Wednesday, February 27, 2013
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7:30–8:30 a.m.
Concurrent Session: Fundamentals of PDC
Energy Efficient and Thoughtful Lighting Design for Health Care
David S. Burson, AIA, NCARB, Senior Project Manager, Partners HealthCare Real Estate and Facilities; Jessica Stebbins, Associate Principal, Perkins + Will; Susannah Zweighaft, Partner & Director of Lighting Design Studio, AKF Group LLC

In this presentation, the project architect and lighting designer explore the state–of-the-art lighting solutions that were designed to allow maximum healing for patients and visitors at Spaulding Rehabilitation Center in Boston. With extensive interior and exterior areas for rehabilitation, lighting was critical and integral to the process. To meet both LEED and IES recommendations for lighting levels, glare control, and flexibility, a clever and inspired lighting design was created and implemented. This session will enable attendees to:

Identify criteria for lighting for staff and specific patient populations.
Teach options for energy-saving solutions while maintaining required usage lighting levels.
Describe exterior lighting challenges and solutions.
Demonstrate ease of maintenance for institutional users.


7:30–8:30 a.m.
Concurrent Session: Innovation in Design
A Day in the Life Healthcare 2020
Terry Miller, BSEE, Execuitive Vice President, GBA; Ted Hood, BArch, Sr. Vice President and COO, GBA

The technology revolution in health care has resulted in increased integration, smart devices at the bedside and throughout facilities, electronic record keeping, advancements in imaging, hybrid operating rooms, telemedicine, and more. How will this explosion in technology change health care? How will the patients experience change? This session will tell the story of a mythical hospital stay in 2020 from the patient’s perspective and address how planning, design, and construction must change to adapt to the future. This session will enable attendees to:

Derive an understanding of health care technology evolution through an examination of history.
Project the path of change into the future—examine the resulting evolution in patient care.
Examine how facilities will evolve as the future unfolds—what are the challenges, opportunities, and the benefits to be derived?
Contrast buildings of today with buildings of the future. Compare planning, design, and construction practices of today with PDC of the future.


7:30–8:30 a.m.
Concurrent Session: Leadership
Helping to Provide Access to Appropriate Health Care in Developing Countries Around the World
Rick Berger, Senior Director, Site Planning/Design, BSA LifeStructures; David Martin, Vice President of Development and CareLink Board Chair, Duke Realty; Mary Owens, Director, TriMedX Foundation

CareLink attempts to find used medical equipment, furniture, and other needed items to give to front-line providors of health care in mission hospitals and clinics around the world. CareLink also leverages relationships with architectural and engineering firms that will provide technical expertise in these remote locations. Learn more about CareLink programs and how your facility/company could make a global impact for positive change. This session will enable attendees to:

Recognize “it’s a small world after all” through technology and global citizenship.
Understand what equipment is appropriate to donate and what is not.
Discover how thinking creatively can solving problems when you don't have clean power, air-conditioned environments, etc.
Learn how to implement CareLink as part of a redistribution strategy for retired equipment, furniture, and medical supplies.


7:30–8:30 a.m.
Concurrent Session: Leadership
Show Me the Beef—Proving the Value of the HFCx Process
Gerry Kaiser, PE, LEED-AP, Director, Ascension Health; Damian Skelton, PE, CHFM, Executive Director of Facilities, St. Thomas Health;

The ASHE processes for health facility commissioning and retrocommissioning represent a sea change from conventional commissioning and retrocommissioning practices. Does the ASHE process work? Is it worth the additional cost? This presentation includes three case studies of real-world applications of the ASHE process including a new hospital on a greenfield site, an existing urban medical center, and an existing critical access hospital. The presentation identifies the actual scope, costs, and benefits for each application. This session will enable attendees to:

Understand the basic components of the ASHE health facility commissioning process and the ASHE health facility retrocommissioning process.
Learn how the ASHE health facility commissioning process yielded the first ENERGY STAR-rated hospital in Alabama.
Cite how the ASHE health facility retrocommissioning process implemented by hospital maintenance staff reduced the energy costs of an existing urban medical center by more than 35 percent and increased its ENERGY STAR rating from 12 to 75.
Learn why a large health organization has standardized the use of the ASHE HFCx process for both new building commissioning and retrocommissioning based on actual experiences with other commissioning processes and the ASHE process.


