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Transformative Design

Transformative Design. Hospitals that Enable Lean Process Improvement. UIA / PHG 2013 Annual Healthcare Forum September 2013. $1.1 billion or 1,485 beds. Approximate annual cost of preventable adverse events in Canada.

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Transformative Design

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  1. Transformative Design Hospitals that Enable Lean Process Improvement UIA/PHG 2013 Annual Healthcare Forum September 2013

  2. $1.1 billion or 1,485 beds Approximate annual cost of preventable adverse events in Canada

  3. “experts suggest that the greatest gains in improving patient safety will come from modifying the work environment of health care professionals” -Canadian Adverse Events Study 2004

  4. Agenda • 1 Current State • 2 Key Elements of Transformative Design • - Characteristics • - Tools • - Measures • - Workflow Analysis • - Building Blocks • - Connecting Processes • 3 Key Design Concepts • 4 Future State of the Hospital

  5. For over 100 years, the hospital has been the core of our healthcare system, and a pillar of every community—the central hub where people enter and leave this world, and where scientific discoveries become life saving procedures. But in the last couple decades, technological, social and economic forces have chipped away at this model. As these trends continue—making traditional clinical environments punishingly expensive to run, and increasingly less necessary for many healthcare needs—the future of the hospital is uncertain.

  6. 1 Current State The traditional approach to health care facility design is fragmented and based on separate perspectives of each clinical discipline or department.

  7. 1 Current State • Current design practice reinforces care delivery processes that contribute to adverse events and also creation of other forms of waste (defects, delays, wasted motion, over production, etc).

  8. Not addressing the real costs 1 Current State

  9. 2 Transformative Design • Basic Characteristics: • Operationally Driven • Standardizes Processes • Focused on Patient Journey • Supports Point of Use/Care • Systemic

  10. 2 Transformative Design • Basic tools: • Workflow Analysis • Multi-Disciplinary Study Teams • 3P Workshops • Clinical Input to Design

  11. 2 Transformative Design 3P (Production, Preparation, Process)

  12. 2 Transformative Design • Key Components: • Measures • Workflow Analysis • Building Blocks • Connecting Processes

  13. 2 Measures • Establish collaboratively • Address waste (defects, over production, unnecessary waiting, confusion, transportation, excess motion, inventory, excess processing) • Measurable • Achievable

  14. 2 Workflow Analysis • Engage multi-disciplinary teams (clinical, support, business processes, patients/families) • Flow map current state • Identify opportunities • Build future state to achieve measures • Analyze 7 flows of healthcare

  15. 2 Workflow Analysis

  16. 2 Building Blocks • Therapeutic Environments • Better clinical outcomes, decrease pain, and reduce the length of patient stays • Respect individual privacy • Environmental control empowers patients & staff • Comfortable, stress-free and unthreatening surroundings

  17. 2 Building Blocks • New clinical service delivery models • New forms of patient provider interaction • Changing clinical service boundaries • Realigning the allocation of service tasks • New locations for deliver of clinical services

  18. 2 Building Blocks • Building Infrastructure (space, function, relationships, systems) • Adaptable – support different care processes • Flexible – manage changing workload cycles (hourly, daily, weekly, etc.) • Efficient – minimize staff and patient movement

  19. 2 Connecting Processes • Multidisciplinary study teams • Reduce number of steps in care process • Ubiquitous information & communications technology • Point of care everywhere • Patient & staff safety

  20. 3 Key Design Concepts • Care platforms • Surge capacity • Collaboration • Universal space • Progressive space

  21. 3 Key Design Concepts What does a transformative hospital look like?

  22. 3 Key Design Concepts Collaborative, flexible, universal Multi-disciplinary Care Teams ER Clinics Care Support Flex Exam Rooms Patient Care Patient Care

  23. 3 Key Design Concepts Collaborative, flexible, universal

  24. 3 Key Design Concepts Collaborative

  25. 3 Key Design Concepts Care Platforms

  26. 3 Key Design Concepts Care Platform: Integrated Interventional

  27. 3 Key Design Concepts FLEXIBLE PLANNING MODULES: Progressive Procedure Room FUTUREControl Room + Electronics Procedure Room Control Room + Electronics Interventional Radiology Surgery Interventional Cardiology Procedure Room Control Room + Electronics

  28. 4 Future State of the Hospital • Safer • Smarter • Smaller

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