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