university of minnesota hospitals and clifjics

UNIVERSITY OF MINNESOTA HOSPITALS AND C L I f J I C S

PRESENTATION ON CAPITAL F A C I L I T I E S DEVELOPMENT

TO THE

UNIVERSITY OF MINNESOTA BOARD OF REGENTS

JUNE 8, 1979

SUPPLEMENTAL MATERIAL

UNIVERSITY OF MINNESOTA HOSPITALS AND CLINICS

PRESENTATION ON CAPITAL FACILITIES DEVELOPFIENT

TO THE


JUNE 8, 1979

The f o l l o w i n g m a t e r i a l i s i n tended t o supplement U n i v e r s i t y H o s p i t a l s and C l i n i c s C a p i t a l F a c i l i t i e s p r e s e n t a t i o n t o t h e Board o f Regents.

The p r e s e n t a t i o n e lements a r e as f o l l o w s :

I. H e a l t h Sciences Master P lan

11. U n i v e r s i t y H o s p i t a l s and C l i n i c s M i s s i o n

Page 3

Page 11

111. U n i v e r s i t y H o s p i t a l s and C l i n i c s C a p i t a l Program - Background, Problems, and S o l u t i o n s Page 16

I V . U n i v e r s i t y H o s p i t a l Renewal P r o j e c t Overview 2

S e c t i o n I

H e a l t h S c i e n c e s Master P l a n

The f i r s t long-range H e a l t h S c i e n c e s P l a n n i n g Committee was a p p o i n t e d i n 1964 by P r e s i d e n t Wilson t o c o n s i d e r o b j e c t i v e s and programs t h a t would respond t o a growing need f o r h e a l t h manpower. T h i s was i n r e sponse t o t h e 1966 H i l l Family Foundation r e p o r t , H e a l t h Manpower f o r t h e Upper Midwest and t o f a c u l t y r e c o g n i t i o n of needs f o r c u r r i c u l a r changes w i t h i n e a c h h e a l t h s c i e n c e s c h o o l and t h e obvious need f o r c o o r d i n a t e d e d u c a t i o n a l programs among t h e h e a l t h s c i e n c e schoo l s .

I n 1966, a r e p o r t e n t i t l e d "Fu tu re P lann ing f o r t h e H e a l t h S c i e n c e s ; Ro les , Ob jec t ives , and Programs" was submi t t ed t o t h e Regents . The recommendations r ep resen ted t h e c o l l e c t i v e e f f o r t s of t h e twenty-member p a r e n t committee and ove r two hundred f a c u l t y who s e r v e d on t h e t h i r t e e n sub-committees.

The r e p o r t set o u t t h e f o l l o w i n g s p e c i f i c g o a l s f o r t h e H e a l t h S c i e n c e s c a p i t a l development. These g o a l s were i n r e s p o n s e t o academic programs.

- expans ion of f a c i l i t i e s t o s e r v e i n c r e a s e d en ro l lmer i t s i n Medicine, D e n t i s t r y , and o t h e r h e a l t h p r o f e s s i o n s e d u c a t i o n programs.

- improvement and c o n s e r v a t i o n of e x i s t i n g f a c i l i t i e s . - p h y s i c a l a r rangements t h a t s u p p o r t and encourage i n t e r a c t i o n among

Hea l th Sc ience u n i t s and among a l l u n i t s o f t h e U n i v e r s i t y . - f l e x i b i l i t y t o a d a p t t o f u t u r e program changes.

The Master P l a n which evolved inc luded t h e p l a n n i n g and documenta t ion of a l l program needs , space a l l o c a t i o n and t h e r e q u i r e d t iming o f moves and space reass ignment n e c e s s a r y t o a c h i e v e t h e o b j e c t i v e s . The l i s t i n g on page 10 i n d i c a t e s t h e documents t h a t p r o v i d e d e t a i l e d p l a n n i n g on each component o f t h e Master P l an .

The p l a n provided d e t a i l e d s t u d y f o r t h e immediate expans ion s p a c e , o r Phase I , of t h e Master P l a n and i n d i c a t e d t h e p r o j e c t e d n e e d s , i n more g e n e r a l t e rms , f o r a Phase 11.

Phase I o f Nea l th S c i e n c e P lann ing i n c l u d e d t h e fo l lowing :

- School o f D e n t i s t r y (Un i t A) - Medical School (Bas ic S c i e n c e s i n Jackson-Owre-Millard-Lyons and Uni t A .

C l i n i c a l S c i e n c e s i n Un i t B/C.) - U n i v e r s i t y H o s p i t a l s and C l i n i c s O u t p a t i e n t Departments (Un i t B/C) - H e a l t h Sc iences Rece iv ing and D i s t r i b u t i o n Cen te r (Uni t E) - Col l ege o f Pharmacy (Uni t F - modif ied i n 1975 t o i n c l u d e t h e School o f

Nursing)

Phase I1 p l a n n i n g i n c o r p o r a t e d :

- School of P u b l i c H e a l t h (Un i t G - modif ied i n 1975 t o v a c a t e d c l i n i c space) - U n i v e r s i t y H o s p i t a l s ( U n i t s H and J )

HEALTH SCIENCES PRIOR TO 1970

School of Nursing - Powell H a l l - 1933 ( c o n v e r t e d do rmi to ry )

Co l l ege of Pharmacy - Appleby H a l l - 1915 ( c o n v e r t e d School of Nines)

School of D e n t i s t r y - Owre H a l l - 1930

Medical School - Jackson - 1912 M i l l a r d - 1912 Lyon - 1952 Jackson-Owre A d d i t i o n - 1958

School of P u b l i c H e a l t h - Mayo - 1954

Dieh l H a l l - 1958

U n i v e r s i t y H o s p i t a l s and C l i n i c s

Main H o s p i t a l Complex - (See page 6 ) E l l i o t H o s p i t a l 19 11 S e r v i c e Wing 191.3 C h r i s t i a n Add i t i on 1925 Todd Wing 1925 E u s t i s Wing 1929 Hea l th S e r v i c e Wing 1929 Mayo Memorial 1954 Mayo 6 t h F1. Add i t i on 1 9 5 7

V a r i e t y Club Hea r t H o s p i t a l 1951

Masonic Memorial H o s p i t a l 1960

C h i l d r e n ' s R e h a b i l i t a t i o n Cen te r 1964

I 8,. . WIVEl)$lfV Of YINNE¶OTA

. UIM HOSPITALS (29)

HEALTH SCIENCES DEVELOPMENT SINCE 1970

Unit A 1973 - new construction School of Dentistry Undergraduate Basic Science Laboratories Two Public Health Programs Shared classrooms/Student support services

Unit K/E 1974 - new construction "Et' Portion - Health Sciences Center for Receiving and

Distribution "Kt' Portion - Paul F. Dwan Cardio Vascular Research Center

Unit B/C 1979 - new construction (Phillips-Wangensteen Building)

University Hospital Clinics Medical School Research, Education and Department space Shared classrooms/Student support services Learning Resource Center

J.O.M.L. 1979 - renovation project (Jackson-Owre-Millard-Lyons)

Medical School Basic Science Departments Shared classrooms Medical School Administration Nortuary Science

Unit F 1980 - new construction College of Pharmacy School of Nursing Shared classrooms/Student support space

Vacated Clinic Space - renovation project (in process) School of Public Health Laboratory Medicine University Hospital Admissions

The completion of Units A, B/C, the J.O.M.L. remodelling project, the initiation of Unit F and planning for the School of Public Health in vacated space rather than new construction, has provided the essential core academic space and outpatient facilities to free the Powell Hall site for the necessary replacement of some Hospital inpatient and support space.

HEALTH SCIENCES ENROLLMENT 78-79

Nursing

Pharmacy

Public Health

Dentistry

Medical School

Mortuary Science 65

TOTAL 5,289

FYE

SQUARE FEET PER STUDENT

Years

250

240

230

220 +' g 210 LL

200 I a

0)

- !

- National average = 242

- - - -

I

f re* .*a

PI 180-

170 - 160-

'

150 -

140 - I I ,

69-70 70-71 71-72 72-73 73-74 74-75 75-76 76-77 77-78 78-79 79-80 80-81

UNIVERSITY OF MINNESOTA HEALTH SCIENCES

CHRONOLOGICAL LISTING OF PLANNING DOCUMENTS

FUTURE PLANNING FOR THE HEALTH SCIENCES - PART I. "Pre l imina ry Repor t

on Roles, O b j e c t i v e s , and Program." Janua ry , 1966.

A SPACE UTILIZATION REPORT. MEDICAL AND DENTAL FACILITIES. James A.

Hamilton A s s o c i a t e s . September, 1966.

FUTURE PLANNING FOR THE HEALTH SCIENCES. PART 11. "Program, P e r s o n n e l ,

and Space P r o j e c t i o n s . " October , 1966.

FUTURE PLANNING FOR THE HEALTH SCIENCES. PART 111. "Subcommittee

Program and Space Repor ts . " February , 1967.

F'UTURE PLANNING FOR THE HEALTH SCIENCES. PART 111. " U n i v e r s i t y H o s p i t a l s

Supplement." February , 1968.

