healthcare provider organizations. Healthcare requires and demands that the physical space supports the therapeutic endeavors of all medical and caring staff, and the nurturing support of families and friends. Generative Space offers a powerful way of understanding how to think beyond the design of the built environment to create the capacity for expanding the impact of the physical space by better integrating how people actually work and live within the physical space. Despite the best intentions of architects, designers, planners and facilities managers, so often the experience of working, and living, within the building falls short of the aspirations of all. Many of the lessons from the discipline of ‘change management’ could help make a powerful difference to the outcomes of all those seeking to create: ‘A Place to Flourish’ for the design community, for healthcare staff, for patients and for communities – for all who depend on the resources these environments offer.

LEARNING OBJECTIVES:
1. Understand design as a change management  issue
2. Identify strategies for creating more sustainable design outcomes with Generative Space  
3. Become more effective in creating Generative Space with change management principles
4. Review your capacity to create ‘A Place to Flourish’ in your work and for your clients.

The current care delivery system is based on early 20th century push manufacturing ideas, which optimized the pieces. But "push" adds significantly to movement of patients and staff. This presentation looks at pull systems of care and applying advanced lean principles to care delivery processes and the facilities that house those processes. These Advanced Lean Principles include: o Building outcomes based integrated care teams® o Basing system configurations on value as defined by patients o Simplifying the building solution o Facilitating transformational changes in organizational cultures Understanding the Transformational Potential: o Better than 40% fewer staff required to produce patient outcomes o Greatly improved outcomes with a zero tolerance for errors (HAI, medication errors, patient falls...) o Facilities that are at least 30% smaller for equivalent care delivery capacities o Buildings that are 35% faster to market o Construction costs that are 25% less per unit area.

LEARNING OBJECTIVES:
1. The impacts of "push" on 8 wastes in healthcare delivery
2. Understanding pull as it relates to facility planning and design
3. Utilizing 3P workshops to facilitate cultural transformation in conjunction with facility design
4. Metrics are everything! What should we measure and why

The Vanderbilt Program in Interprofessional Learning (VPIL) is a collaborative educational program between Vanderbilt University’s Schools of Medicine and Nursing, Belmont and Lipscomb Colleges of Pharmacy, and Tennessee State University’s Master of Social Work program. We are completing our second year of implementation. Beginning in 2010, interprofessional teams consisting of medical, advanced practice nursing, pharmacy and social work students were placed in ambulatory clinic settings one half-day a week to work and learn throughout the duration of their degree programs.

As a capstone to their two-year interprofessional education experience, student teams were challenged to design new health care delivery spaces and processes that focus on patient needs, interprofessional team-based care and workplace learning. Young healthcare Architects from nationally recognized firms (Earl Swensson Associates, Inc.; Gould Turner Group; Gresham Smith and Partners; and Thomas, Miller & Partners, PLLC) joined the student teams to collaborate on innovative solutions that consider the following principles:

• All workers learn and all learners work. How will your solution support learning and learners in the clinic environment?
• Continuous quality improvement to meet the highest level of patient safety is an expectation. How does your solution support quality improvement and what considerations have you included in the design to accommodate future changes in process, people and/or technology?
• Interprofessional care delivery. How will your solution support the interprofessional care of patients, and support all staff that work together to care for patients?
• Patient as part of the team. How does your solution support the best communication for the best care?

These presentations included an executive summary and a jury presentation to a multidisciplinary team of jurors. This session will review and critique those student presentations and the jury comments.

LEARNING OBJECTIVES:
1. Pros and cons of four different design solutions for Interprofessional Care delivery
2. Learn how interprofessional design reinforces continuous learning and quality improvement.
3. Learn how interprofessional care reinforces and extends “patient center care”. Empowering patients to be advocates for their own health.
4. Learn how interprofessional care aligns with ACO’s and the Accountable Care Act

Healthcare infrastructure is one of six distinct domains that comprise the Department of Defense’s (DoD) objective to achieve World Class Healthcare Facility standards. While the MHS annually spends billions on the planning, design, construction and operation of its extensive medical facility infrastructure, no focused organization or platform exists to coordinate, conduct, and contain research on improving the return on investment. The MHS has embarked on developing a platform that synchronizes and coordinates studies as they relate to the built environment. The expected outcomes include (1) optimizing research efforts across the Services, (2) making research efforts collaborative and transparent, (3) avoiding redundancy and waste, (4) allowing sharing of best practice findings, and (5) ensuring that research is conducted with a high level of discipline and rigor. This session will present the experiences of MHS, HKS Architects, and CADRE towards development of such a platform.

