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8/4/16 1 #HFSE Development of an Integrated Platform: Vision to Start of Construction September 20, 2016 1:00 PM – 2:15 PM #HFSE SPEAKERS John Balzer, Vice President, Facility Planning & Development, Froedtert Health Jeff Gruhn General Manager – Healthcare Mortenson Construction Kevin Matuszewski, Senior Vice President, Project Director CannonDesign Todd Accardi, Vice President, Senior Medical Planner CannonDesign

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Page 1: Development of an Integrated Platform: Vision to Start of ... · 1. Understand how a healthcare system can create an integrated platform using the Froedtert & the Medical College

8/4/16

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#HFSE

DevelopmentofanIntegratedPlatform:VisiontoStartofConstructionSeptember20,20161:00PM– 2:15PM

#HFSE

SPEAKERSJohnBalzer,VicePresident,FacilityPlanning&Development,FroedtertHealth

JeffGruhnGeneralManager–HealthcareMortensonConstruction

KevinMatuszewski,SeniorVicePresident,ProjectDirectorCannonDesign

ToddAccardi,VicePresident,SeniorMedicalPlannerCannonDesign

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#HFSE

LEARNINGOBJECTIVES1. Understandhowahealthcaresystemcancreateanintegrated

platformusingtheFroedtert&theMedicalCollegeofWisconsinIntegratedSurgicalandInterventionalPlatformprojectasacasestudy

2. Outlinetheplanningandpredesignprocesstodeterminehowanintegratedplatformcanberealized

3. Discussorganizationalstructuretodeveloptheplatform,gainconsensus,andmaketimelydecisions

4. Exploreintegrationofprojectpartnerstomanagephasingandcostcontrol

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#HFSE

Mission

Froedtert&theMedicalCollegeofWisconsinadvancethehealthofthecommunitiesweservethroughexceptionalcareenhancedbyinnovationanddiscovery.

Vision

Froedtert&theMedicalCollegeofWisconsinwillbetheregion’spremierhealthsystembydemonstratingsuperiorvaluethroughanacademic-communitypartnershipandaligninghealthcaredeliveryacrosstheregion.

SharedMissionandVision

5

Froedtert&MCWStrategicPlan

HealthCareDeliverySystem:AcuteCareHospitals

CommunityMemorialHospital

ACADEMIC COMMUNITYHOSPITALDIVISION

St.Joseph’sHospitalFroedtertHospital

6

StaffedbyMedicalCollegePhysicians

LicensedBeds 655StaffedBeds 536

FY2016NetPatientRevenue* $1.411B

FY2016InpatientDischarges* 27,230FY2016OutpatientVisits* 789,197

TotalMedica lStaff 858Board-Certif ied 774

LicensedBeds 235StaffedBeds 202

FY2016NetPatientRevenue* $191M

FY2016InpatientDischarges* 8,615FY2016OutpatientVisits* 89,551

TotalMedica lStaff 148Board-Certif ied 140

LicensedBeds 106StaffedBeds 78

FY2016NetPatientRevenue* $139M

FY2016InpatientDischarges* 3,804FY2016OutpatientVisits* 87,214

TotalMedica lStaff 81Board-Certif ied 76

Sources :FMLH,CMH, SJHConsolidated FinancialStatements*FY2016totals reflectFY2016Juneunaudited totals

