Presented by Bob Ruebusch, Senior Project ManagerOffice of Design & Construction

Part of Adventist Health Systems faith-based

non-profit nationwide 44 hospital chain

8 Campuses in Orlando under one license with

2,377 licensed beds

Approximately 40% of entire AHS system’s revenue

Largest hospital in US (by patient visits per year,

over 1 million)

ODC – In-House Program Manager

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Affordable Care Act (Obamacare)

Changing Demographics Changing Reimbursements Technology Physician Alignment Sustainable Design

Integration Workforce Shortages Convenience Expandable Changing Clinical Needs Home Care Support Cost Containment -

Value

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Two Distinct Visions with Some Common Themes:

1. The Really Nice “Cookie Cutter” Model

2. The Whole Health Campus Model

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Treating More People for the same $

HCAHPS - The patient votes how much you get paid

Modularity / Standardization / Universal Concept

Efficiency / Flexibility / Expandable

Building Systems Integration Sustainable Design LEAN

More Ambulatory Patients Safety Process Driven Physician SWARMs Decreasing Bed Count Manages “Chronic” Illnesses

more efficiently Outsourcing Models - CVS

ED?

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Big MOB Modeled after Large Inner City

Public Hospitals Kaiser Permanente Evidence Based Design Computerized Planning Programs

Less Costly / LEANest / Most Efficient / Fewer Employees

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More Patients for Same $ Patient Surveys Determine Payment Modular Designs / Universal Concepts Efficient / Flexible / Expandable Building System Integrations Front of House / Back of House Sustainable LEAN More Ambulatory Safety

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Whole Health Campus

with Wellness Emphasis

Efficient but Family

Focused

Wellness / Health Ctrs

Onsite

ED / ASC / POB Onsite

Cancer Care Onsite

Retail Community Services

Child Care Onsite

Focused on Ambulatory Care

& Medical Retail. (It just

happens to have a Hospital)

Hospitalization = The Failure

of the “Whole Health”

System

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LEANer

More efficient than now

More family-focused

Retail Campus look

Focused on wellness to

drive down cost

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1. Nurse Call Replacement 2. Lab Expansion / Renovation 3. OB Unit Renovations @ 4th FL 4. Inpatient Unit 7th FL 5. OR / Surgery Expansion 6. Install MRI in Old Lobby 7. North Market Ortho Practice 8. ED / ICU Study 9. IV Start Room / MOB / Outpatient Radiology

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CT Addition

Dr Alonzo

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1. Global Robotics /ENT Head & Neck Surgery 2. Door Security Upgrade 3. Fire Issues / Atrium Evaluation 4. Parking Garage 5. L & D Triage Expansion / Renovation 6. Cath Lab Expansion 7. Fitness Center Interior Reno 8. MOB 9. Pharmacy 10. 5th FL Beds 11. Lobby Admin / HR Interior Renovation

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1. 5th FL Build Out PCU 2. East Master Plan 3. East Pharmacy 4. ED Expansion 5. Replace Portions of Roof w/Suprema 6. FH East Rehab (3rd FL MOB) 7. CDU Renovation 8. 340b Infusion Suite

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1. KSM Bed Tower / CEP / Connector 2. Urology Table Installation in OR 3 3. KSM ED Expansion 4. KSM OP Neurology Practice Buildout5. 340b Infusion Suite

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1. AHS Florida Division Headquarters 2. Women's Hospital3. CEP to EOB Chilled Water Connection4. Pediatric Prep & Recovery (POPS) 5. Miscellaneous Engineering 6. 3rd FL Med Plaza / Dean Cole Practice Expansion Orlando 7. Orthopediatric Urgent Care Center 8. 615 Princeton / 2nd - 5th FL Corridor Renovation Project 9. Suite 401 Dr Fals - 615 Princeton Bldg 10. Panera Lobby Extension HV MOB 1st FL 11. Marketplace Outfitters 12. Adventist University Fire Alarm Upgrade 13. Orlando Parking Garage (1,241 spaces) 14. Ginsburg 12th FL PCU 15. Nuclear Med / MR 1st FL 16. Orange King Sign17. Orange / King Street Widening 18. OR's 14, 15, 19, 20 Peds 1 N PACU 19. Nutritional Services Call Center20. Perimeter Lockdown

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21. Peds 1 N PACU 22. Peds CVOR / CVICU Elevator 23. Radiology Master Plan 24. INR / 75% Complete 25. ProFil 3rd FL TRI Build-Out 26. Gamma Knife Relocation 27. Welch Café Renovation 28. Ginsburg 4th FL Bathrooms 29. 4 South Renovation 30. Women's Grease Trap Relocation 31. Women's Underground Utilities Relocation 32. Nurse Call Upgrade 33. Children's Lobby Office 34. Cardiology Security Modifications 35. CVOR Central Process Decontam Room 36. G-7 Ultrasound 37. Dispatch Relocation 38. Enclose Alcove Across from ED Imaging Rm 1 39. Central Pharmacy Distribution Center 40. Imaging Residency Program 41. 340b Infusion Suite 42. New Laundry

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1. I Am Safe Project 2. Winter Park Master Planning 3. Surgery Conference Room 4. Cancer Center Expansion 5. Women's Pavilion 1st Floor Build Out 6. South Wing 24 bed Expansion 7. Women's Center in Dr. Breit Building 8. Patient Wall Lighting & Fire Pump 9. Parking Garage (770 Spaces) 10. Endoscopy Relocation & Renovation 11. MRI Equipment Install & Renovation 12. ED / OBS Care Renovations 13. Replace Exterior Directional Signage 14. North Tower Master Plan Study Only 15. Build-out 1st FL Baby Place for Imaging

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