LEARNING OBJECTIVES:
1. Understand the key challenges within the MHS that prompted the establishment of an innovation and research platform.
2. Understand the critical role that ‘soldiers’ readiness’ plays in driving innovation and research.
3. Explore the various tools that will enable research in MHS.
4. Examine the key tools and processes being considered to coordinate and foster innovation across MHS facilities that are spread out across the globe.

When Rush University Medical Center engaged Perkins+Will in 2006 to plan and design their new 1,000,000-square-foot medical campus, addressing the scale and complexity of the project required innovative and deeply collaborative methods. Rush’s vision of building a campus around an improved patient and family experience fostered an “inside-out” approach, starting with the immersion of a dedicated design team (including hospital leadership and construction management) on campus to work directly alongside doctors and staff who both figuratively and literally helped shape the future configuration of the new hospital and campus. The resulting plan achieves a new level of user friendliness, sustainability and operational efficiency. Owner and design team representatives will discuss in detail how the architectural evolution of this medical campus has reinvigorated the culture of clinical excellence and patient care at Rush.

LEARNING OBJECTIVES: 
1. Learn how the team implemented interventional platform design and the value that brought to reorienting its facilities and campus around the patient.
2. Learn how checks and balances in the team’s decision-making process led to culture-changing sustainable design solutions.
3. Explore the advantages of colocating architects, designers, engineers and construction management at the project site.
4. Learn how an $800 million project budget was implemented under a fast track approach over a five-year timeline without increases.

Many hospitals are aging, but a new campus isn’t feasible–especially in urban areas. Our case study focuses on innovative design solutions employed so an urban hospital could expand its clinical programs…without building a new facility. Focus will be on sustainability, reuse, linkages, design and setting. Lillibridge Healthcare Services and Lawrence Hospital Center are working on a $28.5M project to open in 2013. The 42,000 sf project is relatively small, but impact on the hospital is large. A new addition will enable Lawrence to better serve its community with much needed state of the art cancer services, ORs, and many other amenities. It will also dramatically impact its physician alignment / recruitment capabilities. We’ll address how the owner, developer, architect and engineer collaborated on complicated issues so the project could move forward. This project is very “green” in more ways than one–it preserves hospital funds and features many attractive, sustainable solutions.

LEARNING OBJECTIVES:
1. ASSESSING THE PROBLEM – how to view a complex facility challenge in a new light. Challenging traditional paradigms to solve intractable issues.
2. EXECUTING SOLUTIONS – unique design solutions / sustainability in tight urban setting enhanced project feasibility-economically and programmatically.
3. MEASURING THE IMPACT – owner’s perspective of the integrated design process and potential benefits the project will bring to the Hospital.
4.ALIGNING INTERESTS - how project dramatically impacts hospital's physician alignment / recruitment capabilities.

The central plant is as the “heart” of a hospital, the infrastructure that keeps the hospital operational and provides the safety backup. Many aging hospitals face the challenge of relocating their central plants to support campus growth. This session will feature members of the Palos Community Hospital team who will share lessons learned from a recent multi-phased central plant relocation and bed tower addition. The team will share how the collaborative team approach was utilized and played into the success of the project. The panel will discuss the design and coordination approach to account for the countless shutdowns, changeovers, and integration required to keep the hospital operational at all times. The purpose of this presentation will be to explore the advance planning and preparation utilized during design and how the preparation overcame the challenges of maintaining a complex facility of this type in operation while upgrading all major infrastructure components.

LEARNING OBJECTIVES:
1. Convey the process and key considerations regarding replacement of the campus infrastructure.
2. Explore the collaborative approach utilized in the planning and delivery that led to a successful project.
3. Share lessons learned about the phasing plans, backup plans, and how some unforeseen conditions were overcame.
4. Explain the testing process utilized to assure the systems are ready to be put into service.

Ergonomics, the 'science of work', blends art and science to optimize how people successfully interact with products in places. This is especially relevant to healthcare settings where professionals must maintain a high level of performance, where errors can prove fatal, and where the quality of the patient experience is of paramount importance. Ergonomics informs the design process so that products and places better fit human needs. Like generative space, and of necessity, ergonomics is a process of continual evaluation and evolution as people, products, practices and places change over time. The goal of generative space is the creation of places that grow, change, and flourish over time and ergonomics can play a synergistic role in facilitating this process. This presentation will examine the benefits that ergonomics can bring to the generative space design process.