LONG RANGE tIASTER PLANNING - SITE DENSITY STUDY. The A r c h i t e c t s

C o l l a b o r a t i v e , Cambridge, Massachuse t t s . May, 1970.

PROPOSED MATERIALS HANDLING PLAN FOR UNIVEPSITY OF MINNESOTA HEALTH

SCIENCES CENTER EXPANSION. The A r c h i t e c t s C o l l a b o r a t i v e I n c . ; Chas. T.

Main I n c . J u l y , 1970.

REPORT ON BASIC ELECTRICAL SERVICE SYSTEElS FOR HEALTH SCIENCES BUILDINGS.

U n i v e r s i t y of Minnesota O f f i c e o f P h y s i c a l P l ann ing . June , 1971.

REPORT OF THE PLANNING COMMITTEE FOR THE UNIVERSITY CHILDREN'S CENTER.

August, 1971.

REPORT ON AIR CONDITIONING SYSTFIIS FOX HEALTH SCIENCES BUILDINGS.

U n i v e r s i t y o f Minnesota. O f f i c e o f P h y s i c a l P l ann ing . September, 1971.

TRAFFIC ACCESS AND PARKING PLAN FOR HEALTH SCIENCES AREA. B a t h e r ,

Ringros e, Wols f e l d , I n c . Nay, 19 72.

AN ENVIRONMENTAL HEALTH AND SAFETY EVALUATION OF THE USE OF THE UNIVERSITY

HOSPITALS BUILDING 29 and 74 AS A CLINICAL CARE FACILITY. Department o f

Environmental H e a l t h and S a f e t y . U n i v e r s i t y of Plinneso ta. J u l y , 1973.

UNPUBLISHED DEPARTMENTAL CLINICAL FACILITY REPORTS. C l i n i c a l Departments

Medical School . D e n t a l School . School o f Nursing. School o f P u b l i c

Hea l th . C o l l e g e of Pharmacy. August , 1973.

FUNCTIONAL FACILITIES EVALUATION OF UNIVERSITY OF MINNESOTA HOSPITALS.

Techn ica l Paper No. I. Herman Smith A s s o c i a t e s . November, 1974.

ATTEEPTS TO REPROGRATI THE MAYO HOSPITAL - DEFICIENCES AND COST OPTIONS

FOR UNIVERSITY OF MINNESOTA HOSPITALS. T e c h n i c a l P a p e r No. 2. Herman

S m i t h A s s o c i a t e s . November 1 9 7 4 .

A REPLACEMENT HOSPITAL FOR THE MAY0 COMPLEX OF THE UNIVERSITY OF

MINNESOTA HOSPITALS. T e c h n i c a l P a p e r No. 3. Herman S m i t h A s s o c i a t e s .

November, 1 9 7 4 .

RECOMMENDATIONS OF THE PLANNING COIiMITTEE FOR CLINICAL FACILITIES.

Dr. R i c h a r d V a r c o , C h a i r m a n . F e b r u a r y , 1 9 7 5 .

PLANNING REPORT, DESIGN CONCEPT, JACKSON, OWRE, FILLLARD, LYON. F a l l ,

1 9 7 5 .

INTERIM REPORT - UNIT K FEASIBILITY STUDY: POST ANESTHESIA RECOVERY,

SURGICAL INTENSIVE CARE, PEDIATRICS. U n i v e r s i t y o f I l i n n e s o t a .

November, 1 9 7 6 .

FACILITIES REPORT FOR SCHOOL OF NURSING AND COLLEGE OF PHAlUlACY.

J a n u a r y , 1 9 7 7.

REPORT OF HOSPITAL MAYO VACATED SPACE TASK FORCE - CLINICAL LABORATORIES,

DIAGNOSTIC RADIOLOGY. Dr . R o b e r t G o l t z , C h a i r m a n . S e p t e m b e r , 1 9 7 7 .

UNIVESITY OF MINNESOTA HOSPITALS LONG-TERM DEBT CAPACITY EVALUATION.

E r n s t a n d E r n s t. A u g u s t , 1 9 7 8 .

SCHOOL OF PUBLIC IIEALTH FACILITIES. H o s k i n s , S c o t t , T a y l o r . March , 1 9 7 9 .

UNIT H SCHEMATIC DESIGN AVD CONSTRUCTION COST ESTIEIATES. E l l e r b e .

March, 1 9 7 9 .

UNIT H REASSESSMENT. I n t e r n a l Document . March , 1 9 7 9 .

SECTION I 1


STATEMENT OF MISSION AND GOALS

The f o l l ow ing i s t he Statement o f Miss ion and Goals f o r U n i v e r s i t y Hosp i t a l s and C l i n i c s as recommended by t h e H o s p i t a l s ' Board o f Governors and adopted by the Board o f Regents. Page 15 ill us t ra tes t he admission t rends and p a t i e n t o r i g i n s f o r t he Hospi t a l s.

PREAMBLE

The Un i ve rs i t y o f Minnesota Hosp i t a l s and C l i n i cs has many d i f f e r e n t responsi - b i l i t i e s and goals. The pr imary miss ion o f t he i n s t i t u t i o n i s roo ted i n the e a r l y r ecogn i t i on by the U n i v e r s i t y o f Minnesota Medical School o f a need f o r a c l i n i c a l teaching environment. I n the e a r l y 19001s, t h e Flinnesota Leg i s l a - t u r e determined t h a t t h i s need be met by the U n i v e r s i t y o f Minnesota Hosp i t a l s and C l i n i c s . (As prov ided i n Laws o f Hinnesota, 1907, Chapter 80, and as per- petuated i n Minnesota S ta tu te , Chapter 158, f i r s t enacted i n 1921 . )

The L e g i s l a t i v e mandate under1 i es the Wospi t a l s ' r o l e i n p rov i d i ng heal t h care services, programs o f educat ion and research, and r e f e r r a l re1 a t i onsh ips w i t h o ther hea l t h care p rov iders and i n s t i t u t i o n s i n the S t a t e o f Minnesota. I n t h i s r o l e , U n i v e r s i t y o f Minnesota Hospi t a l s and C l i n i cs serves var ious con- s t i t u e n t groups by making h e a l t h care se rv ices a v a i l a b l e t o a l l r es i den t s o f Minnesota, t o those o f t he upper Plidwest reg ion, and i n t h e case o f some more spec ia l i zed se rv i ce programs, by se r v i ng as a n a t i o n a l resource. I t s programs o f education, research, con t i nu i ng educat ion, and p a t i e n t and community hea l t h education, developed i n con junc t ion w i t h t h e u n i t s o f t he U n i v e r s i t y of Minnesota Hea l th Sciences ( t h e Medical School, School o f Nursing, Col lege o f Pharmacy, School of Den t i s t r y , and School of Pub1 i c Hea l th ) , serve students, facu l ty , i ts own medical and p ro fess iona l s t a f f , many o t h e r p r a c t i c i n g hea l t h care de l i ve re r s , and t he general pub1 i c . Fur ther , t h e research conducted i n assoc ia t ion w i t h Uni ve r s i ty Hosp i t a l s b e n e f i t s bo th p rov i de rs and r e c i p i e n t s o f heal t h care s e r v i ces na t i ona l l y and i n t e r n a t i o n a l l y . The Un i ve rs i t y o f Minnesota Hosp i t a l s and C l i n i c s i s o b l i g a t e d t o t he people o f Minnesota t o f u l f i l l i t s spec ia l r o l e as a h e a l t h care resource f o r t he s t a te . Thus, the Board o f Governors of the U n i v e r s i t y o f r l innesota Hosp i ta l s and C l i n i c s , on beha l f o f t h e Board o f Regents, r ep resen t i ng t he people o f Minnesota, s e t f o r t h t h i s statement of m iss ion and corresponding goals which has been developed t o meet the unique r e s p o n s i b i l i t i e s of t h i s i n s t i t u t i o n .

Univers i t y o f Minnesota Hosp i ta l s and C l i n i c s Statement o f Missions and Goals

Page 2

MISSION

The r e s p o n s i b i l i t i e s o f t h e Un i ve r s i t y o f Minnesota Hosp i t a l s and C l i n i c s r equ i r e t h a t i t s miss ion be un iquely broad, a l l ow ing i t t o serve as a p r i n c i - pa l medical and hea l t h care resource f o r the S ta te o f Flinnesota. Elements of i t s mission must a lso permi t the i n s t i t u t i o n t o p rov ide a wide range of spec ia l i zed hea l t h care d e l i very programs designed t o advance qua1 i t y h e a l t h care.

I n t h i s p u r s u i t :

- Un i ve r s i t y Hosp i ta l s and C l i n i c s prov ides p a t i e n t care se rv ices which respond t o l o c a l , State , and i n some instances, na t i ona l needs.