7:30–8:30 a.m.
Concurrent Session: Performance Metrics
Acoustics for Hospitals: FGI Guidelines, HCAHPS, and LEED
Jeffrey Boldt, PE, LEED AP, HBDP, Principal - Director of Engineering, KJWW Engineering

There are three standards that place significant requirements on acoustics in health care: 2010 edition of the FGI Guidelines for Design and Construction of Health Care Facilities, HCAHPS Scores, and LEED for Healthcare. In this session we will discuss how to decide whether FGI acoustical compliance is worth the cost, how to increase your facility’s HCAHPS acoustical score at the lowest possible cost, and identify LEED for Healthcare points for good acoustic performance. This session will enable attendees to:

Understand the potential impact of adoption of 2010 FGI Guidelines on your facility.
Learn how acoustics can improve your HCAHPS scores.
Understand which measures provide the best value in improving HCAHPS scores.
Learn how some physical environment changes can improve HCAHPS scores, move toward FGI-2010 compliance, and even generate LEED points.


7:30–8:30 a.m.
Concurrent Session: Performance Metrics
Benchmarking 2.0: Operations and Maintenance Benchmarks for Health Care Facilities
Ron Kalich, National Facilities Director, Kaiser Permanente; Steve Rees, CFM, Vice President, Capital Management-Edmonton Zone; Dennis Smith, M.S., CHFM, CCM, CEM, Assistant Director Facility Management, Catholic Health Initiatives; and Todd Wilkening, Director, Facilities, Ridgeview Medical Center

The Center for Medicare and Medicaid Services (CMS) will soon require hospitals to verify their quality of care, operational performance, and fiscal efficiency. Stay ahead of the curve by using industry performance benchmarking to enhance your operations. This session will enable attendees to:

Gain influence in the C-suite by providing data to demonstrate your organization�s operational performance and fiscal efficiency.
Lower operating expenses by uncovering operations and maintenance practices that can be improved.
Understand which measures provide the best value in improving HCAHPS scores.
Employ metrics that help the facility department receive the resources it needs to improve operational performance and fiscal efficiency.
Describe best practices that can be incorporated into your facility operations to help achieve best-in-class performance.


7:30–8:30 a.m.
Concurrent Session: Regulatory Issues
Bad Medicine? How Prescriptive Energy Codes Will Ruin Architecture
Jane Rohde, AIA, FIIDA, ACHA, AAHID, LEED AP, Principal, JSR Associates, Inc.; Michael Sheerin, PE, LEED AP, Principal, Director of Healthcare Engineering, TLC Engineering for Architecture

In the quest for more sustainable facilities and increased energy efficiency, energy codes have developed elaborate requirements—presenting owners and designers with restrictive design parameters in many cases. This presentation will identify the challenges posed in present energy codes and explain how the new ASHRAE/ASHE 189.3 Standard for the Design, Construction, and Operation of High-Performance Sustainable Health Care Facilities will benefit health care facilities while providing accessible paths to compliance. This session will enable attendees to:

Recognize how and why the model energy codes are being developed and identify the skills that will need to be developed to avoid the restrictive design parameters of prescriptive path compliance.
Determine the applicability of prescriptive paths for complying with or achieving improved energy performance.
Define the integrated design actions that are key to achieving compliance through performance compliance paths.
Apply a checklist approach to design planning to ensure compliance with sustainability and energy standards.