LEARNING OBJECTIVES:
1.  Become familiar with the concepts of ergonomics, as these relate to designing generative spaces that promote physical and psychological health.
2.  Become familiar with the need to consider ergonomic design solutions for various  users in a healthcare setting.
3.  Develop an awareness of the impact of technology on users in generative spaces.
4.  Gain knowledge of the current empirical research on healthcare ergonomic design  factors that promote and foster health.

What do you get when you combine a progressive Russian hospital with an international hospital operator and an American architecture firm? Answer…an excellent case study on how to plan and design a hospital that is responsive to healthcare reform, local demands, and medical tourism all at the same time. During this session, presenters will provide an overview of healthcare reform in Russia and provide insight into the development of the business plan, implementation strategy, and physician and nurse training/continuing education programs. We will explore regional healthcare indicators affecting the business plan and the facility program. The project is a US-standard, JCI-certified hospital. The session will address cultural, financial, operational and architectural aspects of the project.

LEARNING OBJECTIVES:
1. Summarize the current Healthcare Industry in Russia
2. Assess medical tourism opportunities for RAMC
3. Describe key operations and management strategies
4. Explain the planning and design process for developing RAMC

TRI is a merger of 5 rehab centres, providing specialized rehab care. It is next door to the Research Discovery District, University of Toronto and 4 major tertiary acute care hospitals, ideal to support TRI’s vision of providing an excellent continuum of care with integrated research and teaching programs. The redevelopment is concentrated in a new 16 storey wing - 7 floors of inpatient beds, 5 research floors, 2 outpatient clinic floors and 2 floors of support /mechanical space. The existing floors were also renovated to support similar functions. Accessibility strategies were developed where existing infrastructure were restrictive, looking beyond conventional guidelines to develop super accessible solutions. Roof top gardens respond to clients with recreational needs and those with dementia. The new tower including the iDAPT research lab and simulator suite has now been occupied for a year supporting TRI’s goal for exemplarily patient care and integrated research and teaching.

LEARNING OBJECTIVES:
1. Learn about the roles architects, end users, engineers, suppliers, and manufacturers play in bringing unique research facilities.
2. Discover the design process required to capture the unique accessibility needs of patients and staff.
3. Understand the technical and physical challenges to accommodate the iDAPT simulator within the confines of a tight urban site.
4. See some design solutions to enhance the patient experience in a longer length of stay facility.

Current inpatient psychiatric care models are outdated. They were developed between 1960 and 1970 when the severity of illness for patients was much lower and lengths of stay were much longer. But today, more than 25% of the US adult population is diagnosed with one or more mental disorders in any given year, we treat more acutely ill patients requiring one-on-one staffing, severely ill patients are more intensively monitored, care is provided in shorter periods of time, and patients must be effectively prepared for their transition to outpatient care and ensured seamless transition back into their communities.  The model of care has been changed, but existing physical environment has not answered the clinical reality. This report explains how HOK designed a new Stone Institute of Psychiatry creating a new paradigm of inpatient psychiatric care model in highly urban downtown Chicago. The firm also measured and documented outcomes in a post occupancy evaluation research.

LEARNING OBJECTIVES:
1. Model of life care - integration of clinical neuroscience research into effective care assuring patients faster re-integration back into society
2. Dignity, privacy and safety - a "home and neighborhood" concept where the focus is on restoring normal psychology and patterns of physical behavior
3. Dignity, privacy and safety - "on-stage/off-stage” concept: transparent, but effective operational and functional security separation zones developed.
4. Measured and documented outcomes: Patient throughput and attention by track; LOS; Occupancy by zone; Staff utilization; 50+ other tracks

The Federal Housing Administration (FHA) helps hospitals nationwide access affordable, fixed-rated financing for capital projects and refinancing. FHA mortgage insurance enables hospitals to enhance their creditworthiness because their debt is backed by the United States Government. This session will cover how a Hospital can secure a AA/AAA Credit rating for their new construction project by partnering with the Federal Housing Administration. After completing the session participants will be able to determine: whether their facility would be eligible for FHA 242 Mortgage Insurance, how to start pursuing financing with FHA Mortgage Insurance, and what to expect during the financing and construction of the new project with FHA Mortgage Insurance.

