Health care institutions today face incredible pressures from increased demand for services while experiencing a decrease in capital and human resources. This economic reality requires careful management and new innovative ideas. When approaching capital building projects, thoughtful planning prior to inception reaps enormous benefits in the long term operation of the building. Having a usable strategic plan, creating an effective project vision statement with guiding principles, engaging in process redesign, and managing the impact on the institutions culture that result from change are critical steps in optimization.
Sir Winston Churchill said First we shape our buildings; thereafter they shape us. Nowhere is this statement truer than in healthcare where the facility imposes barriers to providing effective patient care. Design and construction professionals focus on optimizing the dollars that are spent on capital projects. However, staffing costs comprise about 70% of the annual budget for healthcare institutions while capital cost account for 10%. Reducing staffing costs through process redesign has a much greater impact on financial performance and provides the most value to an organization. Every building project is an opportunity; an opportunity to examine how service should be delivered, not necessarily replicating the processes of the past. Each is an opportunity to make significant changes to the care delivery process that is effective, efficient and outcome oriented.
To achieve optimization, it is important to begin with a usable strategic plan. Building projects are most successful when they support the strategic and financial objectives of the institution. A project vision statement which clearly identifies measurable goals provides guidance and the ability to measure success. Guiding principles, which are rules for decision making, keep the project on track during times of conflict.
Prior to functional programming, review current processes and envision optimized patient care processes. Using value streaming mapping an institution can identify gaps in processes and develop methods to streamline patients flow. This is an essential step. A plan for service delivery will ensure that the building will empower the processes rather than encumber them.
Finally, managing the impact to the institutions culture will be the most critical determination of success or failure of a capital project. Physicians and staff that are engaged and supportive of changes will ensure the success. Those who are not will fail to make the adjustments necessary. Clearly communicating the project vision and guiding principles throughout the course of the project will provide staff the opportunity to make incremental adjustments, both in process and culture, prior to occupying a new facility and ensure a smoother transition and the achievement of the measurable goals.