By: David Prusha, AIA, Principal, HKS, Inc. and Dan Scher, Senior Director of Planning and Design, Ascension Health
Standardization is widely used in nearly all industries, except healthcare. The healthcare industry has been slow to develop standards for many reasons, mostly related to misalignment of physician, hospital and technology provider objectives.
Centralizing the approach to the planning, design and construction process can reap many benefits, including lower costs and higher quality within design, as well as better operational and clinical outcomes.
Ascension Health — the largest private nonprofit system and the second largest system (based on revenues) in the United States — has developed and is implementing planning, design and construction standardization in its 23 hospitals located throughout the United States. HKS has partnered with Ascension for more than a decade on projects nationwide and understands that process standardization provides this beneficial consistency.
If you are reviewing your planning, design and construction process, think about these seven key areas of standardization.
- Preferred firms: The selection of prequalified, preferred firms requires less of a learning curve for all involved, including the healthcare system, architect, contractor and consultants. These firms are versed in the healthcare provider’s processes and standards, allowing consistent service and delivery throughout the design and construction process.
- Design and construction standards: Standards provide the groundwork for any and all design and construction discussions. Each section of these standards contains metrics for guidelines, operational assumptions and standards in architectural design, practice standards, environmental stewardship, interior design, implementation and engineering standards. The guidelines are general in nature and used to identify desirable practices, as well as overall intent of the standards. When executives and administrators are convinced of and stand by these standards, many challenges are negated through the design and construction process.
- Facility planning services: It is important to develop operational benchmarks prior to developing your planning, design and construction process. These benchmarks can help to inform design and construction decisions.
- Planning, design and construction scope of services: Master agreements are developed for the architects and contractors, setting a perimeter for the project delivery method. These agreements also define check points throughout the project including project delivery dates — which tie to specific schedule dates and project costs.
- Project delivery methodology: All disciplines sign Integrated Project Delivery contracts with the healthcare system, helping to define expectations on everyone’s behalf. They also establish milestone dates throughout the project to verify everyone is on track in terms of intended quality, budget and schedule.
- Project management software: Using project management software, such as e-Builder, helps manage project costs, scheduling and other key metrics. This allows the healthcare system to benchmark against other projects and maintain data collection on all of its facilities.
- Master contracts for services and materials: Using a group purchase organization provides discounts from vendors based on the collective buying power of the GPO members to control costs of materials and services.
The idea behind healthcare systems standardizing planning, design and construction is simple. It helps create successful, repeatable outcomes from project to project, based on its own set of criteria for success. Healthcare systems can benefit in many ways by developing and using a similar system of standards and processes.