LEARNING OBJECTIVES:
1. Learn how FHA Mortgage Insurance can help lower the cost of capital for Hospitals looking to finance new construction projects.
2. Determine whether a hospital would be eligible for FHA Mortgage Insurance.
3. Discover how to get started in obtain financing for a new hospital construction project with FHA Mortgage Insurance.
4. Decide whether FHA Mortgage Insurance is the right fit for financing a Hospital's new construction project.

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 Netherland's 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.  

New government regulations require implementation of Electronic Medical Record keeping to achieve “meaningful use.”  While every department and every professional in the hospital will feel the effect of EMR roll-out, one area of significant impact is nursing.

We know that much of the information captured in a patient’s medical record is generated by medical devices.  Today, nurse call and similar bedside systems have evolved to play a central role in monitoring patient safety and tracking care activities while capturing, managing, and displaying information related to direct patient care.

Integrating multiple technologies at the bedside to achieve true interoperability has become a necessary element of successful EMR roll-out.

LEARNING OBJECTIVES:
1. Review recent advancement in bedside medical technology – both equipment and IT
2. Identify the types of information and captured in the medical record – how generated, where and how captured in the record
3. Assess physical, operational, privacy and safety challenges typically faced in both newer and older facilities
4. Evaluate the impact of technology and EMR integration on nursing workflow 

Our team will present solutions realized; efficiencies gained and measured results from the effort of merging both Facilities Management with computer Building Information Modeling (BIM). We will show the impact of this effort dove-tailed into the day to day operations. For example, Work Order turnaround and Joint Commission regulatory requirements can be linked into one platform. This same platform can also track maintenance schedules and replacement costs. Ultimately, technology has evolved to allow all of these many complex systems and tracking programs to be merged into one single database. Ridgeview Medical Center in Waconia, MN serves as our case study. We will show the many hours of time this effort has saved from the doing things “the old way” vs. “new way”. Our upcoming elections in November are certain to bring more change to healthcare. How ready is your facility to adapt to change? Do you want to lower your operational costs? Are you being asked to do more with less?

LEARNING OBJECTIVES:
1. Are you being asked to do more with less? We will show you how a single BIM model can provide a means to track multiple complex systems
2. Are you swamped with an immense load of Work Orders? We will show the results of time saved by using a single BIM model.
3. Do you manage tenant leases along with owner occupied space? Todd will share his lessons learned from using a single BIM model.
4. Mechanical systems demand proper function for customer satisfaction. We will demonstrate a trouble-shooting scenario calculating efficiencies.

Over ten years of planning and coordinated teamwork went into the design and construction of St. Mary’s Good Samaritan Regional Hospital in Mt. Vernon, IL. During the project’s journey a number of innovations and techniques developed that saved the client money and made the facility more efficient. The team has used a paperless workflow for the duration of the project, relying on electronic documentation tools to save the client on costs and time, while providing real time project data. The construction site resembled a mission control center with multiple big screen TV’s and computers in use to display project information, making it easy to find and present pertinent data efficiently. The design team also ushered in environmental stewardship to the facility, resulting in Energy Star and Green Guide for Healthcare recognition. This presentation will showcase a client and project team’s coordinated effort to deliver a more efficient facility for the client and their future patients.

 LEARNING OBJECTIVES:
1. Discover what innovations resulted from the project and benefitted the management of the facility.
2. Understand the necessary steps and procedures to design and construct an Energy Star and Green Guide listed hospital.
3. Identify the lean construction techniques that were used to deliver the project on time and on budget.
4. Recognize the elements and conditions of the cohesive relationship among the team members that lead to a successful project.

Construction of the $480 million James Cancer Hospital and Solove Research Institute at The Ohio State University is on track to meet its scheduled 2014 opening. The 20-story, 1.1 million-sq.-ft building will be one of the 15 tallest hospitals in the US. In early 2011, OSU added a radiation oncology treatment center to the scope of the project to utilize a $100 million dollar donation. This new second story floor, with its heavy, vibration-sensitive equipment and shielding requirements, changed the structural design of the building significantly. Since the original structural steel package had already been ordered and partially fabricated, the challenge was to salvage as much steel as possible into the structural redesign. The structural engineer, Thornton Tomasetti, collaborated directly with the structural steel fabricator, Cives Steel Company, to reuse over 90% of the original steel beams and columns into the new design. The redesign and re-fabrication was completed in 6 months.