ProfileofHealthNetwork

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ProfileofHealthNetwork

Froedtert&MCW Community Physicians

HealthCenters andClinics 27

Physicians 350+

FY2016Office Visits* 776,089

FY2016NetPatientRevenue* $205M

HealthCareDeliverySystem:Froedtert&MCWCommunityPhysicians

7

Froedtert&MCWCommunity Physicians HealthCenters1.CentralWaukeshaHealthClinic 15.NorthH ills HealthCenter2.FastCare- SussexMeijer 16.Orthopedic,Sports andSpineCenter3.GermantownHealthCenter 17.SargeantHealthCenter4.GreendaleHealthCenter 18.St.Joseph's HealthCenter5.GreenfieldH ighlandsHealthCenter 19.SpineCareClinic–Oconomowoc6.HartfordHealthCenter 20.SpringdaleHealthCenter7.HeartandVascularCenteratCMH 21.SunnyslopeHealthCenter8.JacksonHealthCenter 22.SussexHealthCenter9.JacksonRehabilitationandSports MedicineCenter 23.TosaHealthCenter(PlankRoadClinic)10.KewaskumHealthCenter 24.TownHallHealthCenter11.OB/GYNLifeTimeOB/GYN- Brookfield 25.WestBendHealthCenter12.OB/GYNLifeTimeOB/GYN-Milwaukee 26.WestBendRehabilitationandSports MedicineCenter13.LincolnAvenueHealthCenter 27.WestbrookHealthCenter14.MoorlandReserveHealthCenter

CPlocations showninboldtexthavebeenrecognizedasLevel3(highest)Patient-CenteredMedicalHomes ,basedonNationalCommitteeforQualityAssurance2014s tandards

Moorland ReserveHealthCenterNorth H ills HealthCenter GreenfieldH ighlands HealthCenter TownHallHealthCenter

Sources :CPConsolidatedFinancialStatement*FY2016totals reflectFY2016Juneunaudited totals

ProfileofHealthNetworkHealthCareDeliverySystem:Alternative Sites

8

MEIJER FASTCARECLINICSThe Froedtert&MCWhealthnetworkisMeijer’s exclusive healthsystempartnerforin-storemedicalclinicsinselectedMeijer storeslocatedin11Wisconsincounties.Oneclinic(Sussex) openedonJune7,2016,whileasecondclinic(Waukesha) openedonAugust2,2016.Twoadditionalclinicsarescheduledtoopenin2017.Theclinicswillprovideeasyaccesstoaffordablecareformanyminorhealthproblemssuchascoldandf lusymptoms,sorethroats,andear,sinusandbladderinfections.TheclinicswillbestaffedbyFroedtert&MCW nursepractitionersandphysicianassistants.

WORKFORCEHEALTH EMPLOYER CLINICS

WithplanstoopensixormoreclinicsinFY2017andbegintoincorporatevirtualvisitcapabilityintoemployerofferings,Froedtert&MCW currentlyoperatesatotalof thirteenworkplacecliniclocationsthroughoutsoutheastWisconsin

• 4 internalworkplaceclinics

• 5 workplaceclinics

• 1 wellnesscenter

• 1 occupationalmedicineclinic

• 2 Meijer FastCare Clinicsites

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ProfileofHealthNetwork

• Anesthesiology

• Emergency Medicine

• Radiology

• RadiationOncology

• Pathology

HealthCareDeliverySystem:MedicalCollegePhysicians

MedicalCollege Physicians

Clinical, Medical,andProcedural Departments 19

Providers (ClinicalMCPphys icians andAPPs only) 1,171

FY2016Office Visits (MCWproviders ) 864,431

FY2016NetPatientRevenue* $370M

• Medicine- Cardiology- Endocrinology- Gastrointestinal- Geriatrics- Hematology/Oncology- Infectious Disease- Internal Medicine- Nephrology- Pulmonary- Rheumatology

• Dermatology

• Family andCommunityMedicine

• ObstetricsandGynecology

• PhysicalMedicine andRehabilitation

• PsychiatryandBehavioralMedicine

• Neurology

• Neurosurgery

• Ophthalmology

• OrthopaedicSurgery

• OtolaryngologyandCommunicationSciences

• PlasticSurgery

• Urology

• Surgery- Cardiothoracic- Colorectal- General- Oncology- Transplant- Trauma- Vascular

MedicalDepartments Clinical Departments ProceduralDepartments

• MedicalCollegePhysicians(MCP)istheadultpatientcarecomponentoftheMedicalCollegeofWisconsin’sclinicalpracticegroup

• MCPisthelargestmultispecialtygrouppracticeinWisconsinandprovidescaretoadultsinallmedicalspecialtiesandsubspecialties

