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Condensed HandoutFor more complete set of slides, go to AHRA website
Functional Space PlanningA Key to Optimizing Workflow
Kathy Altergott, CRADirector of Medical Imaging
Banner Good Samaritan Medical Center, [email protected]
Kenneth C. JohnsonPresident
Kenneth Johnson and Associates, [email protected]
AHRA 2008 Annual MeetingDenver, Colorado
Why should “Functional Space Planning”be important to you?
Benefits include:1. Increased revenue2. Better workflow3. Improved patient safety and
satisfaction4. Fewer change orders and shorter
construction time period.
How to quantify benefits?Evidence Based Design (EBD)?
The traditional process used to design Radiology Departments is .
Too much time and money are frequently spent creating less than optimum outcomes.
Our Premise:
Key Takeaway
“You only get one chance to make the design right!”
Kathy AltergottBanner Good Samaritan Medical Center
flawed
To share tools and techniques to enable ____ to avoid design ________ that destroy workflow, patient safety and patient satisfaction.
Objective for Today’s Talk
YOU
landmines
Banner Good Samaritan Hospital
Color CodeBlue = TechnologistGreen = Radiologist Yellow = ReceptionistRed line = Patient
My “Ah-ha” moment
No significant changes would be allowed, but “refinements” would be considered.
The Starting Point
Landmines to Avoid
1. Do not start with “a clean sheet of paper”
Key Takeaway
Design your department as YOUwould a new home
Dartmouth-Hitchcock Med. Ctr.
Celebration Health
Eliot Siegel, MDBaltimore VAMC
The Johns Hopkins Hospital
Kettering Med. Center
Poudre ValleyHospital
Banner Good Samaritan Medical Center
Ottawa Civic Hosp.
Edison Imaging
Tools and Techniques to adopt
Identify existing sites to use as benchmarks for design, technology and workflow – and learn from them
NorthwesternMedical Center
W. G. Bradley, MDUCSD
M. KanalUPMC
Hosp. forSick Kids
Dameron Hosp.
Example of a “Cockpit Design”
Photo courtesy of Baxter Regional Medical CenterMountain Home, Arkansas
Traditional Space Planning Process
1. Programming2. Schematic Design
3. Design Development
4. Construction Document
5. Bidding and Negotiations
6. Construction
7. Occupancy
Landmines to Avoid
2. Beware of the “Space Program”
Key Takeaway
Do not get blown away by the first step in the process
Where should one go to get the BEST Square Footage estimates for room sizes?
Architects? Vendors?
Owner
Consultants?
A. 194 Square FeetB. 290 Square FeetC. 330 Square FeetD. 436 Square Feet E. 639 Square FeetE. Possibly none of the above.
How much space does a CT require?
< 19’ 6”
10’
A. 194 Square FeetB. 290 Square FeetC. 330 Square FeetD. 436 SF
How much space is needed for a CT suite?
A typical mobile CT has 360 SF of interior space!
Is 397 Square Feet adequate for a CT suite?
4’ 11”
A. 194 Square FeetB. 290 Square FeetC. 330 Square FeetD. 436 Square Feet E. 639 Square FeetE. Possibly none of the above.
How much space does a CT require?
< 19’ 6”
10’
Key Takeway
Square footage estimates without a drawing mean nothing.
Landmines to Avoid
3. Using architectural drawing to analyze workflow
Key Takeway
Use CAD (Computer Aided Design) software for design AND process improvement
Landmines to Avoid
4. Do not start at ground level.The view from 2,000’
Tools and Techniques to Adopt
Color code drawing to understand workflow
Color CodeYellow = Patient CorridorsGreen = Staff CorridorBlue = Reading Rooms
Is 639 Square Feet adequate for CT suite?
Proposed CT Space ProgramSF
Exam Room 300Equipment Alcove 61Control Booth 95Dedicated Toilet 63Dressing Booth 59Vestibule 61
639 SF
View from Ground Level
Tools and Techniques to Adopt
Key Takeaway
To understand architectural drawings, they must first be converted into a “Functional Format”
Exam
D V
T
Control
E
S
Landmines to Avoid
5. Not involving ALL key stakeholders in the RIGHT way
Tools and Techniques to Adopt
Landmines to Avoid
6. Not using mockups to refine designKey Takeaway
Involve all key stakeholders AND make the process fun
Mockup with scale models
Exam
T
Control
Prep
D
Patient Consult
D
Net Result of Functional Space Planning
Tools and Techniques to Adopt
Tools and Techniques to Adopt
Before After
Summary of “Refinements” to CT suite
Test to see if tools and techniques actually work
Would you approve this Digital Rad Room?
500’ View
D
Electronics
TT D
Tomo DR
“Functional Drawing” of radiographic rooms
D
The “Cockpit”Design
“Refinements” made to DR Room
Photo courtesy of UCSD
Overview of “Refinements” to diagnostic area
New CT
Key Takeaway:Avoid designing to mimimum room size.
Traditional Space Planning Process1. Programming
2. Schematic Design
3. Design Development
4. Construction Document
5. Bidding and Negotiations
6. Construction
7. Occupancy
Landmines to Avoid
8. Being blindsided by design changes othersmake after YOUR design has been “finalized”
Key Takeaway:Stay involved
MRI
Interventional
IP CT
HoldingBays
IP
OP
Understand current state conditions BEFORE you start your design process
Correct size and location
MRI
Interventional
IP CT
Patient Holding
Inpatient
Outpatient
Telephone& data
MRI
Interventional
IP CT
Patient Holding
Telephone & data
MRI
Interventional
IP CT
Patient Holding
Landmines to Avoid
9. Beware of “Value Engineering”
Photo courtesy of Dameron HospitalStockton, CA
Example of “Value Engineering”
Key Takeaway:Stay involved
CAD (Computer Aided Design) Demo- A must for design and process improvement initiatives
Fluoro Rad
New Work Area
Best Design for Fluoro? A or B?Further improvements to make?
Color CodeOrange = Electronics and Bldg columnYellow = Storage and counters
A B
Fluoro Fluoro
Value of:-Better workflow?-Space savings?-Elimination of one toilet?-Creation of staff work area?
If I could start all over . . .
Conclusions:
What is the difference between a “change” versus a “refinement”?
#1 Key Takeaway
Demonstrate the value of “refinements.”
Do not request changes.
How can a “Functional Space Planning Analysis” be of value to you?
Benefits include:1. Increased income2. Better workflow3. Improved patient safety and
satisfaction4. Fewer change orders and shorter
construction time period.
Well-designed space is a necessity, not a luxury.
Key “Functional Planning” Tools and Techniques
1. You only get one chance to make the design right!
2. Well-designed space is a necessity, not a luxury.
3. Focus on presenting “refinements”, not making changes.
4. Design your Department as you would a new home
5. Square footage estimates without a drawing mean nothing.
6. Convert drawings into a “Functional Format” to first understand, then improve upon designs.
7. Involve all key players in the process and make it fun.
8. Stay involved in the entire process to optimize the outcome.
9. Avoid designing rooms to minimum requirements.
Comments?
Questions?
-Interest in “Evidence -Based Design”?
Feedback?
Please fill in your critique form AND let us know if you see any way we could better explain what we presented.
Kathy Altergott, [email protected]
Kenneth C. Johnson, [email protected]