- Un i ve rs i t y Hosp i t a l s and C l i n i c s i s an i n t e g r a l p a r t of t he Heal th Sci ences Center o f the U n i v e r s i t y o f !li nnesota. T h r o u ~ h i t s mu1 ti p l e hea l t h care programs, U n i v e r s i t y Hosp i t a l s and C l i n i c s w i 11 p rov ide an environment f o r the c l i n i c a l educat ion o f Heal th Sciences students; con t inu ing educat ion f o r i t s medical s t a f f and o the r hea l t h p r a c t i - t i oners ; and, i n t h e course o f p a t i e n t care, hea l t h educat ion i n the areas o f p reven t i ve care, and i n personal management o f p a t i e n t s ' own hea l th .

- Uni ve r s i ty tlospi t a l s and C l i n i c s prov ides a d i s t i n c t i ve environment f o r the advancement o f bio-medical research and techno log ica l development, as w e l l as innova t ions i n the d e l i v e r y o f medical care and heal t h serv ices.

- Un i ve rs i t y Hosp i ta l s and C l i n i c s a l s o f u l f i l l s a r o l e i n educat ion f o r hea l t h serv ices management. I n t h i s r o l e , i t w i l l serve as a Statewide and na t i ona l resource f o r t he management o f the h e a l t h del i very sys tern.

GOALS

I. PATIENT CARE: Services f o r t h e s i c k and convalescing t o g i v e comfort , a s s i s t i n recovery, and ma in ta in hea l th .

A. To o f f e r sens i t i ve , q u a l i t y p a t i e n t care programs a t t he lowest poss ib le cost .

0 . To p rov ide i nnova t i ve pr imary and p reven t i ve care programs and models, both w i t h i n the U n i v e r s i t y s e t t i n g and a t o t h e r s i t e s and t o p rov ide we1 1 f unc t i on i ng , spec ia l i zed and advanced o r t e r t i a r y care f o r p a t i e n t s o f r e f e r r i n g phys ic ians.

Univers i t y o f Ninnesota Hosp i t a l s and C l i n i c s Statement o f Missions and Goals

Page 3

C. To prov ide w e l l organized modern medical care se rv ices f o r ambu- l a t o r y p a t i e n t s n o t r e q u i r i n g h o s p i t a l i z a t i o n , thus promot ing the appropr ia te use o f h e a l t h care resources, and t o p rov ide emergency medical se r v i ces cons i s t en t w i t h the develop ing reg iona l r e f e r r a l emergency medi ca l s e r v i ces cons i s t en t wi t h the developing reg iona l r e f e r r a l emergency care network and the educat iona l needs o f the i n s t i t u t i o n .

D. To p rov ide programs o f home h e a l t h care and o the r outreach serv ices as a1 t e r n a t i v e and l ess c o s t l y methods f o r p r o v i d i n g medical care.

E. To assure q u a l i t y h e a l t h care d e l i v e r y 24 hours a day, 7 days a week through a h i g h l y spec ia l i zed medical and p ro fess iona l s t a f f .

11. EDUCATION: programs f o r students, f a c u l t y , s t a f f , p r a c t i t i o n e r s and o thers i n t e r e s t e d i n l ea rn i ng , teaching, p r a c t i c i n g , ma in ta in ing and using hea l t h s k i l l s .

A. To p a r t i c i p a t e i n and develop h e a l t h care programs i n support of the educat ional ob j ec t i ves o f t he Hea l th Sciences Un i t s .

8. To p rov ide p a t i e n t educat ion programs as a means o f he l p i ng p a t i e n t s become invo lved i n the process of improving t h e i r h e a l t h s t a tus .

C. To suppor t con t inu ing educat ion programs f o r h e a l t h ca re profess ionals bo th w i t h i n t he Hosp i ta l and throughout t h e S ta te o f Minnesota.

D. To p a r t i c i p a t e i n the d isseminat ion o f com~nunity h e a l t h educat ion in fo rmat ion t o h e a l t h p ro fess i ona l s throughout t h e S ta te .

E. To expose s tudents t o a wide v a r i e t y o f management experiences bo th i n i n t e r n a l Hosp i t a l opera t ions and ex te rna l h e a l t h p o l i c y .

111. RESEARCH: p r o j e c t s and programs which suppor t t he commitment o f t h e U n i v e r s i t y Hea l th Sciences as a major research resource f o r the S ta te and na t i on i n bio-medi ca l and c l i n i c a l research.

A. To encourage and suppor t the medical s t a f f and o t h e r h e a l t h profess iona ls i n research i n q u i r i e s and i n v e s t i g a t i o n s .

B . To recognize the r e l a t i o n s h i p between a v a r i e t y o f i n v e s t i g a t i v e programs so t h a t research f i n d i n g s can be used f o r p a t i e n t care.

University of Minnesota Hospitals and Clinics Statement of Missions and Goals

Page 4

In pursuit of a1 1 these goals, University of Minnesota Hospitals and Clinics strives to provide leadership through the development of model programs. These model programs serve as examples for individuals and institutions in the health care f ie ld and stimulate the planning for and improvement of the health care system. Excellence, therefore, i s sought in these patient care, education and research models so that they may be shared with confidence. Thus, Uni versi ty of Minnesota Hospi tal s and Clinics attempts to p rov i~e a health care services environment for Health Sciences students, practitioners, and cl ini cal investigators which wi 11 be of benefit to a l l other health care programs in Minnesota. In respect to this , University of llinnesota Hospital s and Cl ini cs wi 11 serve as a resource to publ i c groups studying health issues and pol icy and wi 11 par- ticipate fully in local, State, and national health systems planning. University of llinnesota Hospitals and Clinics will continue to provide a governance model which reflects the publ i c accountabi 1 i ty of a Statewide heal t h care resource.

HOSPITAL INPATIENT ADMISSIONS 1969-1978

I-III Trend Line

PATIENT ORIGIN (77-78)

Metro (7 County)

Out-State

Other States

Year

SECTION I 1 1


CAPITAL PROGRAM - BACKGROUND, PROBLEMS, AND SOLUTIONS

The c a p i t a l f a c i l i t i e s p lanning process f o r U n i v e r s i t y Hosp i t a l s and C l i n i c s was i n i t i a t e d i n the 1960's as an i n t e g r a l p a r t o f the Hea l th Sciences Master Plan. The goal o f Hosp i ta l f a c i l i t i e s p lanning has been t o prov ide f a c i l i t i e s which adequately suppor t t he Serv ice, Research, and Education missions o f the Hosp i ta l s and C l i n i c s and the Un i ve r s i t y .

The planning process has ex tens i ve l y u t i l i zed i n t e r n a l and ex te rna l resources which are l i s t e d on page 10. On the bas is o f these s tud ies i t was determined t h a t Un i ve r s i t y Hosp i ta l s and C l i n i c s should r e t a i n and remodel present space where poss ib le and t h a t new cons t ruc t i on should be u t i l i z e d where no cos t - e f f e c t i v e o r acceptable a l t e r n a t i v e s e x i s t .

These s tud ies have a lso i d e n t i f i e d , i n some d e t a i l , t he phys ica l f a c i l i t y de f i - c i t s being encountered i n t h e e x i s t i n g f a c i l i t i e s a v a i l a b l e f o r I n p a t i e n t and Support Services. These d e f i c i e n c i e s a re summarized s t a r t i n g w i t h page 17. An analys is o f a1 t e r n a t i v e so l u t i ons f o r r e s o l u t i o n o f these d e f i c i e n c i e s i s prov ided on page 20.


EXISTING FACILITIES AND DEFICIENCIES

The Un i ve rs i t y o f Minnesota Hosp i ta l s and C l i n i c s u t i l i z e s a1 1, o r a p o r t i o n o f , the f o l l ow ing bu i 1 dings :

Mayo Complex Bui 1 dings (Main Hosp i ta l Complex)

Var ie ty Club Heart Hosp i ta l

Chi ldren 's R e h a b i l i t a t i o n Center

Masonic Memori a1 Hospi t a l

Boynton Heal th Serv ice ( f i f t h f l o o r i n p a t i e n t u n i t )

Powel 1 Hal 1 ( p o r t i o n houses computer, few department o f f i ces , c a f e t e r i a and motel f a c i l i t y )

Paul Dwan Var ie ty Club Cardiovascular Research Center ( U n i t K/E) ( p o r t i o n houses rece i v i ng and n u t r i t i o n s torage)

Phi 11 i p-Wangens teen Gui 1 d ing (Uni t B/C) ( p o r t i o n houses o u t p a t i e n t c l i n i c s , Medical Records, and Business Of f ice)

The fo l low ing are some o f t he opera t iona l , func t iona l , and space d e f i c i e n c i e s encountered i n t he present f a c i l i t i e s - p r i m a r i l y the Mayo Complex

General Bui l d i ng Def i c ienc i es

I. Transpor ta t ion and C i r c u l a t i o n

A. S ing le loaded c o r r i d o r ( " race t r a c k " ) design

1. i n e f f i c i e n t t r a f f i c pa t t e rns

2. congestion, no ise and unnecessary t r a f f i c

3. inadequate widths

4. c i r c u l a t i o n o f a i r

B. E levators

1. too few i n number

2. cannot be used i n a manner so as t o e f f e c t i v e l y r e t a i n a c lean and d i r t y separa t ion o f m a t e r i a l s f rom people

