Miron HealtHcare ServiceSMedical center expertiSe

Our commitment reaches beyOnd cOnstructiOn;

Our passion brings dreams tO life.

INTRODUCTIONMIRON HEALTHCARE SERVICES speaks to bottom line results. It’s more than a slogan; it’s our philosophy. We are driven by the overriding principle that whatever we recommend meets not only the physical, but also the financial requirements of the organization. Before we present a solution we must all ask the question “Can we afford it?”

MIRON HEALTHCARE SERVICES is led by Dennis Lynch who has 25 years of experience in the planning, design and construction of healthcare facilities including new facilities, expansions, and remodels. MIRON HEALTHCARE SERVICES’ primary customer base is hospitals, clinics, and group practices.

The PROCessOur process typically begins with a kick-off and needs assessment of the key project drivers, critical issues and the current facility. We conduct our kick-off and needs assessment with 5 major issues in mind:

Size•Location•Budget•affordaBiLity•ScheduLe•

Size:How much space is needed? To answer this question we will meet with the appropriate stakeholders to gather their insights and compile this information to help inform the future space program. We will also conduct an operational audit to gain a clearer picture of how the current operation functions and collaboratively identify any process improvements that will impact how the new space will function.

Welcome to miron HealtHcare ServiceS

miRon HeaLtHcaRe seRVices helps decision-makers in the healthcare industry build the right facility in the right location at the right time.

We eXIsT TO...

create ReLationsHips,

built on honesty

and integrity, with

clients, partners, and

employees. at miron,

people come first.

Location:Where should the project be located? Location is a function of understanding your current competitive marketplace, future growth and expansion ability, flexibility and the ability to accommodate your workforce. Whether it’s one location or a dozen, the facility expansion plan and space needs must be analyzed thoroughly in order to select the best possible site for your building.

Budget:How much will it cost? Once the space needs are determined, we have the ability to collaborate with the architect to develop a conceptual budget and a proforma for the business plan.

affordaBiLity:Is the project affordable? Many projects fail when this question isn’t asked or if it is asked too late in the project. Affordability should be a key project driver that all design and construction solutions should provide. In order to determine affordability, revenue and expenses must be projected. MIRON HEALTHCARE SERVICES team members use a very conservative model to project and analyze affordability.

ScheduLe:How long will it take and what are the steps? This is a frequent question asked and this will be spelled out in detail during the project analysis phase. Only by being committed to keeping a schedule, will things get done.

We eXiSt to...

fulfill dReams and

assist our clients in

turning their visions

into realities.

eXPeRIeNCeBefore founding MIRON HEALTHCARE SERVICES, Dennis was Vice President - Consulting Services and in charge of the consulting group for the nation’s largest design-build firm for healthcare projects with a focus on planning, design and construction for the healthcare industry. He held this position for over fifteen years. Dennis’ past clients include Mayo-Midelfort Clinic of Eau Claire, WI, Kaiser Permante and Cleveland Clinic of Cleveland, OH and Naples, FL.

sTRaTegy DRIves eveRyThINgThe Owner and team must be clear on the strategy before attempting to design anything. What services are you planning on delivering and does the market need those services. Do you have the providers willing and able to provide the services? How do we measure success? Do we need to make a profit? Is this a mission driven project?

Once the strategy is set, the Owner must then determine if the project is financially feasible. What are the assumptions for volume, revenue, staffing and operating margin? If the project shows a profit in five years but loses money the first year is that a problem? What other scenarios are available that can be proposed and studied for consideration? Are our assumptions to aggressive or to conservative?

OPeRaTIONs PlaNNINg Is CRITICal

Simultaneously with the financial analysis, the operational plan must be developed. Staffing assumptions must be verified with managers and front-line personnel. The equipment must be signed off by the users to verify the staff is qualified and trained on the equipment. The patient experience must be planned; staff and patients are a rich source of knowledge on current processes and

process improvements. The staff must be part of the design and agree with the process changes being proposed. Too often process improvements are planned without staff input and therefore, fail. In our experience, the most successful operational designs have been those with staff input.

We eXIsT TO...

promote innoVation and be the leader in

providing and utilizing

the best tools,

processes, and safety

measures.

Page 1

ALTERNATIVE SCENARIOSNET MARGINAL INCOME

($1,000,000)

($750,000)

($500,000)

($250,000)

$0

$250,000

$500,000

$750,000

1999 2000 2001 2002 2003 2004 2005 2006

Do Nothing

3-Phase New building- existing building sold in 3 Phases

41,500 sf small building-Keep existing facility

UNIqUe COmbINaTION Of seRvICesIn essence, MIRON HEALTHCARE SERVICES helps decision-makers in the healthcare industry build the right facility—in the right location—at the right time. What this means differs largely from client to client. Some may simply need construction services. Others may need an objective analysis, including financial projections of the feasibility of establishing a healthcare facility on an existing or new site. Increasingly, we’re asked to help design memorable patient experience that differentiate our clients from their competition. Others have already traveled down the design path and look to us for our Building Information Modeling and LEED/Sustainable services to help them (and their stakeholders) build healthier buildings and to visualize their facility in new ways to save them time and money during design, construction and future operations. Whatever the need, our team often sets the direction for a facility solution that exceeds patients’ expectations, meets budget requirements, turns a profit, and accommodates market changes and future growth.

