the future for strategic planning of healthcare...

Dr Michael Phiri, The Sheffield University, UK

The Future for Strategic Planning of Healthcare

Infrastructure

22-24 October 2012, København Denmark

Dr Michael Phiri The University of Sheffield, UK


Design Strategies + Approaches ~ Evidence-Based Design.

~ Design for Sustainability.

~ Lean Healthcare and Lean-led Design.

~ Learning from Completed Construction Projects

(Post-Project Evaluations - PPEs including Post-

Occupancy Evaluations - POEs) + Feedback.

~ Six Sigma.

~ Simulation Studies + Modelling.

~ Varying combinations of all these.


Importance of Design

Strategies

Approaches Can Aid

Organisations Determine:

~ What to produce and do?

(Products or Outcomes)

~ How and when to do it?

(Process)

~ How consistently innovative

the products are and over

time perform responding to

changing contexts to

deliver on Return on

Investment?.(Performance)

Strategy, Tactics + Operations

Interrelationships


Importance of Design

Strategies Clarity of:

1. The Care Model.

2. The Estates Strategy

Model

3. The Physical Model.

TO ACHIEVE SUCCESS AND DELIVER

POSITIVE HEALTH OUTCOMES REQUIRES

ADDRESSING THESE IN TANDEM


To successfully implement

evidence-based design

principles, healthcare

design teams must

continually adopt

approaches that create

an environment of care

that incorporates

streamlined processes,

new technologies, and

nurtures innovative

design elements.

Importance of Design Strategies


Aim of Design Approaches in Health Identify proven evidence-based strategies and

corresponding interventions that:

~ Improve patient safety and health outcomes.

~ Enhance staff efficiency and effectiveness.

~ Increase patient, family, and staff satisfaction.

~ Accommodate today’s best practices, with flexibility to

adapt to the future.


Design for Sustainability

From Green Buildings to Sustainable Building

Building Assessment Methods which rate + rank buildings

and groups of buildings, based on their environmental

performance.

Need for Systems to Evolve with a Holistic Sustainability

Emphasis or Focus integrating Environmental, Economic

and Social issues (Hill & Bowen 1997, Cooper 1999, Cole

2005, Lutzendorf & Lorenz 2006, Kaatz et al. 2006 and

Turner 2006),


Key Drivers & Underlying Concepts

~ Design Matters: A basis for creativity, innovation &

continuous improvement. A means to

make ideas tangible and human-centred.

~ Evidence-Base: A source of authority.

~ The Role of Standards: A threshold + minimum

criteria to be achieved, for example, a

guarantee of safety + quality.

~ Design & Evaluation Tools: To aid the design

process and delivery of (health)

outcomes.


Case Studies Showcase:

America + EU Projects: ~ Houghton Le Spring Health Centre, UK.

~ New Aarhus University Hospital, Århus Bygning

Jylland, Denmark.

~ New Parkland Hospital, Dallas, USA.

Australasia + China Projects: ~ First People’s Hospital of Shunde, Foshan

District, People’s Republic of China.

~ Glenside Campus Re-development Adelaide,

Australia.

~ National Heart Centre, Singapore.


Context – New Hospital Building Programmes UK – ‘1960 Hospital Plan’, ‘1980s’, ‘2000s PFI

Hospital Building Programme - 187’

China – 2000 County-Level Hospitals + 29000

Township Hospitals in the 3-Year Plan in 2007

(China spent $38 per capita on health compared with

$3076 US – Source WHO 2006)

20000 New Hospitals – China’s 12th 5-Year Plan

Quality, Fit-4-Purpose, Affordable + Manageable

Denmark – 16 “Quality Fund Construction Projects” + 22

Hospitals


Context – New Hospital Building Programmes - Problem of ‘Rate of Replenishment’ with New Build (BMJ

1960)

- Issue of Proportion of ‘Existing Accommodation’ to New

Build (Vision + Aspirations vs. Actual Outcome + Reality!)

- Delivery of the New Build Programme, Impact +

Anticipated Benefits.

- Problem of ‘Replacement or Renewal’ at the End of the

Life of the New Build (60 years time!)

- How Research can Inform the New Hospital Building

Programme?


Houghton Le Spring Health

Centre, UK:

.

Implement a number of integrated and

innovative low-energy features in

one building targeting BREEAM

Healthcare 2008 ‘Outstanding’

Rating.

Promote Sustainability through

provision of a Quality Health & Social

Environment which addresses

micro-energy generation , energy

use, impact of transport + travel and

engages the local community in the

debate on sustainable lifestyles and

healthy behaviours to impact on

outcomes (e.g. obesity, diabetes).


Houghton Le Spring Health

Centre, UK:

.


Aarhus University Hospital Århus

Bygning Jylland Denmark:

Evidence-based Design: DNU

consultant group developed a

concept of a “Healing Wheel

of the Environment” as a basis

and generator for planning the

entire hospital project.

Design for Sustainability:

Learning from the idea of a

traditional ‘walkable’ town

which has evolved over a

period of time focusing on

flexibility, generality,

adaptability + standardisation ,


Aarhus University Hospital Århus

Bygning Jylland Denmark:


Parkland Hospital Dallas

USA

implement proven Evidence-based

Strategies + corresponding interventions

that improve patient safety & outcomes,

staff efficiency & effectiveness, increase

patient, family, and staff satisfaction

while accommodating today’s best

practices, with flexibility to adapt to the

future. Sustainability goal of LEEDTM

Silver Certification, Low-Emitting

Materials, Public Transportation Access,

User-friendly and navigable facility.


Parkland Hospital Dallas

USA


First People’s Hospital of

Shunde, Foshan District,

People’s Republic of China

Integrating Western + Chinese Cultures

2000 bed General Hospital

that improves patient safety

& outcomes, staff efficiency

& effectiveness, increase

patient, family, & staff

satisfaction, accommodates

Chinese practices & local

traditions, and provides

ability & capacity to adapt to

the future. Green Hospital

Building Evaluation Criteria

: 2 ★★ to 3 ★★★


Glenside Campus

Redevelopment Adelaide

Australia:

Mental Health: A Place of Refuge,

Safety, Security + Healing to

Achieve Demystification +

Destigmatisation of Existing.

‘Village Common or Green’: A

common shared green space +

an external area for social

activities which help nurture and

foster the community spirit while

increasing up-take of physical

activity.

Alternative Approach to

Greenstar or BREEAM


Glenside Campus

Redevelopment Adelaide

Australia:


National Heart Centre,

Singapore

.

Centre of Excellence with a design

philosophy of “Placing People

First” providing a structure that is

flexible & adaptable to change

both internally + externally

Recognising + responding to the

often swift advances in medical

and healthcare technologies.

Healing properties of natural light

and planting - as ‘a carbon

sponge, noxious pollutants filter

and heat reducer ‘ in Sky +

Ground Healing Gardens


National Heart Centre,

Singapore

.

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PART 1 PART 2 PART 3 PART 4 PART 5

Target Credits Points Available

Achieved Credits Points


Emerging Issues:

~ A Definition of ‘Evidence’ and ‘Sustainability’.

~ Cautionary Note: Dangers of Ignoring the Past.

~ Centralisation vs. Decentralisation.

~ National vs. International Guidance + Standards +

Tools.

~ Prescription vs. Performance Guidance +

Standards.

~ Public vs. Private Sector Involvement.

~ Self-assessment vs. Independent or Third Party

Verification.


National

Centralisation

Public Sector

Prescription

Self-Assessment

International

Decentralisation

Private Sector

Performance

Independent Verification

the future for strategic planning of healthcare...

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