U n i v e r s i t y o f Minnesota Hospi t a l s and C l i n i c s E x i s t i n g F a c i l i t i e s and D e f i c i e n c i e s

Page 2

I I . Storage and Space D e f i c i e n c i e s

A. Consequences

1. misuse o f c o r r i d o r s f o r s to rage i n v i o l a t i o n o f codes, ordinances, and good p r a c t i c e

2. increases d i f f i c u l t y i n a t t a i n i n g a p p r o p r i a t e a s c e p t i c techn ique and p r a c t i c e

3 . creates i n e f f i c i e n t methods o f s to rage and resupp ly

4. adds t o o v e r a l l workload due t o i n e f f i c i e n t opera t ions

P a t i e n t Care S t a t i o n De f i c ienc ies

I . P a t i e n t Rooms and F a c i l i t i e s

A. Room s i z e

1. S ize d e f i c i e n c i e s

a ) 24% below c u r r e n t space minimum standards

b ) 75% below one o r more dimensional s tandard

c ) 12% have no a d j o i n i n g t o i l e t

2 . Size problems

1 . cannot adequately accommodate necessary equi pment

2. compl i cates p a t i e n t ca re techniques

3. d i f f i c u l t t o respond i n emergency s i t u a t i o n s

4. l a c k o f s to rage f o r p a t i e n t ' s persona l be long ings

B. Nursing s t a t i o n suppor t f a c i 1 i t i e s

1. F a c i l i t i e s l a c k i n g o r d e f i c i e n t

a ) p a t i e n t day rooms

b) wai t i n g / v i s i t i n g areas

c ) p r i v a t e consul t a t i o n rooms

d ) inadequate i nserv i ce , conference, 1 ocker , 1 ounge, t o i l e t f a c i l i t i e s

e ) inadequate c h a r t i n g l s t u d y areas

f ) p h y s i c i a n o f f i c e , o n - c a l l o r s l e e p i n g f a c i l i t i e s

g ) inadequate supply, medicat ion, equipment s to rage areas

h) inadequate t reatmen t/exam rooms

i ) inadequate number o f i s o l a t i o n rooms conforming t o standards f o r maximum i s o l a t i o n s

2. S t a t i o n f a c i 1 i ty problems

a ) l a c k o f p r i v a c y f o r p a t i e n t s and s t a f f

b ) congest ion and i n e f f i c i e n t o p e r a t i o n

-1 8-

Uni v e r s i t y o f Minnesota Hosp i t a l s and C l i n i cs E x i s t i n g F a c i l i t i e s and Def i c ienc ies

Page 3

Therapeuti c and Diagnost ic System De f i c i enc i es

I. Diagnost ic Radiology/Nuclear Medicine

A. Size de f i c i enc i es

1. room f l o o r t o c e i l i n g and l i n e a r dimensions too small t o accomnodate modern equipment

B. Inadequate space f o r proper f u n c t i o n

1. p a t i e n t space: wa i t i ng , dressing, and t o i l e t f a c i l i t i e s

2. s t a f f space: f i l m reading, i n t e r p r e t a t i o n , consul t a t i o n , teaching, 1 i b r a r y , conference, storage, o n - c a l l , locke r , 1 ounge

11. C l i n i c a l Laborator ies

A. Inadequate space f o r proper f u n c t i o n

1. e x i s t i n g l abo ra to r y working space i s 40 t o 100 square f ee t per s t a f f person and should be 150 t o 200 square f ee t

2 . separat ion o f v i t a l f a c i l i t i e s and an i n a b i l i t y t o c e n t r a l i z e some equipment causes i n e f f i c i e n c y o f ope ra t i on and i n e f f i c i e n t use o f s t a f f t i n e

3. r a p i d expansion i n the use o f l a b o r a t o r y t e s t i n g and l abo ra to r y mon i to r ing o f p a t i e n t s has caused a dramat ic expansion i n t he o v e r a l l l abo ra to r y a c t i v i t y du r i ng recen t years

4. c o r r i d o r wid ths and improper s torage space make some areas n o t up t o codes and good p r a c t i c e

I 11. Radia t ion Therapy


1. p a t i e n t space: wa i t i ng , dressing, t o i l e t f a c i l i t i e s

2. s t a f f space: exam rooms, recep t ion , c o n t r o l storage, consul t a t i on, conference, classroom, o f f i c e

I V . Pharmacy


1. i . v. addi t i v e program cannot be adequately developed.

2 . drug i n f o rma t i on cen te r developments cannot be accommodated

3. s t a f f space: d ispens ing compounding, work storage, conference, teaching, o f f i c e

V. Central S t e r i l e Processing

A . Inadequate space f o r e f f i c i e n t storage, p repara t ion and process ing

V I . Other

A . Inadequate space f o r proper f u n c t i o n

B. Inappropr ia te l o c a t i o n and func t iona l i n t e r f a c e s

-19-


ANALYSIS OF ALTERNATIVE SOLUTIONS

FOR INPATIENT AND SUPPORT SERVICE FACILITIES

A1 t e r n a t i v e so lu t ions t o c o r r e c t t he d e f i c i e n c i e s be ing encountered i n i n p a t i e n t and support se r v i ce f a c i l i t i e s f a l l i n t o f o u r gener i c ca tegor ies :

I. Remodeling

This p o t e n t i a l s o l u t i o n would l i m i t c a p i t a l improvement a c t i v i t y t o t he remodeling o f e x i s t i n g f a c i l i t i e s - p r i m a r i l y the Hayo Complex. Unfor- tunately, remodeling alone cannot reso lve the f u n c t i o n a l obsolescence and space de f i c iency problems which e x i s t .

Un i ve r s i t y Hosp i ta l s c u r r e n t l y has approximately 750 gross square f e e t a v a i l a b l e f o r each opera t ing bed. Th is amount o f space i s s u b s t a n t i a l l y below (40-45%) cu r ren t h o s p i t a l i n d u s t r y standards f o r U n i v e r s i t y and teaching hosp i t a l s . I n add i t i on , remodeling would n o t r e s u l t i n contemporary design con f igua t ions f o r i n p a t i e n t bed u n i t s (even i f space were adequate) because o f t h e short-span cons t ruc t ion , 1 ack o f mechanical space, i n s u f f i c i e n t f l o o r t o c e i 1 i n g he ights , and o t h e r phys ica l con- s t r a i n t s o f the present f a c i l i t i e s - e s p e c i a l l y t h e Mayo Complex.

11. Complete Replacement

Complete replacement o f t he present Hosp i ta l f a c i 1 i t i e s would represent the bes t design s o l u t i o n t o the d e f i c i e n c i e s being encountered. To ta l replacement would permi t t h e development o f adequate space, f unc t i ona l i n t e r r e l a t i o n s h i p s , and design con f i gu ra t i ons f o r a1 1 Hospi t a l departments and serv ices.

To ta l replacement, however, waul d r e q u i r e the abandonment o f t h e present f a c i l i t i e s which can remain f u n c t i o n a l , f o r var ious a c t i v i t i e s w i t h r e - modeling. I t would a l s o be t he most c o s t l y s o l u t i o n - approximately two t o th ree t imes t he c o s t o f a l t e r n a t i v e s I 1 1 o r I V .

111. Phased New Const ruct ion and Remodeling P ro j ec t s

Th is a1 t e r n a t i v e s o l u t i o n would u t i l i z e two cons t ruc t i on and remodel i n g p ro j ec t s t o reso lve t he f a c i l i t y de f i c i enc i es . The f i r s t phase, r e - f e r r ed t o as U n i t H, i nc ludes t he replacement of p e d i a t r i c beds, t he expansion and remodeling o f opera t ing room f a c i 1 i t i e s , t h e rep1 acement of su rg i ca l i n t e n s i v e care through remodeling o f c u r r e n t f a c i l i t i e s and new cons t ruc t ion ad jacent t o t he Mayo Complex and on t op o f t he Dwan Va r i e t y Club Cardiovascular Research Center. The second phase, r e f e r r e d t o as U n i t J o r t he l l ed ica l /Surg ica l Replacement P ro j ec t , would c o n s i s t o f new cons t ruc t ion on the Powel 1 Hal 1 s i t e and Mayo remodel ing t o r eso l ve t he remaining f a c i l i t y d e f i c i e n c i e s f o r I n p a t i e n t and Support Serv ice a c t i v i t i e s

Univers i t y o f blinnesota Hosp i ta l s and C l i n i c s Analysis o f A l t e r n a t i v e So lu t ions f o r I n p a t i e n t and Support Serv i ce Faci 1 i t i e s

Page 2

Fo l lowing the development o f schematic p lans f o r U n i t M, an assessment o f the p r o j e c t i nd i ca ted t h a t t h i s a1 t e r n a t i ve s o l u t i o n would h inder the s a t i s f a c t o r y f unc t i ona l i n t e g r a t i o n o f a l l f a c i l i t y components and ad- ve rse ly e f f e c t the ongoing opera t ions and f inances o f the Hosp i ta l bo th dur ing and subsequent t o cons t ruc t i on . I n a d d i t i o n , i t was concluded t h a t the phased approach would compl icate and p ro long the ex te rna l review process. These disadvantages a re f e l t t o outweigh any cons t ruc t i on schedule o r cos t advantages which m igh t be r e a l i z e d through phased con- s t r u c t i o n and remodeling.