LEARNING OBJECTIVES:
1. Observe how collaboration between the structural engineer and the steel fabricator can contribute to project success.
2. Evaluate how project design and construction teams can successfully manage large programming changes through intense communication and collaboration.
3. Discover best practices and lessons learned to address major additions to the building structure during construction
4. Learn the advantages of building with steel – flexibility to change, fast schedule, offsite fabrication, low cost, and efficient framing systems.

The project team for the redesign of Loyola University Medical Center’s Emergency Department was given one mission by its generous donor: make a visible difference to improve the patient and staff experience. The Hospital turned to Lean methodologies to achieve this mission and provide the best care possible for their patients. They engaged their front line staff, their Operational Excellence group, and a design/build team led by Walsh Construction. The process produced dramatic results including reduced travel time of staff by 60%, increased overall efficiency of the unit by 38%, and increased the ED capacity without increasing the number of patient care areas. Through continued partnership with Walsh Construction in a Lean Construction and Design Build environment the project was able to accelerate the project schedule and reduce costs. But most importantly, it gives the Emergency Department patients what they deserve: the best and most efficient care that can be provided.

LEARNING OBJECTIVES:
1. Find out how Loyola Medical implemented a consistent process to measure and promote progress.
2. Take home ideas and knowledge to empower staff to drastically improve and standardize their work processes.
3. Hear how Lean Methodologies transformed the Loyola University Medical Center Emergency Department.
4. Learn how to reduce project costs and accelerates project schedule through Lean Construction.

It might sound a bit corny but using suites in your health care facility is really sweet. The requirements for suites have been very mystifying in the past due to lack of clarity in code language and a lack of understanding. Once facility managers and designers realize how the application of suite requirements can help them provide a more operationally friendly space for the facility staff they are sold on the usefulness of these requirements. This presentation will provide an overview of how suite requirements have evolved over the years and how they can be applied to a wide variety of applications for existing facilities and new designs. In addition, the common mistakes and misconceptions for applying suite requirements will be reviewed. Finally, some of the common compliance and operational issues that can be remedied by applying suite requirements to a space will be discussed, including The Joint Commission (TJC) and Centers for Medicare/Medicaid Services Standards (CMS).

LEARNING OBJECTIVES:
1. Participants will be able to distinguish the difference between the three health care suite types.
2. Participants will be able to list the common issues that suite application will remedy.
3. Participants will be able to determine the limitations for suite application.
4. Participants will be able to apply suite requirements to their facility or design.

Healthcare leaders and planners are facing numerous challenges to their budgets and operations such as: • Healthcare reform • Silo departments • Space restrictions • Over-taxed Trauma Centers • Reduced capital budgets • Mergers acquisitions and take-overs Given these challenges many providers are re-tuning their long term strategic and master plans with a new focus on efficiency and performance not just in the clinical sense but in their overall logistics and operations. Planners are being tasked with finding solutions that deliver long-term value to providers. This presentation illustrates new methodologies practices and approaches used to deliver the “value” solutions providers are seeking. Simulation modeling lean and automation will be presented as just a few of the ideas which can be leveraged to achieve a high performance hospital. The $1-billion dollar transformation program at Rush University Medical Center in Chicago will be presented as a successful example.

LEARNING OBJECTIVES:
1. Learn to strategize, plan, integrate, and design logistics and operational needs to deliver over the long term a high performance healthcare facility.
2. Measure and evaluate the results, value, and performance received from various solutions.
3. Explore how new trends, best practices, and approaches can be used to plan a high performance hospital, and how they differ from traditional practices
4. Asses, build, and balance goals with available resources.

The continuing scientific discovery linking light to human health, disease, and wellness is one of the most exciting stories of the decade. Epigenetic Design is an emerging design practice of creating health promoting built environments that is firmly established on medically relevant knowledge of how genetic expression, physiological, neuroendocrine, and behavioral response is impacted by built environmental sensory stimuli - primarily that of LIGHT. This three-part series – delivered in the context of cultivating a generative space - bridges the gap between science, medicine, and design by presenting an advanced understanding of the human circadian system and its connection to ambient lighting conditions as primary sensory stimuli capable of direct health impact.

LEARNING OBJECTIVES:
1. Evaluate from a neurophysiological perspective why view, pattern, shape, and form determine successful wayfinding and outcomes while uncovering how to apply this design knowledge predicated on occupant age and health status.
2. Examine how the body’s pain and immune systems work together with environmental stimuli to enhance the wound healing pathway while discovering how the correct architectural light dosing protocol may improve LOS outcomes and reduce the need for pain meds.
3. Review the current economic healthcare burden and related costs assigned to lost productivity, employee errors, and patient safety as they related to fatigue and insomnia and discover how circadian correct lighting protocols may play a role in reducing those costs.  
4. Learn how to integrate the design approach of ‘generative space’ into the healthcare environment while utilizing epigenetic design techniques and evidence based design criteria. 