We eXIsT TO...

develop soLutions that exceed the needs

and requirements of

our clients, partners,

and employees.

TOOls UseD by mIRON healThCaRe seRvICesStaffing/RecRuitmentPlanThis staffing analysis shows the groups utilization of staff. Staffing levels are compared to MGMA Better Performing Groups.

OPeRatiOnalaudit/encOunteR-BaSedPROgRammingThis operational audit looks at the current operation and identifies operational flow within the existing facility. Our team looks for areas where the organization has patient-flow problems and inadequate work areas for the staff.

SPacePROgRamOnce the operational audit and capacity analysis have been completed, a space program can be generated.

BuildingandSitecOncePtTypically, this is where the architect takes over the analysis and provides building and site concepts to the client.

cOncePtualBudgetWorking jointly, MIRON HEALTHCARE SERVICES and the architect will develop a project budget.

OPeRaTIONal effICIeNCy IN ClINICal aReasMIRON HEALTHCARE SERVICES will conduct an operational audit that tracks patient, staff, and paper flow. Having observed hundreds of clinics, we are able to make suggestions regarding design, work patterns, and staff assignments that may improve your operational efficiency. Other firms may be able to show you how you compare to MGMA staffing and procedure benchmarks; we can show you how to exceed them.

We develop our programming solutions using a technique we call encounter-based programming that also takes into account both present operations at the client’s existing facilities and the large number of best practices we have identified from other facilities. Actual patient schedules and volumes are tracked against the number of exam rooms and nursing staff. Staff and exam room resources are programmed to accommodate the number of patient encounters, rather than the number of providers in the clinic.

We eXIsT TO...

integrate

sustainabiLity to

enhance health and

well-being and reduce

our environmental

impacts.

PatientflOwThe goal of analyzing patient flow is to make it as easy as possible for the patient to check-in, register, see the doctor and checkout. It is no longer acceptable to make the patient stop at 2 or 3 windows to check-in and have an entirely additional set of windows to checkout. Optimally, all business should be conducted at one location (i.e. changes in address, payor, co-pay collection, and reappointments) with staff cross-trained to handle all functions rather than at many locations throughout the building. MIRON HEALTHCARE SERVICES observes the flow through a facility from the patient’s perspective noting the number of staff the patient encounters, the frequency of stops made, and any barriers confronted in making their way from initial phone call to exiting the facility.

infORmatiOnflOwThe paper handled on any given day is choking the system. The goal each day is to have the patients’ medical record to the doctor when the patient needs to be seen. A lot of time is spent looking for the elusive record, or relying on faxes. Shadow files are created due to breakdowns in the system. A paperless office and an automated medical record will eliminate many of these issues. Until implemented many issues exist with all the paper in the system – lab requests, ancillary tests, dictation, lab results, etc. MIRON HEALTHCARE SERVICES’s goal is to analyze the paper and each form from the staff’s perspective. Is there a better way? Change is recommended when increased staff efficiency is possible.

StaffflOwIn small offices, communication between reception, nursing and physician is pretty simple. However, as physicians combine into larger facilities the simple procedure of checking-in, checking-out, re-appointing and cashiering become more complex. Many times the small office is repeated by creating separate registration and checkout for each doctor or for each department with the philosophy that the provider is the most important element. This tends to be expensive and lacks efficiency in the use of staff. The reception, check-in, reappointment and checkout function can be combined and done centrally at one location in the building or on each floor. Two-thirds of the total operational cost is staffing cost. MIRON HEALTHCARE SERVICES’s goal with staff flow is to attempt to minimize the number of staff needed based on analyzing each staff function. The result is a staffing plan that is efficient and cost effective.

We eXIsT TO...

serve the

communities in which

we live and work,

giving back whenever

and wherever we can.

w w w . M i r o n - C o n s t r u C t i o n . C o M

We eXIsT to . . .

create ReLationsHips, built On hOnesty and integrity, with clients, partners, and emplOyees. at mirOn, peOple cOme first.

fulfill dReams and assist Our clients in turning their visiOns intO realities.

prOmOte innoVation and be the leader in prOviding and utilizing the best tOOls, prOcesses, and safety measures.

develOp soLutions that exceed the needs and requirements Of Our clients, partners, and emplOyees.

integrate sustainabiLity tO enhance health and well-being and reduce Our envirOnmental impacts.

serve the communities in which we live and wOrk, giving back whenever and wherever we can.