Michael Pukszta
Michael Pukszta
August 6, 2019

Using Prototype Standards to Accelerate Hospital from Concept to Grand Opening

Michael Pukszta
Michael Pukszta

For a health system building a new community hospital, it’s natural that everyone who will be using the space wants to have a say in how it turns out.

Nurses want easy access to supplies and to their patients. Surgeons want an operating room aligned with their workflow. Patients want to get in and out of the hospital as fast as humanly possible. Administrators want a building that is incredibly efficient, will save them money during construction and make money after it’s open.

But taking the time and energy to design a hospital by listening to every possible constituent isn’t always possible: It’s expensive and could result in a facility that can’t easily adapt to changes in care delivery if it’s customized to the loudest voice in the room. Tailored facilities also take a significant amount of time, a luxury health systems don’t have as they strive to outpace competitors, jump-start revenue capture and best serve the populations in their care.

For health systems looking to get their new community hospital to market faster than conventional methods and develop a facility that has a high degree of operational economy and future-proofing, we’ve come up with best practice standards that can save time and the headaches that can accompany designing a new hospital.

Building the portfolio
Two of our recent hospital projects, Bayhealth Hospital‘s Sussex Campus and Franciscan St. Anthony Health Michigan City, use our best practice standards. Bayhealth is a replacement hospital that serves a growing population in southern Delaware. Franciscan is also a replacement hospital, located in Michigan City, Indiana. Both are built with the ability for multiple departments and service lines to expand, such as the emergency department, inpatient units and the diagnostic area, according to future needs.

These projects leverage prototype principles that have continually proven to be successful, such as room standard templates, modular planning and CannonDesign’s proprietary Universal Grid system. Both designs optimize workflow for clinical staff, allow flexibility to incorporate the latest and greatest medical technology, and respond to necessary future growth in services.

These principles can be applied to any community hospital between 100-250 beds. Based on our experience, hospitals that employ these standards can reach completion up to a year earlier than comparable hospital projects designed from scratch.

Our templates deliver community hospitals up to a year earlier than those designed from scratch.

Opening doors faster
For Bayhealth, the project was delivered using integrated project delivery – a collaborative delivery method that controls costs through a single contract between the owner, architect and constructor. This process incentivized all parties to work together to deliver a highly efficient hospital on budget and significantly faster than the usual replacement hospital construction timeline using the traditional design-bid-build method. Key to reaching the team’s goals for early completion were standards and templates we created for key spaces throughout the facility.

For Franciscan, templates were also utilized to jump-start the design process for a client who wanted to achieve incredible speed to market. Within 60 days of being awarded the project, a rough plan of the hospital was drawn up and the team began applying the templates with modest customizations to meet Franciscan’s needs. This saved at least a year’s worth of time in the planning phase and allowed this project to go from conception to first patient in 38 months.

Proven strategies
Keeping things standardized where possible is key to long-term flexibility. Spaces and facilities that consist of highly customized spaces are often challenged when health delivery models change. Our key room prototypes, based on ideal room dimensions, can be repeated throughout a facility to maintain standardization, increase staff efficiency and create more predictable patient experiences.

Modular design and prefabrication construction techniques go hand-in-hand with room prototypes, and CannonDesign has designed and built more than 1,000 prefabricated rooms in the last three years. Prefabricating these rooms reduces on-site construction needs by creating “modules” built in a warehouse. These modules are typically spaces that don’t require individual customization — exam rooms, inpatient rooms, physician offices, bathrooms, reception and intake spaces — but can also include larger systems like walls, building skins and engineering components. These components are built offsite in a warehouse, transported to the construction site and then seamlessly installed. Prefabrication was used in Bayhealth for bathrooms, patient room headwalls, stairway plumbing systems, electrical rooms, the concrete panels enclosing the building, and even for the LINAC vault — all helping to keep costs down and shorten the project timeline.

Both Bayhealth and Franciscan use CannonDesign’s Universal Grid, which enables future flexibility for the hospitals by using optimal vertical and horizontal dimensions for structural bays and building systems. This makes the building adaptable if the potential arises for changes or expansions in a service line without having to do significant rework. New technology can also be easily installed without extensive renovations. The Universal Grid has been shown to reduce the typical 10-18 month time span from planning to groundbreaking by 60 percent.

Customization is still possible
Looking at the layouts of Bayhealth and Franciscan, they look like buildings separated at birth. Yet each project has customizations that fit the needs of each organization — from minor differences like Franciscan having a four-story office building and Bayhealth having a three-story office building — to bigger aesthetic and functional variations.

For example, Bayhealth’s exterior and interior reflect its environment, specifically its proximity to the ocean. The exterior facade is sand-colored and features wave-like ripples. Wood paneling on the interior also has this wave-like rippling, and ocean-inspired artwork is featured throughout the space. Franciscan is set off a major interstate outside of Chicago and features an earth tone color scheme with tiles in the lobby that look like drifting sand and walls that recall the waves of nearby Lake Michigan.

Clinically, each facility has been adjusted to their unique services and marketplace. For example, Franciscan features a robust cardiovascular platform, while Bayhealth features a large cancer program. The basic intent of the template is not to dictate program or aesthetics in a specific fashion, but to provide a flexible framework that allows 75 percent of a hospital to be “standardized” while a facility’s unique attributes can be customized.

    

Ensuring future flexibility
While certain aspects of template-based facilities can be personalized, more customization means less future flexibility. Healthcare will continue to be an unpredictable industry, and the more we customize around one type of patient or physician vision, the less the facility will be able to respond to change or demand in a particular service line or patient population.

Though health institutions can’t often predict what their operations, patients, services or care models might be like 10 or 20 years from now, creating adaptable and standardized design solutions that are aimed at future-proofing capital investments is important to serve its local community for years to come.

As an institution faces a major capital investment like a replacement hospital, there is often not enough time in the day to address every need by every user. The template hospital concept allows for extreme focus to be applied to those areas that represent true distinction and customization that play to that specific organization’s strengths, with confidence that the operational foundations and standards of the hospital are rock solid.

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