I V . Un i f ied New Const ruct ion and Remodeling P r o j e c t

Th is s o l u t i o n would reso lve t he f a c i 1 i t y d e f i c i e n c i e s through a s i n g l e cons t ruc t ion and remodeling p r o j e c t . I t would i nco rpo ra te the elements o f both U n i t H & J and would l i m i t new c o n s t r u c t i o n t o the Powell H a l l s i t e (and poss ib l y t he ad jacent Card iovascular Research Center ) . Re- modeling o f vacated Mayo f a c i l i t i e s would occur subsequent t o the com- p l e t i o n o f new cons t ruc t ion . Th is s o l u t i o n would maximize t he func t iona l i n t e g r a t i o n o f a1 1 departments and serv ices , m i n imi ze opera t iona l impact dur ing cons t ruc t ion , and simp1 i f y t he ex te rna l rev iew process. While t h i s approach might delay t he complet ion of some U n i t H components i t i s f e l t t h a t i t would n o t delay, and migh t improve, t he complet ion schedule f o r a1 1 p r o j e c t components

SECTION I V

UNIVERSITY HOSPITALS RENEWAL PROJECT OVERVIEW

The Un i ve rs i t y Hospi t a l s Renewal P r o j e c t i s env is ioned as a s i n g l e cons t ruc t i on and remodeling p r o j e c t t o reso lve t h e f u n c t i o n a l and space problems now being encountered by I n p a t i e n t and Support Serv ice A c t i v i t i e s . Whi le some p re l im ina ry ana lys is and p lanning has been completed, t he exact nagni tude o f new cons t ruc t ion , remodeling and cos t can on l y be d e t a i l e d through t h e a c q u i s i t i o n o f a r c h i t e c t u r a l and program consu l tan t serv ices f o r feas i b i 1 i ty s tud ies and schemat i c development. The p r o j e c t overview on page 23 should the re fo re , be considered a very p r e l irninary est imat ion o f the p r o j e c t s scope,

The d e t a i l e d s tud ies which w i l l be conducted w i l l u t i l i z e the f o l l o w i n g p lanning c r i t e r i a t o guide the o v e r a l l development o f p lans:

1. Present f a c i l i t i e s i n Masonic Memorial Hosp i t a l , Boynton Hea l th Services ( 5 t h f l o o r ) , Var ie ty Club Hea l th Hosp i ta l , Ch i l d ren ' s R e h a b i l i t a t i o n Center, Paul Dwan Cardiovascular Center (Receiv ing Center) , and Phi 11 i p s - Wangensteen B u i l d i n g ( c l i n i c s ) , w i l l cont inue t o be u t i l i z e d .

2 . Hosp i ta l po r t i ons o f the Mayo Complex a re unacceptable f o r the development o f contemporary Nursing S t a t i o n and c e r t a i n o the r p a t i e n t care f a c i l i t i e s . Therefore, new cons t ruc t i on w i l l be u t i l i z e d f o r these serv ices and vacated f a c i l i t i e s w i l l be remodeled f o r low-technology and o the r support func t ions .

3. A l l f a c i l i t i e s w i l l be developed t o assure maximum f l e x i b i l i t y i n t h e f u t u r e .

4. Const ruct ion and remodeling w i l l be l i ,m i t ed t o f i nanc ing l i m i t s o f revenue bondi ng .

A summary of the r e s u l t s o f t he Debt Capaci ty eva lua t i on conducted by Erns t and Erns t i s prov ided on page 24 and a p r e l i m i n a r y p r o j e c t schedule on page 26 . A copy o f the r e s o l u t i o n under cons idera t ion by the Regents i s prov ided a t the end o f t h i s sec t ion . Adopt ion of t h i s r e s o l u t i o n w i l l pe rmi t t he a c q u i s i t i o n o f A r c h i t e c t u r a l and Program Consul tant Serv ices t o assess the f e a s i b i l i t y and exact components o f t h e p r o j e c t by Summer, 1980.


RENEWAL PROJECT PRELIMINARY FACT SHEET

S i t e - New cons t ruc t ion would occur on the present Powell H a l l s i t e which m o u n d e d by Essex S t r e e t (Nor th) , Harvard S t r e e t (Eas t ) , R ive r Road (South), and the Paul Dwan Va r i e t y Club Card iovascular Research Center - U n i t K/E (West). Considerat ion w i l l a1 so be g iven t o u t i 1 i z ing t he capac i t y o f U n i t K/E f o r add i t i ona l f l o o r s , s t a r t i n g w i t h t h e f o u r t h f l o o r , t o increase the ava i l ab l e square f oo tage / f l oo r . Remodeling would be p r i m a r i l y r e s t r i c t e d t o the Mayo Complex.

Scope

Ten ta t i ve New Const ruct ion Com~onents .............................. ------ -Adu l t and P e d i a t r i c beds i n Mayo Complex (approx imate ly 500)

-Operating Room and Post Anesthesia Recovery

-Central S t e r i l e Processing

-Labor/Del i very

-Cys toscopy

-Diagnost ic Radi 01 ogy

-Physi ca l Medi c i ne and Rehabi 1 i t a t i on Treatment

-o ther support , pub1 i c, c i r c u l a t i o n , and mechanical space

Ten ta t i ve Mayo Come1 ex Remodel i ng Components ------------ ----- ---- ------ -Laboratory Medicine and Pathology

-Soci a1 Serv i ce

- N u t r i t i o n

-Pharmacy

-Kidney D i a l y s i s -Biomedi ca l Engineer ing

-General Support Departments

-Ma jo r i t y o f .admin is t ra t i ve and departmental o f f i c e s -&-ca l l rooms

-Payro l l /Personnel

-Management Engi neer i ng

-o ther - 2 3-


LONG-TERM DEBT CAPACITY EVALUATION

I n 1977, an ana lys is o f t he long- term debt capac i t y o f U n i v e r s i t y Hosp i t a l s was i n i t i a t e d t o analyze t t ie Hosp i ta l ' s capac i t y t o support a1 t e r n a t i v e forms of long-term debt i n con junc t ion w i t h t h e proposed c a p i t a l program.

With the assistance o f the a u d i t i n g f i r m o f E rns t & Ernst , t he debt capac i t y of the Hospi ta l was evaluated f o r each o f t h ree a l t e r n a t i v e methods o f f i nanc ing (State Ob l iga t ion Bonds, U n i v e r s i t y Bonds, and Hospi t a l Revenue Bonds) w i t h two a l t e r n a t i v e complet ion dates f o r new cons t ruc t i on (1986 and 1989). The e l ements o f the study i n c l uded:

1 ) The p repara t ion o f income and expense p r o j e c t i o n s on a Hospi ta l -w ide and departmental bas i s f o r each year, 1977-78 through 1993-94.

2) A p r o j e c t i o n o f average r a t e increases necessary f o r each year t o o f fset i n f l a t i o n , cap i t a l p r o j e c t costs ( dep rec i a t i on ) , and i n t e r e s t expense (on each f inanc ing a1 t e r n a t i v e ) .

3) A p r o j e c t i o n and comparison o f cash a v a i l a b l e f o r i n t e r e s t expense and bond re t i r emen t w i t h cash needs under each f i nanc ing a l t e r n a t i v e .

4 ) A comparison o f debt s i z e and o the r f i n a n c i a l r a t i o s t o cu r ren t i ndus t r y standards.

The study concluded t h a t adequate debt capac i t y e x i s t s f o r t h e p r o j e c t u t i l i z i n g e i t h e r S ta te General Ob l i ga t i on o r U n i v e r s i t y Bonds. I t was a l s o determined t h a t adequate debt capac i t y does n o t e x i s t i f Hosp i ta l Revenue Bonds a re u t i l i z e d .

The at tached t a b l e summarizes t he p ro j ec ted t o t a l c o n s t r u c t i o n and debt se r v i ce costs f o r S ta te General Ob l i ga t i on Bonds and U n i v e r s i t y Bonds i n 1986 and 1989. I t should be noted t h a t t h e U n i v e r s i t y Bonds r e q u i r e a f a r g r e a t e r l e v e l o f debt se rv ice than the S ta te General Ob l i ga to r y Bonds. I n add! t i o n , ac tua l cons t ruc t i on costs, using present est imates, would increase by over 50 m i l l i o n do1 l a r s i f the completion o f new cons t ruc t ion i s delayed u n t i l 1989.

