cox-p - benchmarking.pdf

8/14/2019 Cox-P - Benchmarking.pdf

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HospitalProject PlanningBenchmarks

ICEC 2004, Capetown

HospitalProject PlanningBenchmarks

ICEC 2004, Capetown


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Peter Cox and Lyndal Rofe

PRESENTERS


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AGENDA

Definitions & Objectives Australian BM study

Functional, Area & Cost Benchmarks

Example of BM applications

Outcomes & Conclusions

Applications to other sectors & countries


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AGENDA

Definitions & Objectives


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WHAT IS BENCHMARKING?

A standard or point of reference against which things may becompared or assessed TheOxford Dictionary


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OBJECTIVES OF BENCHMARKING(Hospital planning)

Promotes the equitable distribution of (limited) public capitalresources

Provides a basis for setting realistic forward program budgets

Provides a basis for setting realistic individual project budgets

Provides a defensible basis for setting departmental space andcost targets

Provides a tool for comparing project performamnce

Provides a tool for examining the utilisation of existing facilities


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OUTLINEPROPOSALS

Project Planning & Development CycleProject Planning & Development CycleA B C D E F

BRIEFPLANNING

SKETCHDESIGN

DOCUMENT CONSTRUCTPOSTOCCUPANCY

Budget SettingBenchmarking


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AGENDA


Australian BM study


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DEPARTMENT OF HUMAN SERVICESVICTORIA, AUSTRALIADEPARTMENT OF HUMAN SERVICESVICTORIA, AUSTRALIA


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DEPARTMENT OF HUMAN SERVICES

Approx 150 hospital campuses

Approx 15,000 beds

Approx 1million patient separations annually

Approx AU$250m (US$187m) capital works annually


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Rural Health (Seymour)Rural Health (Seymour)


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CBD Tertiary/Referral Hospital (The Alfred)CBD Tertiary/Referral Hospital (The Alfred)


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STUDY TEAM

Department of Human Services (DHS)Capital Development Managers

Acute & Rural Health Program Managers

Silver Thomas Hanley (Architects & Health Planners)

Steven Grimes (Project Manager)

Padghams (Cost Managers)


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STUDY PROCESS

National & International Research Analysis of selected completed projects (12 in detail)

Development of Benchmark Model Plan

Development of Proposed BMs

Function

Floor Area

Cost (Building & Equipment)

Testing model against completed projects


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INITIAL RESEARCH FINDINGS

Area based Cost BMs in common use

(Nationally/Internationally)

Departmental (functional unit) Cost BMs used

No evidence of Integrated - Service/Functional/Area/Cost

planning BMs

No evidence of Activity - Linked BMs


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INITIAL ANALYSIS CONCLUSIONS

Cost per bed results - varied by up to 250%

Individual department Cost per floor area unit (m2)results - varied by approx 150%

Comparable Department Cost per floor area unit (m2)

results - varied by up to 34%


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ANALYSIS CONCLUSIONS

Key Cost Drivers

Type of Hospital (Complexity - Role Deliniation)

Type of Department (Functional unit)

Type of Patients (Same Day or Multi Day)

Building configuration (no of floors etc)

Type of works (new build, refurbishment) etc

Standards & quality of materials & equipment

Locality of site/Timing of Project/Procurement method


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Service Function Area

(Space)

Cost

How many andwhat type ofservices are

required?

How manyfunctional unitsare required to

deliver that

number & typeof services?

What area isrequired to

accommodatethat number &

type of functionalunit?

What is thecapital cost ofproviding that

accommodation?

Service Plan Functional

PlanArea Plan Cost Plan

Planning Process (Four Main Elements)Planning Process (Four Main Elements)


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METHODOLOGY

Numberof Units

Area

ServiceAnalysis

FunctionalAnalysis

AreaAnalysis

CostAnalysis

Services p.a.

