Last year, at around this time, the Facilities Optimization Solutions (FOS) team had a unique opportunity to work alongside our colleagues in Advisory Services and Architecture in a massive assessment of the State Psychiatric Hospitals and State Supported Living Centers in the State of Texas. Pairing our services with efforts to optimize operational, clinical, and design excellence and improve the statewide care model gave us the chance to demonstrate how facility conditions assessments can fit into a larger picture to improve services and care – in this case for the substantial behavioral health population across the state of Texas.
FIGURE 1: State Psychiatric Hospital and State Supported Living Center sites throughout the state of Texas. FIGURE 1: State Psychiatric Hospital and State Supported Living Center sites throughout the state of Texas.

A Tour of Texas

For our portion of the work, we deployed six FOS teams to travel to six different sites that were representative of conditions and facilities at sites across the state (Figure 1). At each of these sites we conducted comprehensive assessments at each facility that included condition, life cycle, and last date of replacement/repair for the all critical systems and infrastructure. Additionally, we analyzed historic facilities data from all other sites to give an educated estimate of the current state of those facilities. All of this information was further analyzed to provide a Facility Condition Index (FCI) value (Figure 2) to determine which buildings were considered distressed with low return on investment.

FIGURE 2: The FOS team utilized both current and historical data to calculate the Facility Condition Index of each campus. FIGURE 2: The FOS team utilized both current and historical data to calculate the Facility Condition Index of each campus.

Meanwhile, our colleagues in Advisory Services and Architecture were doing assessments and research of their own. They spent many hours visiting sites across the state – interviewing staff, leadership, and other stakeholders and documenting current practices. They researched best practice care models that are being implemented at other states and facilities. They analyzed data related to bed needs, workforce needs and staffing. They assessed the ability of existing facilities to support new care models and the viability of current real estate assets.

Multi-Faceted Facility Recommendations

In the case of the State Psychiatric Hospitals, all of this information was used to inform the creation of a comprehensive 10-year plan for the Department of State Health Services, which includes recommendations for transformative changes to care models, staffing, operations and facilities. The FCI values played a critical role, alongside the planning assessment and the bed need assessment in providing preliminary recommendations for what should be done with the facilities on each site (Figure 3), ultimately setting the stage for comprehensive care model transformation over time. 

The work we did with the State of Texas demonstrates the critical role FOS can play whenever a health system is considering an extensive overhaul to the services they provide. Understanding how facility conditions will impact the ability to support operational or clinical changes is critical to achieving any goals. The information brought forward in facility condition assessments can help leaders make educated, financially viable decisions about their next steps.

Our work also demonstrates the power of multi-disciplinary collaboration at CannonDesign, pairing our services with other disciplines across the firm has resulted in truly transformative solutions that will impact the lives of Texans for years to come.

State of Texas_revised table-02

Figure 3: Facility Condition Index was considered together with real estate viability and bed need to make facility recommendations at each site.