PROJECTED TOTAL PROJECT COSTS

$487 Million

$327 Million

Debt Service

r

Debt Service Estimate

$299 Million I -C_

Construction \ Estimate

$188 Million - - - - . - - - - - - - I

Construction Estimate i r

_.._.____I__L- -- -. L $Ia8

State G/O Bonds

1986 Completion

University Bonds

$623 Million

$418 Million


$177 Million

Construction

$241 Million

9


$382 Million

i

Construction Estimate

$241 Million

A

1989 Completion

State GI0 Bonds

University Bonds

UNIVERSITY HOSPITALS RENEWAL PROJECT

PRELIMINARY PROJECT SCHEDULE

Regents Review and A u t h o r i z a t i o n f o r Schematic Development

A r c h i t e c t and Program Consu l tant S e l e c t i o n

Compl e ti on o f Schema t i c Development

Regents Review and Approval

Externa l Review

New Const ruc t ion S t a r t

New Const ruc t ion Completion

Remodeling Completion


AGENDA ITEM FOR Physical Plant and Investnents COMMITTEE

I. Title Medical-Surgical Replacement Project

( ) Information ( X ) Resolution or Motion Required

11. Administration Recommended Resolution or Proposed Action:

Whereas, the Board of Regents have continually reviewed and confirmed the Health Sciences Master Plan for Capital Improvement; and

Whereas, the Board of Regents have long recognized the need to upgrade and expand the facilities available to University Hospitals and Clinics for the fulfillment of i t s educational, research, and service missions; and

Whereas, the Board of Regents have reviewed the recent recommendations from University Hospitals and Clinics ' Board of Governors that the Unit H and Medical/Surgical Replacement projects be consolidated into one capital project;

Therefore, be it resolved, that the Board of Regents endorses and adopts the University of Minnesota Hospitals and Clinics ' Board of Governors recommendation for the development of a single capital replacement project and authorizes the administration to proceed with the implementation of the recommendation including the acquisition of necessary and appropriate resources for planning and design.

111. Purpose or Intent of the Item:

To familiarize the Board of Regents with the proposed project and to obtain Regental approval to proceed with the project.

IV. Previous Board Action and/or Pertinent Information:

1. March 197 8 - Document titled " University Hossitals Planning Summary - March 1978" was presented.

2 . November 1978 - Document titled "University of Minnesota Hospitals and Clinics Capital Facilities Planning Summary" was presented.

3 . January 1979 - Unit H - Pediatric Nursing .Unit/Operating Suite Project - Informa tion.

4. February 1979 - Advised the Board of the proposed Medical-Surgical Replacement Unit.

5 . March 1979 - Received Regental approval to se lec t a functional pro- gramming consultant for the Medical-Surgical Replacement Project.

6. s e e attached.

V. Presented by Donald P. Brown VI, Date: May 10, 1979

TO : Facilities Committee

UNIVERSITY OF MINNESOTA TWIN CITIES

FROM : Planning and Operations Staff

University Hospitals and Clinics 420 Delaware Street S.E. Minneapolis, Minnesota 55455

SUBJ : Five Year Projections-Certificate of Need Projects

June 12, 1979

Attached is the updated five year projection for construction and equipment projects which will require a Certificate of Need (exceed $150,000).

Many of the items are familiar to you. since the list is prepared and updated annually as an extension of the annual renovation and equipment budgeting process.

A brief summary:

(1) Capital requirements for the next five years are large, approaching $200,000,000.

(2) The items are primarily of a replacement nature. Only one project (an Emission C .A.T. Scanner planned for fiscal year 1981 purchase) represents a planned introduction of new technology. The Bone Marrow program represents an expansion in program activity.

(3 ) Many of the equipment items on the list are those of diagnostic radiology. This represents no particular new emphasis in this department. Equipment costs are high and regularly exceed the Certificate of Need threshold.

HEALTH SCIENCES

h

2 8 4 a 4

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Page #2

Fiscal Year Item

Xonics Versagraph- Diagnostic Radiology

Peripheral Cardiovascular Special Procedures Equip- ment-Diagnos t ic Radiology

Emission C.A.T. Scanner- Nuclear Medicine

University Hospital Renewal Pro j ec t

Clinical Laboratories Computer

Pediatric Suite Radio- graphic Equipment- Diagnostic Radiology

Radiographic-Fluoro- scopic System-Remote Control

Dynamic Imaging Equipment- Nuclear Medicine

High Precision- Tomographic Unit- Diagnostic Radiology

Estimated Cost

$ 150,000

In excess of '$150,000,000

Description

Replacement of a 9 year old tomographic unit . Replacement of 15 year old angiographic equipment located in the Heart Hospital.

Clinical introduction of new brain metabolism testing equipment.

Bed units, operating rooms and patient related support department replacement and spatial expansion.

Addition of second small computer to process laboratory result reporting.

Replacement of 10 year old radiographic-fluoro- scopic equipment used for pediatric diagnostic work.

Replacement of 10 year old radiographic equipment.

Replacement of 10 year old nuclear medicine scanning equipment used for measuring blood flow.

Replacement of 10 year old tomographic equipment used for inner ear diagnostic radiology procedures.

Page #3

Fiscal Year

1984-85

Item Estimated Cost

Computerized Total Body Scanner-Nuclear Medicine $ 150.000

C.T. Scanner-Diagnostic Radiology $ 785,000

Radiographic-fluoro- scopic equipment- Diagnostic Radiology $ 250,000

Description

Replacement of 10 year old general nuclear medicine scanner.

Acquisition of second total body scanner to handle anticipated workload.

Replacement of 10 year old general radiographic equipment.

Facilities Committee

of the

Board of Governors

University of Minnesota Hospitals

Meeting: Wednesday, May 16, 1979 11:30 A.M., Dining Room I11 Called to Order: 12:lO P.M. Adjourned: 1 : 2 0 P.M.

Present: Harry Atwood John Tiede Cheri Perlmutter John Westerman Paul Quie Tom Jones

C Absent: Timothy Vann Clint Hewitt Jeanne Givens Joseph Resch Michael Eisenberg

Guests : A1 Hanser

Staff : Johnelle Foley Bob Dickler Ron Klemz

Minutes of the April 18, 1979 meeting were approved as mailed.

University Hospitals Renewal Project - Progress Report Mr. Atwood commented on the discussion and recommendation of the Facilities Committee at the April 18 meeting to combine projects H and J into a single construction project. This recommendation was accepted by the Board of Governors and forwarded through Vice-President French to the Board of Regents.

Mr. Dickler and Mr. Westerman reported the action of the Board of Regents on May 10 and 11 regarding this recommendation. The

C item was extensively discussed at the Physical plant and Invest- ments Committee on May 10. A recommendation was made by this

committee to the full Board of Regents on May 11 to proceed with the combined project. The proceed recommendation was deferred for one month by the full Board to permit time for the Regents to 3 refamiliarize themselves with the project. Chairman Moore will arrange the mechanism to permit this briefing.

Mr. Atwood stated that the Facilities Committee ,and staff would be'prepared to provide the necessary background and briefing information so that the project could proceed as expenditiously as possible.

1979-80 Annual Equipment and Remodeling Budget

Mr. Jones, Mr. Van Hulzen and Mr. Klemz presented the 1979-80 budget recommendations using a briefing information memorandum. Discussion included:

a) The proposed budget falls within preplanning target figures.

b) The equipment budget represents 2.8% of the proposed operating budget.

c ) The usual extensive review process was used including review by the Program Committee of the Clinical Chiefs.

d) The equipment budget, adjusted for extraordinary items such as the linear accelerator in 1978-79 and the C.A.T. scanner in 1979-80, has remained consistently at the 2.1 million level for the past three years. The annual renovation budget has remained at historic spending levels as well

e) Three Certificate of Need Items, those exceeding $100,00Oin cost, are part of this budget.

f) The budget was reduced by $400,000 compared with total requests and does not include yet to be defined requirements for the proposed bone marrow transplantation and pediatrics intensive care programs.

After discussion, a motion was made by Dr. Tiede and seconded by Dr. Quie to recommend this budget for approval to the Board of Governors. The motion passed unanimously.

Plannin~ Staff Re~ort

C Tom Jones commented that architectural development on the clinical laboratory project was moving ahead. This includes renovation of vacated business office and admissions space on the second floor of the Mayo building and completion of shelled space in Unit BC. Schematic development drawings and cost estimates will be brought to the Committee for review and recommerldation in the fall.

C TJ: jmm


Proposed Annual Equipment and Remodeling Budget

Fisca l Year 1979-80

1

I i I

C ' UNIVERSITY OF MINNESOTA : Un~vers~ty Hospitals and C l ~ n ~ c s I TWIN CITIES

' 420 Delaware Street S E ( Minncupol~r. Minnesota 55455

I I

I I

May 8, 1979

Facilities Committee, Board of Governors

FROM: Hospitals Planning and Operations Staff

SUBJ: Proposed Annual Equipment and Renovation Budget, Fiscal Year 1979-80

The long range financial plan of the Hospitals and Clinics has established the following as pre-planning objectives for the 1979-80 annual equipment and renovation budget:

Annual Equipment Budget: $3,000,000 Annual Renovation Budget: $ 500,000

These target figures are based upon:

(a) Analysis of historic capital requirements

(b) Adjustment of historical trends to reflect "extraordinary" equipment needs as identified in the five year equipment plan

*

(c) Consistency with industry standards of annual equipment expenditures equaling 2.5 - 4.0% of the annual operating budget.

The proposed 1979-80 capital budget falls within the preplanning guidelines.