Service Plan(OoS etc)

Functional Plan(Beds, Theatres

etc)

Area Plan(m2)

Cost Plan($)

Demographic& Policy Data


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METHODOLOGY

Demographic/Service BM

Functional BMs(Services/Unit)

Area BM(M2/unit)

Numberof Units

Cost BM($/m2)

Area

Service

Analysis

Functional

Analysis

Area

Analysis

Cost

Analysis

Services p.a.



etc)

Area Plan(m2)

Cost Plan($)



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METHODOLOGY

Demographic/Service BM

Functional BMs(Services/Unit)

Area BM(M2/unit)

Numberof Units

Cost BM($/m2)

Area

Service

Analysis

Functional

Analysis

Area

Analysis

Cost

Analysis

Services p.a.



etc)

Area Plan(m2)

Summary

Cost Plan($)



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AGENDA


Australian BM study

Functional, Area & Cost Benchmarks


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Define levels of hospital complexity

Define Functional & Planning Units

Design the BM Model

Agree on Benchmarks

Benchmark Development Process


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Level of Complexity (Role Delineation)

Speciality Hospital eg

Paediatric, Cancer

Separations p. a -


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Functional Planning Units(Departments)

Total

2 + 7 Spec FPUsEngineering &Travel, Spec.

9

18 FPUsEducation,

Support

5

8

16 FPUsDay Areas4

30 FPUsClinical3

4 FPUsAdministration2

22 PFUsInpatient1

99 FPUs


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Functional Planning Units- Inpatient Areas


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ALTERNATIVE MODELS ADOPTED

Initial (Global data) Model

where early planning is undertaken but detailed throughputdata for each functional unit is not yet available (eg; totalpatient separations).

Developed (Specific data) Model

when detailed services throughput data is available for theindividual functional units (eg; separations for each speciality).


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Service Function Area Cost

Service Plan FunctionalPlan

Area Plan Cost Plan

Planning Process - Main ElementsPlanning Process - Main Elements


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2002001116

Number of Sub-acute Multi-day &Same-daySeparations per

annum

Ward Sub Acute(Rehab + GEM)

N/AN/A5550

Number of Medical &Surgical Multi-daySeparations perannum

Ward Acute -Medical/Surgical

INPATIENTDIVIDED BY BENCHMARK

Level5

Level6

Level5

Level6

SAME-DAYMULTI-DAY

FUNCTIONAL BENCHMARK

SERVICE PLANTHROUGHPUT

FUNCTIONAL/PLANNING UNIT

Functional Benchmark


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362002001116Multi-day=590

Number of Sub-acute Multi-day &Same-daySeparations per

annum


332N/AN/A555016507



INPATIENTDIVIDED BY BENCHMARK

Level5

Level6

Level5

Level6

SAME-DAYMULTI-DAYOUTPUT - No

of Beds

FUNCTIONAL BENCHMARK

INPUTDATA

(Service Plan)

SERVICE PLANTHROUGHPUT

FUNCTIONAL/PLANNING UNIT

Functional Plan


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Benchmark Development

Review standards & design guidelines

Review project area schedules National/International

Analysis & interpretation

Key assumptions

Agree Area Benchmarks

Area


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4343

Number of Sub-acuteMulti-day and Same-day Separations perannum


3031



INPATIENT

MULTIPLIED BYBENCHMARK

Level 5Level 6

AREA BM (m2/unit)

AREA BENCHMARK

FUNCTIONAL PLAN

THROUGHPUT

FUNCTIONAL/

PLANNING UNIT

Area Benchmark


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1545434336

Number of Sub-acuteMulti-day and Same-day Separations perannum


104163031332



INPATIENT

MULTIPLIED BYBENCHMARK

Level 5Level 6

AREA BM (m2/unit)OUTPUT - Total

m2

AREA BENCHMARK

INPUT - No ofFunctional

Units"SpaceDrivers"

FUNCTIONAL PLAN

THROUGHPUT

FUNCTIONAL/

PLANNING UNIT

Area Benchmark


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Definition of Capital Cost:

Building works & services (New or Altered)

Site works & project specifics

Furniture, furnishings, equipment & IT

Consultants, Authorities & client costs Contingencies & other risk provisions


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Methodology

Review of standards & guidelines

Review of cost data of selected recent projects

Analysis & interpretation

Review assumptions

Agree Cost Benchmarks

Agree specific variables & factors

Test model against built or planned examples


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$ 345$ 345$ 2,041$ 2,386Ward Sub Acute(Rehab + GEM)