Would you believe that in the last 5 years an 89-bed “community” hospital, which grew to 120 beds, wins 6 prestigious quality awards including 3 as a Top 50 or Top 100 Cardiovascular Hospital? Not your ordinary community hospital! There are many success stories to be told about Saint Joseph London, but this one will focus on the lessons learned to build a new greenfield hospital to replace an old tired hospital. On August 19, 2010, seven years after starting this process, Saint Joseph London opened a new $152 million, 345,000 square-foot regional facility that featured the latest technology, 120 private rooms complete with room service, outpatient diagnostic services in one convenient location, whirlpool tubs in all labor delivery rooms, and a faith-based healing environment with a pond and garden on a 52-acre campus. And it is already expanding! This session will tell the story from start to after opening and highlight lessons learned that we would do different the next time.

LEARNING OBJECTIVES:
1. Identify best ways to organize a project and maintain continuity when staff changes to prevent common process and organization mistakes.
2. Use design and way-finding to maximize flexibility, provide efficient operations and improve patient satisfaction and identify improvements.
3. Recognize common detail and building component mistakes to prevent these in future design and construction.
4. Create a checklist of 20 frequent mistakes and process weaknesses that can be applied in all design and construction projects.

When Spectrum Health a non-profit, award winning US top 10 health system bolstered its physician network by acquiring several large medical groups in 2009 it desired a new outpatient facility model; one that responded to market volatility, expressed its mission and established a new standard for programmability. Key team members will share how they used planning principles to remove architectural and physical obstacles and how they identified and quantified optimal patient/staff environments.

LEARNING OBJECTIVES:
1. Recognize how to integrate various disciplines and initiatives into a balanced symbiotic solution, utilizing the Spectrum Facility Assessment Tool.
2. Utilize research data and behavioral influences that positively affect the individual patient and clinical team to create an optimal design.
3. Identify and utilize unique planning principles to craft an underlying modularity that aids in planning a flexible, responsive building.
4. Develop a building shell and deploy building systems to create an unparalleled level of programmability in an outpatient setting.

The purpose of this presentation is to share how Advocate Health Care, through a consistent system-wide approach, has streamlined the EOC rounding process and corresponding knowledge sharing on all its ten hospital campuses. This highly integrated approach utilizes web-based and mobile technology databases, combined with a streamlined approach to the EOC rounding process and zone definition.  The consistent system-wide approach enables the sharing of best practices and allows for the trending and analysis of data at a site and system level.  The web-based technology has enabled Advocate to make data driven decisions such as system-wide computer based training for contractors and the standardization of policies across the system.

LEARNING OBJECTIVES:
1. How to transform an EOC rounding solution into a business tool to manage risk, add transparency, reinforce accountability, and increase operations efficiency.
2. How a properly structured EOC solution can effectively interface with other critical functions including: life safety management, preconstruction risk assessment, and hospitals’ maintenance management process.
3. How an effectively implemented EOC program can become a trending and benchmarking tool for senior management.
4. How web and mobile technologies that are customized based on hospital’s objectives, can increase the communication among responsible departments involved with the EOC process.

The MODA Project, a new medical city for the Ministry of Defense and Aviation – Saudi Arabia, is a 7200-Bed Specialty Hospital Campus being designed on a four and one half square mile site north of Riyadh. The Project, envisioned over four phases with significant future considerations, will provide Saudi Arabia with one of the most advanced medical treatment and education campuses in the world, supporting both inpatient and outpatient services in a chain of individual components such as medical/surgical/trauma, pediatrics, neurology and orthopedics. The campus will include medical services, a health sciences university and housing/retail for over 50,000 people. The challenge: How to develop a mega-campus on a desert site to handle the shear volume of users that this type of complex will generate, all the while providing world-class service, security, education and sustainability. The result is a combination of the best medical design combined with new urban planning concepts.

LEARNING OBJECTIVES:
1. Discuss the urban plan for the complex, outlining our methodology for calculating user impact and our interpretation of the client’s goals.
2. Discuss transforming an existing operational system into a specialty-driven model of care while integrating sub-specialties with academic goals.
3. Discuss the strategy for medical planning and incorporation of the patient experience in 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.