• TheprimaryclinicalaffiliationofMCPiswithFroedtertHealth,andtheyprovidecareattheAMC,communityhospitals,andmultipleoff-campusspecialtyclinics. TheyalsoprovidecareatClementJ. ZablockiVAMedicalCenterandotherareahospitalsandclinicsthroughcontractualrelationships

• CareprovidedbyMCPprovidersatFroedtertHealthhospitalsandcentersismarketedunderthejoint“Froedtert&theMedicalCollegeofWisconsin”brand

Cancer Heart&Vascular

MusculoskeletalNeurosciences

Spine

SolidOrganTransplant

FroedtertHealthandMCPServiceLineDyadStructure

9Sources :MCWIncomeStatement, MCWAmbulatory Stats Report*FY2016totalreflects FY2016Juneunaudited total

ProfileofHealthNetworkHealthCareDeliverySystem:MedicalCollegeofWisconsinAffiliation

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FroedtertHospital is theprimaryadult teachingaffiliateoftheMedicalCollegeofWisconsin(MCW)

• Amajority of FroedtertHospital’s medical staff iscomprised of MCPproviders(867providers)

• 716uniqueresidentsandfellows rotateatFroedtert Hospital• 845medical studentsare enrolled atMCW

Aclose,workingaffiliation betweenthe twoorganizations exists,which includeseconomicandstrategicalignment

• Froedtert HospitalandMCW jointlyoperate andownanetworkof clinical sitesforprimary care andoutpatientclinical initiatives

AnesthesiologyCardiologyDermatologyDiagnosticRadiologyEmergency MedicineEndocrinologyGastroenterologyGeneral SurgeryGeriatric PsychiatryGeriatricsHematology/OncologyInfectiousDiseaseInternalMedicineMedicine-GeriatricsMedicine-PediatricsNephrologyNeurologyNeurosurgery

Obstetrics/GynecologyOphthalmologyOral/Maxillo SurgeryOrthopedicSurgeryOtolaryngologyPalliative CarePathologyPhysicalMedicine/RehabPlasticSurgeryPsychiatryPulmonary/CriticalCareMedicineRadiationOncologyRheumatologySleepMedicineSurgical CriticalCareThoracicSurgery – IntegratedUrologyVascularSurgery

MedicalCollegeofWisconsinresidencyandfellowship

programsforwhichFroedtertHospitalisused

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ProfileofHealthNetworkHealthCareDeliverySystem:RecoveryandRehabilitationCare

The KathyHospiceislocatedontheSt.Joseph’sHospitalcampusandopenedonFebruary6,2006.Transitionof fullownershiptoHorizonHomeCareandHospiceisscheduledforAugust,2016.

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Rehabilitation Care Locations

Community Memorial Hospital

Froedtert Memorial Lutheran Hospital

Skin CancerCenter Clinic

Hope Clinic

Rehabilitation Services Acute

Center forAdvancedCare

Center forAdvancedCare: WoundHealing

Neurorehabilitation

OrthopaedicRehabilitation, SpecialtyClinics

Hand/UpperExtremity Center, SpecialtyClinics

Central WaukeshaHealthClinic

Hartford Health Center

JacksonRehabilitationandSports Medicine Center

KewaskumHealthCenter

Moorland ReserveHealth Center

NorthHills Health Center

OrthopaedicRehabilitation Clinic

Orthopaedic,Sports and SpineCenter

Sports MedicineCenter

St.Joseph's HealthCenter

Sunnys lopeHealthCenter

WestBendRehabilitationand Sports MedicineCenter

Co-ownershipofHorizonHomeCareandHospice,Inc.,CommunityMemorial HospitalrepresentationontheLindenGroveBoardof Directors,andspaceleased toCedarCrossingsonSt.Joseph’sHospitalcampusallowsforcaretobeprovidedthroughoutsoutheastWisconsin.

