Not every healthcare provider can afford a replacement facility. Creative renovation upgrades and expansion-in-place may be required. The investments made by hospital ownership in land, existing buildings, equipment and other capital assets is significant.

The most effective campus and systemwide master plan measures all the key variables and asset values to determine the "highest and best use" of what the Owner has presently. The master plan should also include several engineering and environmental attributes that are often not considered by consultants, for example; infrastructure condition (Mechanical/Plumbing/Electrical, Life/Safety, Communications and overall Technology) and capacity as well as longer term viability. In addition, healthcare linkages to adjoining office buildings, satellite clinics, remote transport systems and home-based support programs must be reviewed (Transcription, Marketing, Office/Clerical, Home Health and Physician Consultation as examples).

These "systemwide factors" all equate to what has often been referred to as the "smart hospital or smart healthcare system".

This presentation will address the steps one might consider to conduct a thorough comprehensive campus master plan (MP), including for example:
1) Assess the Present Situation and Owner's Strategic Position,
2) Obtain the Existing Building Information in Detailed Composite and Factual Format (floor plans, site plans, engineering and communications systems and drawings/specifications, accurate capacities, consumption rates and conditions),
3) Collect inpatient and clinical work load data from each service and department suitable to determine past, present and future growth trends.
4) Conduct detailed service line and departmental interviews with architect/engineer and technologist combining forces to assess the current situation in each location and within each service (goals, facts, concepts, needs and issues).
5) Complete space projections by service line and department to include growth/change factors, work loads and strategic concerns. Include major infrastructure factors impacting both space needs, environmental concerns and on-going facility and site improvements.
6) Conduct campus and site specific zoning studies to expand, relocate and improve conditions including departmental relocations, space additions or reductions, off site needs and site needs impacted by parking, access and infrastructure improvements.
7) Finalize campus master zoning and site studies including project phasing by priority need and service line. Refine documents suitable for either Agency (AHJ) review and/or Certificate of Need (CON) submission and include ROI factors relevant to each phase of re-design/renovation or expansion.
8) Work closely with Owner, A/E and Construction Advisors to determine budgetary factors, cost savings and constraints which represent Total Project Costs or possible savings for all phases. Technology, systems upgrades, equipment and asset enhancements will be included (art, signage, interior upgrades, systems, etc).
9) Finalize service line and departmental input and approvals utilizing a CONSENSUS perspective on priorities and reach closure with systemwide leadership on MP direction.
10) Present findings and recommendations to the Board of Directors and/or Ownership for comment and feedback.

This process is not a rigid listing of tasks but a suggested sequence which has been benchmarked from over 500 planning engagements. The presenters are finding that the communications and technology components are becoming more and more relevant to the Owner's budget, functionality and service delivery protocols.

The presenters will also share both OPERATIONAL, FUNCTIONAL and INFRASTRUCTURE perspectives that reflect financial savings and improvements by using this master planning process (pre-construction decisions). The "evidence based findings" will serve as examples of what healthcare providers might wish to consider early in the "decision making phase" of campus re-development.

Replacement based on a smaller facility with better space utilization and "smarter infrastructure" may prove to be the best alternative to consider. Tradeoffs will be measured considering small, medium and larger healthcare facilities. These helpful hints will lead to better consultant selection, space management improvements and higher valued outcomes.