Pre-Planning Proposed Guidelines Budget

Annual Equipment Budget: $3,000,000 $2,932,835 Annual Renovation Budget $ 500,000 $ 421,625

The equipment budget figure represents 2.8 percent of the operating budget.

HEALTH SCIENCES

Budgeting Process

Annual Capital Equipment

and Remodeling Budget

Step:

1. Hospital/clinical departments identify needs and recommend budget items. Pre- planning target figures reviewed by General Director's Group.

2. Administrative staff review.

3. Certificate of Need items reviewed by Program Committee, Clinical Chiefs

4. General Director's Group Review

5. Facilities Committee Review

6. Board of Governors Review

Annual Equipment Budget 1979-80

Equipment b u d g e t s are "ze ro based" and i t i s t h e r e f o r e d i f f i c u l t t o draw c o n c l u s i o n s from a y e a r t o y e a r comparison. However, comparisons do h e l p i l l u s t r a t e c a p i t a l r e q u i r e m e n t t r e n d s .

Proposed

* I n c l u d e s $1 ,050 ,000 L i n e a r A c c e l e r a t o r p r o j e c t - R a d i z t i o n Thera?:;

SUMMARY

Annual Renovation Budget 1979-80

. . Although renovation budgets are "zero based1', historical comparison does illustrate the constant requirements of this type of expenditure.

Proposed 1976-77 1977-78 1978-79 1979-80

$476,373 $343,290 $497,100 $421,625

The annual renovation budget is developed and based upon the following principles: % .

-. a) Highest priority is given to expenditures which

will have a positive effect on direct patient care and/or are regulatory agency required.

b.) Renovation in areas which will be' moved to new clinical facilities must be acutely essential and/or minor in scope.

Proposed 1979-80

C a p i t a l Budget-Equipment -

D e s c r i p t i o n o f Budget Composit ion

The equipment budge t i s p l u s 3 i t ems which w i l l Twenty-nine (29) o f t h e i n d i v i d u a l l y . These it c o s t of $27 ,762 . The r have a n average c o s t o

composed of 842 i n d i v i d u a l i t e m s , r e q u i r e C e r t i c a t e o f Need approva 842 i t ems c o s t $10,000 o r more

ems t o t a l $805,088 a t a n ave r age emaining 813 i t e m s (842 minus 29) I£ $ 1 , 1 4 1 p e r i t e m and t h e s e items

t o t a l $927,747;

I t ems $10,000 o r more (29) I t e m s l e s s t h a n $10,000 (813)

S u b - t o t a l . . . . . . C e r t i f i c a t e of Need I tems Contingency

Proposed 1979-80 Equipment B u d g e t . . . $2 ,932 ,835

Fol lowing i s a breakdown of t h e equipment budget by d e p a r t m e n t / f u n c t i o n a l g roup ings ( exc lud ing C e r t i f i c a t e of Need i t ems ) :

*

b Department

Nursing Services Operating ~oom/Anesthesiology Laboratories Outpatient Clinics Rehabilitation Center Respiratory Therapy Therapeutic Radiology Medical Records Pharnacy Material Services PsychiatryfClinical Psychology Diagnostic/Nuclear Medicine Environmental Services -

LaundryILinen Nutrition Business Office/Accounting Patient Monitoring Bio-Medical Engineering Infection Control Administrative Services

9

All departments. . . .

#

#Equipment I terns Average Cost/Item Budget Amgunt

Descript ion of Equipment $10,000 o r More

1. Operating RoomslWajor Operating Room Table ($10,000)- Replacement.

2 . Medical Word Processing Center lCent ra l D i c t a t i o n System ($41,475) - Replacement The cur ren t system components (8 d i c t a t i o n u n i t s ) a r e f i v e years o ld and have operated 24 hours a day, 7 days a week. Each u n i t records 100-250 r e p o r t s a day during t h e week, and 50 per day on weekends. System has worn o u t .

3 . Labs/Fetal Lung Maturi ty Analyzer ($14,000) - New Equipment. This instrument measures t h e degree of f e t a l lung matu r i ty . Fa l se p o s i t i v e r e s u l t s f o r f e t a l lung matu r i ty can l ead t o t h e premature de l ive ry of i n f a n t s wi th t h e consequent deve.lopment of r e s p i r a t o r y d i s t r e s s syndrome, which has a

8

high m o r t a l i t y r a t e . This new instrument w i l l r e s u l t i n .\ fewer f a l s e p o s i t i v e r e s u l t s and i s l e s s time consuming (112-hour versus 3 hours f o r the cu r ren t method) and t h e r e f o r e , could lead t o reduced c o s t and improvement of c a r e provided t o p a t i e n t s .

b 4. LabslDupont ACA I1 ($76,160) - New Equipment. This instrument w i l l i nc rease t h e automation i n the handling of specimens. Purchase of t h i s machine w i l l e l iminate the need t o h i r e an a d d i t i o n a l medical t echno log i s t , r e s u l t i n g i n a pro jec ted n e t c o s t b e n e f i t (savings) of $1384 per yea r .

5 . LabsIBlood Gas System ($30,800) - Replacement. Current system has extens ive down-time and r e p a i r expenses. The computer i n t e r f a c e of t h e replacement system w i l l provide more rap id emergency t e s t r e s u l t s t o nursing s t a t i o n s .

6 . LabslGama Counter ($23,000) - Replacement. Because of cu r ren t equipment which has worn o u t , counting capaci ty has decreased by 25%. During the p a s t year the gamma counting workload has increased 20% and an e f f i c i e n t replacement machine i s r e q u i r e d .

7 . LabsIABA - 100 Analyzer ($19,000) - Replacement. This machine w i l l r ep lace an analyzer purchased i n 1966. Be- cause of reduced personnel t ime, purchase of t h i s machine i s pro jec ted t o r e s u l t i n a 5400 per year n e t c o s t b e n e f i t .

8 . LabslABA-100 Analyzer ($19,200) - New Equipment. An a d d i t i c n a l instrument i s needed t o provide s u f f i c i e n t s e r v i c e on chemistry t e s t procedures.

9. ~abs/~ut&~icrobic System ($49,500) - New Equipment. This machine is the first major technological step in microbiologic automation, and can automate urine cultures (2000-3000 testslmonth) and biochemical identification of gram negative bacteria (100 testsfmonth). Currently these two'tests require approximately 400 technologist-hours/ month, plus test results are available the same day, not the 1 to 2 days currently required. Because of reduced personnel time required with this instrument it is projected that there will be a net cost benefit of $8,945 per year.

10. Lab/High Pressure Liquid Chromatography Apparatus ($,-2,405)- New Equipment.

This instrument is needed to implement more accurate, faster methods for measuring antibiotic levels. Current workload in this laboratory requires 125 tests per month temporarily performed by the services of an outside laboratory. This .. is deemed inadequate with regard to quality control. Because of projected increased revenue, purchase of this instrument is expected to result in a net cost benefit of $7,260 per year.

11. Labs/Scintillation Counters ($27,000) - Replacement Current 2 instruments iail 10 times per week. These problems have caused an increase of about 15% in technical time 3 required to process cultures, as well as delays in getting - donor selection test results to physicians.

12. Labs/Liquid Nitrogen Refrigerator (S13,200) - New Equipment Tests for the assessment of donors and recipients for kidney - - - - -

and bone marrow transplantation requires an- extensive library of cells properly frozen so as not to deteriorate. The equipment will eliminate an extreme shortage of space for frozen cells.

13. Labs/Ultramicrotome ($10,500) - Replacement. This instruement will replace equipment purchased in 1962, and is used to cut the sections to be viewed with an electron microscope.

14. Labs/~eiss -- Microscope ($11,193) - Replacement This purchase will replace a ten-year old microscope.

15. Pharmacy/Modular Shelving Systems (S20,OOO) - New Equipment This purchnse provides tor storage of medications and processing of orders for the satellite pharmacy program.

Respiratory TherapylEar __--_ Oxvmeter ---c ($11,000) -- - New Equipment ~ r e hospitals arc treating an increasing numb~- patients with acute respiratory failure. A means of rapidly measuring oxygen saturation is required to maintain homeostasis and avoid oxygen toxicity.

Materials Services/Steam Sterilizer ($44,455) - Replacement Existing unit has approached the end of its useful l i f e . Unit is used to sterilize medical/surgical instruments.

t

Environmental Services/Solid Waste Compactor ($43,000) - New Equipment. - Because of changes of policy in the metro area with regard to solid waste, and because of increasing volume in solid waste at University Hospitals, a solid waste compactor is needed.

Kidney Dialysis/llillipore System ($11,000) - Replacement. This machine removes impurities irom water used in the * process of dialysis. .. Kidney Dialysis/Foam Detector ($10,500) -Replacement The instrument detects minute air bubbles and prevents them from entering the patient's bloodstream during dialysis.

Diagnostic Radiology12 Overhead Suspended Xray Tubes (-$52,000) - New Equipment The primary function oi ceiling mounted tubes is to obtain radiographs with the patient on his side. Existing tubes are coupled to the tables and cannot serve in this capacity. The patient side view is the single most important view for some cancer detection procedures.