Behavioral HealthServices

Care isofferedat thefollowingFroedtert &MCW locations:• Community Memorial Hospital (16-bed inpatient unit)• Germantown Health Center• Harford Health Center• Moorland Reserve Health Center• North Hills Health Center• TosaHealth Center

• With thegoal of providingcare topatients withintheircommunities, the Froedtert&MCW health networkprovides bothinpatientandoutpatientrehabilitationcare at multiple locationsthroughoutMilwaukee,Waukesha, andWashingtoncounties

• Offerings includeoccupational, physical, andspeech therapy inadditiontosportsmedicine andamultitudeof specializedrehabilitation andmanagement programs

• Over 140,000inpatientandoutpatientrehabilitationvisits occurredatFroedtert&MCW locationsinFY 2015– a f igurethatis onpace tobe surpassedinFY 2016*

*Rehabilitation vis its are included in hospital, CP,andMCP volumes reported onprevious s lides

Inception Health’s Areas of Emphasis

Outside-In/Consumer-DrivenSeek to understand anddeliver what consumers value

ContinuousCareAbility to accept data from customers 24/7and meet their needs

On-DemandSpecialtyCareAbility to deliver specialized knowledge of the AMC to the s tate of Wiscons in andbeyond

InnovationCultureAbility to drive innovation sourcing and implementation atan accelerated pace

InnovationNetworkFormation of adynamic network of people, organizations , and

start-ups to identify early opportunities and thought leadership

InceptionHealthpartnerswithAVIA,aforward- leaninghealthsystemcollaborativecreatedtosolveshared,pressingchallenges tohealthcare

Historically, thehealth care industryhas notbeenprepared fortherateat whichnewinnovationsare beingimplemented intothemarket ortherate at whichnon-traditionalproviders are offeringhealth care services.

InceptionHealth wascreated asa newentity underFroedtert Health andisfocusedontwomainconcepts:

• Development of digital health services andpartnershipswithoutsidedigital organizations;

• Productionof somedigitalhealth services.

InceptionHealth isnotmeanttobe amajor revenuestream, butisinstead inplace toinformFroedtert&MCW ondisruptivetechnology soas tobetteradaptstrategy andcompetitiveness intheshiftingenvironment. The company hasa f ive-personboard, protectedfunding,a dedicated attorney, priorityIT resources, andmultiplekey advisorsfromthehealth network– thiscompositionallows forInceptionHealth tobeextremely nimble inworkingtowardsitsgoals of research and partnerships.

ProfileofHealthNetworkHealthCareDeliverySystem:InceptionHealth

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ProfileofHealthNetworkIntegratedHealthNetworkofWisconsin:AccountableCareStrategies

FoundedasQualityHealthSolutions in2005, andbased inBrookfield, Wisconsin, IntegratedHealthNetworkofWisconsin (IHN)isnowoneofthe largestACOs in thecountry,representing 6independent healthsystems.

IHNisaclinically integratednetwork representingmore than8,400clinicians, 1,180clinical locations, 53hospitals,and100associatedproviders, includingspecialtyhospitals, skilled nursing facilities, durablemedicalequipmentproviders, andhomehealthproviders.Thecaremanagementmodelcoversmore than3.1million lives.

• WhilecollaboratingintheACOmodel,Froedtert&MCWstill competesformarketsharelocallywithWheatonFranciscanandColumbiaSt.Mary’s,alongwithlocalAboutHealthmembersystemsAuroraHealthCareandProHealthCare

• AddingWheatonFranciscantoitsbookofbusinessinMarch2016,AscensionHealth,whichalreadyincludesColumbiaSt. Mary’sandMinistryHealthCare,hasbecomeakeyplayerinWisconsinaswellaswithinIHN

• Withinthelastyear,theIHNValueScorecardhasbeenimplemented.Metricsarebasedonqualityandcost,andthescorecardisusedinafundsdistributionmodelwhichredirectsmillionsofdollarstohighperformingsystems

• Children’sHospitalofWisconsinalsocollaborateswithIHNonacontractualbasis

13Source:ihnwi.com,HFMA

ProfileofHealthNetwork

NETWORKHEALTH’S RECENTHISTORY

Source:NetworkHealth MediaKit2016

Commercialinsured,individual, self-funded,andMedicareAdvantageproductswithannualpremiumstotaling$945million

