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Welcome to the Healthcare Facilities Symposium & Expo
Webinar SeriesChicago, ILOctober 1-3, 2013Pre-Conference September 30thConference, October 1-3Expo, October 1-2
www.hcarefacilities.com
Incorporating Simulation Modeling & Master Planning
Susan O’Hara, RNO’Hara HealthCare ConsultantsPresident
Karen Purnell, RNWinter Park Memorial HospitalDirector of Nursing
Steven Langston, AIA, ACHA, EDAC, LEED RLF | Healthcare Design Director
Vince Della Donna, AIARLF | HealthcarePrivate Healthcare Director
1.0 Master Plan Process2.0 Simulation Modeling3.0 Case Study4.0 Master Plan - Modeling Integration5.0 Summary
1.0 Compare & Contrast Traditional Process VS. Simulation Aided Master Planning
2.0 Identify Evidence-based components of Simulation Modeling
3.0 Learn the value of incorporating modeling & simulation parameters
4.0 Bridging the information gap between designers & clients
a) Mission & Visionb) Strategic Plan
- organizational goals/mission- market analysis- financials
c) Operational Assessment- volume projections- master space program- service lines + support
d) Facility Assessment- structure + enclosure- engineering systems- circulation- code issues
e) Site Assessment- land ownership + acquisition- infrastructure- circulation- zoning + code issues
a) Visioning- confirm strategic plan- image
b) Prioritizing Goals
c) Establish Protocols- decision making groups
- process + schedule
d) Assessment Review- site + facilities
e) Tools- interviews
- surveys- tours- space planning guidelines - formulas + programs- clinical flow mapping - lean design
a) Big ideas / Conceptsb) Block plans + Stackingc) Adjacencies + Connectionsd) Expansion / Flexibilitye) Phasing / Schedulef) Costs
a) Post occupancy evaluations
b) Patient satisfaction surveys
“ Simulations is a technique for using computers to imitate, or simulate, the operations of various kinds real‐world facilities or processes.”
“Quantitative data is used to create a mathematical series of relationships forming a model that is used to understand how a system behaves.”
Simulation Modeling & Analysis 4th Edition By Averill M. Law Published 2007
• Answer questions• Solve problems• Gain understanding• Animation• Faster & Less Expensive than
“Real World” testing• Compared to other tools…
– Incorporate variation– Models interactions of sequential
processes
• Simply a confirmation of what you know
• Complicated plan to identify existing flow in existing space
• Static• Completed when foundation model is
built• Dead when master plan completed• Obsolete when disasters change the
world
A doctor did a study of his practice. He collected the service time data from his
patients. He saw that the average service time was 15 minutes…
So is it reasonable to think he should schedule four
patients per hour?
Robin Clark | QMT Group
Arrive Wait Get Treated Leave
Dr Office Without Variation
Dr Office With
Variation
Constant15 min
Constant15 min
Exponential15 min Lognormal
(15, 3) min
Robin Clark | QMT Group
Robin Clark | QMT Group
1. Averages are totally different than reality2. Variation
Service times, arrival rates and patient type probabilities
3. Does not account for highs and lows
1. Appointment schedule2. Optimizing flows and throughput3. Right-sizing space requirements
• Better able to assess healthcare operations and productivity opportunities
• Improve ‘real life’ scenarios of future staffing needs, space utilization
• Allow for changes in capacity or ‘surge’ and community needs consistent with demographics crises, catastrophes, epidemics
• Observe duplication and cost redundancy of services, movement and equipment through system
• Objective, not subjective
Susan O’Hara | O’Hara HealthCare Consultants
Mark Sullivan, AIA + Susan O’Hara | O’Hara HealthCare Consultants w/ Leo A. Daly Architects
• The process of basing decisions about the built environment on credible research to achieve the best possible outcomes– EDAC Vol. 1. Introduction to
evidence based design
• A field of study that emphasizes the importance of using credible data to influence the design process
• To extend the healing ministry of Christ.
– Visually Arresting– A Healing Environment– Superior Results– Optimize Cost Performance– Time Optimization– Supportive Work Environment– Value Received for $ Spent
• WPMH wanted to replace their aged campus and optimize their operations while transforming their image within the community.
– New Women’s Center– All Private Rooms– New Emergency Department– New Imaging Department– Optimal Surgical Department
MAIN ENTRY
SERVICE
WALK‐INAMBULANCE
STAFF
nexisting site plan
19
MAIN ENTRY
SERVICE
WALK‐INAMBULANCE
STAFF
25STAFF
PUBLIC
SERVICE
nexisting 1st floor plan
1886
1912
1932
Seminole Hotel + Alabama Hotel | 1886 ‐ 1932
To re-create the feeling of the old Winter Park grand hotel experience transforming the campus to a hospitality | resort environment. This is accomplished by:
• Replacing & Increasing Beds
• Replacing Aged Facilities
• Transforming Image of Hospital
• Intuitive Wayfinding
• Optimizing Operations
• Integrating with Campus
• Creating Healing Gardens
MAIN ENTRY
SERVICE
WALK‐INAMBULANCE
STAFF
nexisting site plan
nsite plan – phase 1a
nsite plan – phase 1b
nsite plan – phase 2a
nsite plan – phase 2b
nsite plan – phase 3
site plan
nsite plan - current
n
site plan - proposed
• Where are the bottlenecks?• Where are the best locations?• What is the capacity?
• Reviewed Collected Data• Space Planning Formulas• Applied Safety Factors
Susan O’Hara | O’Hara HealthCare Consultants w/ Robin Clark | QMT Group
Lessons Learned:
Raises issues “bringing items to the surface” through
data analysis.
• Conduct Interviews• Review Hospital Statistics• Distance Matrix• Utilize Planning Equations
Susan O’Hara | O’Hara HealthCare Consultants w/ Robin Clark | QMT Group
Whole Hospital Flow Map
• Data Base Table• Floor Plan• Model (merged)
ED changes affect
Inpatient changes affect
SurgicalChangesaffect
Interdependencies
• Distance/Time Data within Departments• Distance/Time Data between Departments
Susan O’Hara | O’Hara HealthCare Consultants w/ Robin Clark | QMT Group
ED Inpatient
Imaging
Surgery
DischargeAdmission
Lessons Learned:
Modeling helps identify downstream + upstream flow issues early on.
• Conduct Interviews• Review Hospital Statistics• Utilize Programming Equations
Lessons Learned:
Modeling helps predict the potential outcomes of the
“what‐if” scenarios.
1.0 Compare & Contrast Traditional Process VS. Simulation Aided Master Planning
2.0 Identify Evidence-based components of Simulation Modeling
3.0 Learn the value of incorporating modeling & simulation parameters
4.0 Bridging the information gap between designers & clients
“Nursing is the act of utilizing the environment of the patient to assist him in his recovery”
Florence Nightingale, 1860
Thank you for participating!
• Please email jenabeth@jdevents.com your AIA number if you did not supply it during registration.
Chicago, ILOctober 1-3, 2013Pre-Conference September 30thConference, October 1-3Expo, October 1-2
www.hcarefacilities.com
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