$ 460$ 465$ 2,150$ 2,512Ward Acute -Medical/Surgical

INPATIENT

MULITPLIED BYBENCHMARK


Level5Level 6Level5Level 6

($/m2)($/m2)

F.F& E.BENCHMARK

BUILDING COSTBENCHMARK

FUNCTIONAL/

PLANNING UNIT

Cost (Building & FF&E) Benchmarks


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$ 532,886$ 345$ 345$ 3,152,522$ 2,041$ 2,3861545Ward Sub Acute(Rehab + GEM)

$ 4,843,349$ 460$ 465$ 26,164,499$ 2,150$ 2,51210416Ward Acute -Medical/Surgical

INPATIENT



Level5Level 6Level5Level 6

($/m2)($/m2)

OUTPUT - $

F.F& E.BENCHMARK

OUTPUT - $

BUILDING COSTBENCHMARK

INPUT -

Total m2

FUNCTIONAL/

PLANNING UNIT

Cost (Building & FF & E) Plan


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Building Configuration

New single storey

New low rise

New medium rise

New high rise

Refurbishment - low Refurbishment - medium

Refurbishment - high

No work

Index 100

Index 118

Index 126

Index 134

Index 15 Index 56

Index 80

Index 0

Cost Adjustment Factors


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Project Specific allowances

Central Energy Plant Site prep & siteworks

External services

Contingencies (D&C)

IT PM, Design & Cost Mgt

Authorities & client

Future cost escalation

Add 5.0%

Add 7.5%

Add 7.0%

Add 10.0%

Add 5.0% Add 12.0%

Add 2.5%

Add 3.5% p.a.

Cost Adjustment Factors


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AGENDA

Definitions, Objectives & Benefits

Australian BM study

Example of BM application


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Total Separations p. a

x Factor (0.7)

Level 6 Hospital Emergency Department

1,300 ED attendances per Treatment Place p.a.

Resuscitation Bays = 10% of Total Treatment Places

GDA Requirement:x m2 x No. of Treatment Places

Capital Cost Estimate:GDA x $m2 plus specific allowances

ED Attendances p. a

Example

Input

Model A

BM

Output

Model B


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AGENDA


Australian BM study

Examples of BM application



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Study completed - 2002

Model now being adopted by State Health Ministries nationally

BMs being used for program and project planning

BMs also being used for evaluation of BOOT projects

Keen interest from other Health Ministries in the region

OUTCOMES


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Service Data availability/interpretation

Facility data- availability/reliability

Cost Data - fluctuations in market prices, locality

Translation of service data into facility requirements

Delineation of Hospital roles

Dealing with growth in clinical specialties (varying space needs)

Recognition of Regulatory Codes and Standards

CHALLENGES OF BENCHMARKING


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BENEFITS OF BENCHMARKING

Produces best value rather than lowest cost solutions

Encourages more effective/efficient designs

Controls excessive "user demands" for more space and moreinvestment...

Provides a tool for examining the utilisation of existing facilities

Avoids unexpected cost blowouts


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BENEFITS OF BENCHMARKING

And provides a foundation for successful project delivery,

But . must be seen as only a part of the total costmanagement process


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Project Planning & Development CycleProject Planning & Development Cycle

OUTLINEPROPOSALS

BABRIEFPLANNING

CSKETCHDESIGN

DDOCUMENT

ECONSTRUCT

FPOSTOCCUPANCY

Cost Management Process

Cost Planning Bills of Quantities,TenderEvaluation

CostControl&Reporting

Specialistservices;AnalysisAudits


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AGENDA


Australian BM study

Examples of BM application


Applications to other countries & Discussion


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Relevance of Benchmarking to other

sectors and countries?

The need for BM is universal!

Applicable to Healthcare, Education, Commercial etc sectors

Applicable to Govt Ministries, Defence Depts & Corporations

Opportunity to develop appropriate BMs to suit local norms

Feedback invited from ICEC 2004 delegates!

Further questions - Email [email protected]

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