NHPCOVERAGE

COMMERCIAL959 Employer Groups106,573Members*1,967 PCPs10,564 Specialists51 Hospitals1,404 Ancillary Services Providers

MEDICARE ADVANTAGE

63,904 Members*1,351 PCPs9,205 Specialists42 Hospitals1,168 Ancillary Services Providers

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NetworkHealthPlan:ManagedCareStrategies

*Current as ofJune2016month-end

Countymember totals as reportedinNetworkHealth MediaKit2016

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ProfileofHealthNetworkCommunity:CollaborativeCareStrategies

Federally Qualif ied Health Centers(FQHC) are outpatientclinicsthatqualify forspecif icreimbursement systems underMedicare andMedicaid. Free andcharitable clinics utilize a

volunteer/staff model toprovideservices toindividuals whoare uninsured,underinsured,orhavelimited ornoaccess tohealth care. Froedtert&MCW is partneredwiththree FQHCs inMilwaukee

Countyandthreefree andcharitable clinics inWashington andWaukesha Counties.

FreeandCharitableClinicsAlbrecht Free Clinic (Health and Dental Clinic)

Community Outreach Health Clinic

Waukesha County Community Dental Clinic

FederallyQualif iedHealthCentersSixteenth Street Community Health Centers

Progress ive Community Health Centers

Outreach Community Health Centers

TheMilwaukee Health Care Partnership(MHCP)isa partnershipdedicated toimprovinghealth care forunderserved populationsinMilwaukee County. By focusingoncoverage, access, andcare coordination,theMHCP isworking to improvehealth outcomes,reduce health disparities, andreduce thetotalcostof

care. InadditiontoFroedtert&MCW, theMHCPincludesMilwaukee’s otherfourmajorhealthcaresystems, fourFederally Qualif ied Health Centers, as well as city, county,andstate health departments.

Educating theCommunityThroughoutFY 2015,over3,500localresidents attendedfree,communityeducation classes conductedonavariety of topicsranging fromspecif ic clinical areas tooverall healthand wellness.

Source:Froedtert &MCWCommunity EngagementReport 2015,mkehcp.org 15

#HFSE

Honors&AccoladesU.S.News&WorldReport

Source:Froedtert &MCWCommunity EngagementReport 2015,mkehcp.org 16

2016-2017"BestHospitals"List:

• No.1inMilwaukee• No.2inWisconsin• NationallyrankedinEar,NoseandThroat,Nephrology,

Pulmonology,Urology• NationalHighPerformerinDiabetesandEndocrinology,Cancer,

GastroenterologyandGISurgery,andNeurologyandNeurosurgery

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Honors&AccoladesBernardA.Birnbaum,MD,QualityLeadershipAward

Source:Froedtert &MCWCommunity EngagementReport 2015,mkehcp.org 17

HighperformanceinqualityandsafetyasmeasuredbytheQualityandAccountabilityStudy.ThestudyanalyzesorganizationalperformanceintheInstituteofMedicine’ssixdomainsofcare:

FroedtertHospitalistheonlyacademicmedicalcenterinWisconsintowinthisawardin2015.

• Mortality• Effectiveness• Safety

• Equity• Patientcenteredness• Efficiency

#HFSE

Source:Froedtert &MCWCommunity EngagementReport 2015,mkehcp.org 18

• Recognizedforhighvalue– deliveringhigherquality,highersatisfactionandlowercost– Top100HospitalfourconsecutiveyearsbyTruvenHealthAnalytics

• ReceiveditsthirdMagnet®recognitionin2016

Honors&AccoladesTruvenHealthAnalytics&Magnet

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#HFSE

Froedtert&theMedicalCollegeofWisconsin

IntegratedSurgicalandInterventionalPlatform

#HFSE

• FroedtertHospitalopensin1980adjacenttoMilwaukeeCountyHospital.Hospitalseachprovidepartialspectrumofcare

• FroedtertlocatesOR’stoalignwithfuturefacilityplannedbyMilwaukeeCounty

1980:FroedtertHospital

202019801990 2000 2010

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#HFSE

1988:BridgeBuilding• ProposedbyMilwaukeeCountyHospitaltoconnectcampus

institutionsviaasharedfacility• Plannedinmid-80’s,butbudgetaryshortfallrevisesstacking.