Diagnostic RadiologylPortable Xray Unit ($27,000) - New Equipment. A portable unit is needed to adequately serve patients in

*

conjunction with ambulatory surgery.

Diagnostic RadiologyIMobile Xray Film Storage System ($60,000) - New Equipment. - This system provides enhanced personnel efficiency in storing and retrieving of films. In addition the system requires less floor space than a fixed-shelf system.

Diapnostic RadiologylAbdominal Scanner ($15,000) - Enhancement of existing equipment system. The addition of this component to the existing system will result in more versatile procedures, permitting visualization of otherwise "blind areas", plus permitting more rapid scanning.

2 5 . D i a e s t i c -- R a d i o l o ~ y / S m a l l Vesse l Scanner ($90,000) - ~ n h a n c e m c n t o f c x i s t i n G equipment s y s t e m .

Th i s component p rov ides t h e i d e a l survey method t o d e t e c t anatomic and p h y s i o l o g i c a l d e f e c t s on a non- invas ive b a s i s .

3 It enables e a r l y d e t e c t i o n of a r t e r i a l l e s i o n s w i thou t r e s o r t i n g t o an i n v a s i v e a r t e r i o g r a m .

~ d i o l o e v / H e a r t Ca the t e r - --

hine automates t h e r a p i d i n j e c t i o n o t dye I n t o n and blood b e s s e l s t o be seen on x - r a y movies.

2 7 . Nuclear Medicine/Automatic S c i n t i l l a t i o n Counting ~ ( $ 2 2 , 0 0 O ) ~ ~ e p l a c e m e n t . This device w i l l r e p l a c e an o b s o l e t e u n i t purchased over 10 yea r s ago, and permi t s t h e s e q u e n t i a l count ing of gamma r a y s emi t ted from r a d i o a c t i v i t y .

28. Nuclear Medicine/Multiformat Image ($10,000) - Replacement Replacement p a r t s t o r e x i s t i n g equipment can no longe r be .. ob ta ined . The dev ice permi t s m u l t i p l e images t o be acqu i r ed on f i l m .

2 9 . P a t i e n t Mon i to r ing / In t r a A o r t i c Balloon Pump ($20,000) - Equipment Addi t ion Another machine i s needed t o handle t h e demand f o r t h i s machine, The ba l loon pump i s used w i t h p a t i e n t s a f t e r h e a r t su rge ry and a s s i s t s t h e h e a r t i n pumping blood u n t i l t h e p a t i e n t i s more f u l l y r ecove red .

2

C F i s c a l Year 1979-80

C e r t i f i c a t e of Need Equipment

1. Diagnostic Radiolo /CAT Scanner (855,000: Equipment $785,000 + Remodefng $70,000) - Replacenlent.

The Department of Radiology c u r r e n t l y has two computerized tomographic scanners . The f i r s t i s an o r i g i n a l t r a n s l a t e - r o t a t e type of machine w i t h a scanning time of 4-1/2 minutes f o r t h e head and 6 minutes f o r the body. This length of time allows a r t i f a c l from p a t i e n t motion i n a l a r g e number of c a s e s , severe ly degrading t h e q u a l i t y of t h e image. I n a d d i t i o n , t h e s p a t i a l and c o n t r a s t r e s o l u t i o n a r e i n f e r i o r t o r e s o l u t i o n found i n equipment made c u r r e n t l y . .

The second u n i t i s p r imar i ly a r e sea rch u n i t on loan from .. P f i z e r , Incorporated. This machine has a s h o r t e r scanning time bu t p a t i e n t motion remains a problem.

New equipment can scan i n approximately f i v e seconds wi th marked inc rease i n s p a t i a l a n d . c o n t r a s t r e s o l u t i o n . Very -

C small l e s i o n s can e a s i l y be seen. I n sum, t h e new high r e s o l u t i o n scanners r ep resen t a s i g n i f i c a n t advance i n d iagnos t i c p r e c i s i o n .

2 . Nuclear Medic ine /Sc in t i l l a t ion Camera ($110,000)-Replacement. The replacement of t h e c u r r e n t equipment with a new u n i t w i l l provide t h e s t a t e - o f - t h e - a r t device f o r imaging the d i s - t r i b u t i o n of r a d i o a c t i v i t y . This camera permits t h e study of d i s t r i b u t i o n s of r a d i o a c t i v i t y t h a t a r e r e l a t i v e l y f ixed ( i . e . , l i v e r o r lung scan) or those d i s t r i b u t i o n s which a r e r ap id ( i . e . , ca rd iac func t ion , o r r e n a l blood flow) .

3 . Diagnostic Radiology/Urological X-ray Table ($135,000: Equipment $130,000 + Remodeli-ng $5 , 000) - Replacement. Exis t ing equipment can no longer be maintained i n a s a t i s f a c t o r y opera t ing s t a t u s . This t a b l e w i l l be used pr imar i ly f o r urodynamic s t u d i e s and has f e a t u r e s which a r e d i r e c t e d toward reducing the r a d i a t i o n dosage t o t h e p a t i e n t and a r e considered e s s e n t i a l .

. Proposed 1979-80 'Canital ~udGt-~emodelinc

Description of Budret Comnosition

The proposed budget for 19J9-80 is $421,625 and is comprised of 82 projects. Eleven (11) of the projects have costs of $10,000 or more. These projects average $24,710 each and comprise $271,805 of the proposed total budget. The remaining 71 projects (82 minus 11) total $149,820 and average $2,110 per project.

Projects $10,000 or more (11) $271,805 Projects less than $10,000 (71) 149,820

Total Proposed Remodeling Budget . . . $421,625

-. Following is a breakdown of the budget by department/functional groupings:

Nurs ing Operating Rooms/Anesthesiology Laboratories Outpatient Clinics Rehabilif-.ation Center Medical Records Pharmacy Materials Services Psychiatry/Clinical Psychology Computer/Managernent Services Diagnostic/Nuclear Medicine Environmental Services/Laundry Linen Nutrition Patient Monitoring Administrative Services PhysicaliBuilding Systems Pre-Planning Studies

Total Proposed Remodeling Project . . .

Descr ip t i .on of P r o j e c t s $10,000 o r Flore

1. Masonic Ga l l ey ($44,805) - Renovat ion o f former d ishwashing a r e a - t o c r e a t e modern g a l l e y c o n s i s t e n t w i t h o t h e r g a l l e y f a c i l i t i e s i n t h e h o s p i t a l .

2. Autopsy En t r ance ($10 ,000) - The c u r r e n t e n t r a n c e a r e a t o t h e au topsy l a b i s i n c l o s e p rox imi ty t o t h e R a d i a t i o n Therapy w a i t i n g room. Remodeling would e l m i n i a t e program lncom- p a t i b i l i t i e s .

3 . B i r t h i x - R o o m ($45,000) - I n c r e a s i n g demand of o b s t e t r i c a l s e r v i c e s , e s p e c i a l l y d e l i v e r y rooms w i t h a "home-like" environment, c r e a t e s t h e need f o r t h i s p r o j e c t .

4 . Low Temperature F r e e z e r Alarm System ($10 ,000) - T i s s u e samples s t o r e d f o r y e a r s i n l a b o r a t o r y f r e e z e r would b e -. des t royed i f t empe ra tu r e r i s e s t o a c e r t a i n l e v e l , which cou ld happen due t o f r e e z e r m a l f u n c t i o n o r a l o c a l i z e d i n t e r r u p t i o n of t h e power supp ly .

C 5 . Remodel - P u b l i c Restrooms ($10 ,000) - T h i s p r o j e c t w i l l conve r t t h e p u b l i c r e s t r ooms on main f l o o r of Mayo Bu i ld ing t o hand icap a c c e s s i b l e f a c i l i t i e s .

6 . Remodel Former R e s p i r a t o r y Therapy Area ($20,000) - Minor remodeling f o r changing occupancy p l u s a l t e r a t i o n s t o meet code r e q u i r e m e n t s .

Main LobbylCoffee Shop ($50 ,000) - Thi s p r o j e c t w i l l 7 ' M a e t h e a p p r o p r i a t e l e v e l o t f i r e p r o t e c t i o n .

8 . Remodel Areas f o r S a t e l l i t e Pharmacy Program ($25,000) - Conversion o f space t o accomodate pharmacy a r e a s th roughout t h e h o s p i t a l s .

9. Remodel -- Areas f o r Linen Exchange Program ($10,000) - Conversion of e x i s t i n g l i n e n s t o r a g e a r e a s t o accomodate a n exchange c a r t sys tem.

1 0 . I n s t a l l a t i o n of Cool-Shade Screens ($27.000) - I n s t a l l a t i o n of such s c r e e n s r e s u l t s i n energy c o n s e r v a t i o n .

11. Remodel Areas f o r Medical Supply E x c h a n ~ e Sv_stems ($20,000) - Convers ion of e x i s t i n g supp ly rooms t o p rov ide i n c r e a s e d manpower e f f i c i e n c y i n t h e p r o v i s i o n of s u p p l i e s t o n u r s i n g s t a t i o n s .

university of minnesota hospitals and clifjics

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