Result:2ORSuitesin2buildingsandon2differentfloors

202019801990 2000 2010

#HFSE

1995:Integration• MilwaukeeCountycloseshospitalin1995;Froedtertand

MilwaukeeCountyagreeonstructuredpurchaseofassets• Froedtertintegratesmost clinicalandsupportprogramsand

expandsfacilitiesonnearlycontinualbasisfrom1995onward• NotableexceptiontointegrationstrategyaretheOperatingRooms,

whichremainin“east”and“west”regionsofthehospitaltopresentday

202019801990 2000 2010

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#HFSE

IntegratedPlatformVision• ConsolidateallOperatingrooms,CardiacCath,Electrophysiology,InterventionalLabs,Neuro-InterventionalwithIntake/ProcedureArrivalandRecoveryononefloorofthefacility

• EliminateredundancyandtransportsbetweenORs

• Permitconsistent,high-qualityexperienceforallSurgicalandInterventionalpatientsandfamilies

• Supportlongtermflexibilityandgrowth

OperatingRooms

Cath/E.P.

I.R./N.I.

CommonPre-PostCare

CommonIntake,

Reception,&

Discharge

#HFSE

PlatformbytheNumbersOperatingRooms 32 79,200SFIntra-OperativeMRI 1 1,800SFCathLabs 2+2Future 9,000SFElectrophysiologyLabs 2 7,200SFInterventionalRadiologySuites5 10,700SFNeuroInterventionalSuites 3 8,800SFProceduralCT 1 750SFMinorProcedureRooms 4 3,700SFPACUBays 44 15,000SFPrep/RecoveryBays 56 24,600SFRegionalAnesthesiaBays 6 2,150SFPublicWaiting 10,600SFKeyRooms+Support 158 173,500SF

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#HFSE

PreparingforanIntegratedPlatformCHALLENGE: LocatecontiguousfootprintforthePlatformandaccommodate clinicaldisplacements

`

#HFSE

PreparingforanIntegratedPlatform

CenterforAdvancedCare

RESPONSE:CenterforAdvancedCare;Completed2015

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#HFSE

PreparingforanIntegratedPlatform

MINORPROCEDURE

PROCEDUREARRIVALANDRECOVERY

PRE-PROCEDUREEVALUATIONCENTER

PUBLICWAITING

#HFSE

PreparingforanIntegratedPlatform• Platformpre-planningcommencedduringCenterforAdvanced

Caredesignandconstructionphases• CFACLevel3wastreatedas“given”• Teamdefineda“portfolio”ofPlatformprojects:

– CentralSterileReplacement(LowerLevel/Level1)– Platform:OR/Cath/IRintegration(Level3)– VerticalExpansion:PlatformSupportandProgramGrowth(Level4)

• Totalportfoliocost(lessCFAC):$125Million

202019801990 2000 2010

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PreparingforanIntegratedPlatform

PlatformPartners

Owner

Owner’s Representative

Construction Manager

Architect/Engineer/AdvisoryServices

EarlyTradeInvolvementPartners

Facility Planning and Development

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#HFSE

PlatformPredesign&Planning• Goal:Confirmscopeanddefineoptimalspaceplanningmodelfor

thePlatform• Focused9montheffortinvolvingwidespectrumofstakeholders

withinFroedtertHealth• GuidedbyCannonDesignAdvisoryServicesteam• Precursortotraditionaldesignphases• Paralleleffort:DevelopintegratedITinterfacetosupportplatform

(customizedEPICarrangement)• FroedtertDirective:Timingofpredesignanddocumentationmust

permitPlatformconstructiontobeginimmediatelyafterCFACcompletion(winter2015)

202019801990 2000 2010

#HFSE

PlatformPredesign&Planning

ClinicalTeam

Supp

ortTeam

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#HFSE

PlatformPredesign&Planning

#HFSE

CurrentStateAssessment• Investigationofcurrentstatevolumes,processflows,travel

distances,delaytriggers,physicalspace,andstaffing• Utilizedsimulationmodeling(FlexSim)with3monthsamplingof

datatounderstandcurrentpracticesinphysicalcontext

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#HFSE

CurrentStateAssessment• Identifiedover900uniquepatienttracksincurrentstate

operations

#HFSE

FutureStateVisioning• Mappedidealizedfuturestateprocesses• Establishedperformancetargetsforplatform• Involvedvisitstopeerinstitutions

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#HFSE

OptionsDevelopment• 10+conceptsdevelopedforconsideration• ThreeconceptselectedfordetailedpresentationtoPlatform

workingteam

#HFSE

OptionsReview• ConceptsscoredonquantifiablemetricsdefinedbyPlatform

SteeringTeam andCannonDesign• EachconceptsimulatedinFlexSimtodeterminedperformance

usingsamedatasetasexistingstate

Todd– toprovidenewgraphic

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#HFSE

Summer2014:PreferredConcept

202019801990 2000 2010

#HFSE

Summer2014:DesignCommences• Design,constructionandearlytradepartnerteamfullyengagedin

designprocessinSummer2014• TeamdeterminedtocarryallofPlatformthroughSD/firstphase

tofulldocumentation• Earlyfocusofefforts:

– Maintainingoperations/Phasing– Maintainingroomcountsthroughoutprojectdevelopment– Interstitialspaceresolution/codecompliance– Emergencypowerstrategy

• FirstmilestonepackageNovember2014

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#HFSE

February2015:EstimateUpdate

#HFSE

TeamResponse• Projectplacedonhold• Teamdirectedtoregaincontrolofprojectcostrelativetobudget• Teambrokeintoworkgroupstofocusonspecificscopes

Architectural ClinicalPlanning

Mechanical/Plumbing Electrical/Low Voltage

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#HFSE

TeamResponse• Owner-Architect-Contractorteamdevelopedandmaintained

“PathwaytoBudget”log/scheduletoguideprocess

#HFSE

PlatformPlanningBook• Collaborativelyproduceddocumenthighlightingplanningoptions

andcosts

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#HFSE

Teamunderestimated impactofreworktoexistingsystemsandfacilities

KeyFindings

KEYTOSUCCESSBuild support fromproject SteeringTeamanddistribute information toallstaffviaTownHallstrategytobuild alignment

Required teamtoseriouslyreconsiderclinical planning

GREATESTCLINICALIMPACTRetention ofrecentPACUinvestmenttoavoiddemolitionandreconstruction

GREATESTMEPCOSTIMPACTRetentionofexistingelectricalandtelecommdistributionclosetsandplumbing/morefocusedrehabilitationofmechanical systemsinlieuoffullreplacement

#HFSE

CurrentPlanning:Phase1

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#HFSE

CurrentPlanning:Phase2

#HFSE

DesignPhaseTakeaways• Developaproactivestrategyforteamstructure

– Projectoversight,constituentinvolvement,communication(i.e.TownHallmeetings), recommendationversusdecision

• Workasateamtodevelopathoroughlistofbudgetassumptionstoguidedevelopment

• Engagetradepartnersatoutsetofdesign• Determinehighestandbestuseoftradepartners

– EarlyDesign:Costanalysisandoptionsdevelopment– LaterDesign:Finalcoordinationanddocumentation

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#HFSE

OwnerTakeaways• OACSessionseveryWednesdayAM(dedicatedtimecritical)• Physician/Surgeon“Dyad”• Present,Present,Present…• Onlineresources• SAYNO• Whatgetsmeasuredgetsdone!• Programdrivesfacility!• PickthebestTeam,PEOPLE,notfirms

#HFSE

NextSteps• Phase1Construction: Present– March2017• Phase1Occupancy:March– July2017• Phase2Construction: April2017– Mid2019• Phase2Occupancy:Late2019

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#HFSE

QUESTIONS?