8:40–9:40 a.m.
Concurrent Session: Fundamentals of PDC
Noise and Particulate Monitoring...We Have an App for That
Anthony Colonna , Director - Innovation, Skanska USA Building Inc.; Bryan Durkin, Project Executive, Skanska USA Building Inc.; Pamela Sanders RNC-NIC, MSN, Nurse Manager - Neonatal ICU and Transition Nursery, Tampa General Hospital

Maintaining patient safety during the expansion and renovation project at the Tampa General Hospital Neonatal Intensive Care Unit was absolutely paramount. And that goal became the driving factor behind the development of an application that allowed the project team to remotely monitor noise, negative pressure, and particulate matter at the site. This presentation will address the challenges associated with working in an operational NICU and describe the development and implementation of an innovative monitoring application. This session will enable attendees to:

Learn strategies to address the concerns of the hospital NICU staff when working in such a sensitive area of a hospital.
Learn how to work with hospital staff on environmental monitoring and understand the benefits of utilizing monitoring systems on projects in and around active NICUs.
Expand the definition of innovation on hospital construction projects to the benefit of the patients, hospital owner, contractor, and other key constituents.
Discover some lessons learned associated with the development of new technology.


8:40–9:40 a.m.
Concurrent Session: Innovation in Design
Using Fuel Cells in Health Care Settings
Walter Vernon, PE, MBA, JD, LEED AP, Principal, Mazzetti Nash Lipsey Burch

Fuel cells have been developing slowly as an energy supply system for health care, despite the clean, reliable power they produce and their low emissions. Many environmentalists suggest fuel cells as strategies for replacing emergency generators. Yet hurdles of cost, system performance, size, and lack of familiarity have prevented the effective implementation in health care settings. This session will examine the barriers and suggest opportunities and developments that will render this a viable future technology. This session will enable attendees to:

Distinguish between fuel cell technologies and their performance characteristics.
Define financial strategies for implementing fuel cell technologies.
Identify code barriers to fuel cell adoption and developments that will permit radically different emergency power designs.
Learn about Kaiser’s implementation of 5 megawatts of fuel cells at its Southern California campuses.


8:40–9:40 a.m.
Concurrent Session: Performance Metrics
Understanding LEED for Healthcare: Comparing Previous Rating Systems, Highlighting Anne Arundel Medical Center, Annapolis, Maryland
Melissa Gallagher-Rogers, Director of Technical Solutions, U.S. Green Building Council

As of January 2012, health care projects are required to register under the LEED for Healthcare rating system. The LEED for Healthcare rating system includes additional, healthcare specific, credits that will change the parts of the project reviewed in a certification and thus the planning and design process itself. This presentation will provide a comparison of the Healthcare rating system to previous rating systems using the examples from the Anne Arundel Medical Center (AAMC) projects. This session will enable attendees to:

Understand the LEED for Healthcare rating system.
Asses how LEED for Healthcare would have impacted work at AAMC.
Identify how the LEED for Healthcare rating system will affect planning, design, and construction for future projects.
Identify key differences between other LEED rating systems and the Healthcare rating system.


8:40–9:40 a.m.
Concurrent Session: Performance Metrics
Water Damage Loss Prevention During and After Construction of Health Care Facilities
Jennifer Fortunato, ARM, AIS, CRIS, Risk Engineering Consultant, Zurich Services Corporation; William Franklin, PE, CRIS, PMP, Senior Risk Engineering Consultant, Zurich Services Corporation; Kevin Imming, Project Manager, Linbeck Group, LLC; David Kubicki, Senior Risk Engineering Consultant, Zurich Services Corporation

Water damage is a leading cause of losses in health care projects both during construction and after occupancy. This session will present loss statistics, case studies, and lessons learned related to both water-related property damage and construction defect claims. After the loss discussion, the presenters will discuss best practices to prevent such losses. This session will enable attendees to:

List principal causes of water damage losses during construction.
Describe the features of a plan to prevent water intrusion and potential damage during construction.
Describe the impact of a water damage construction defect on the operations of a health care facility.
Affirm the important role played by a commissioning plan that includes the building envelope in preventing water damage after construction is completed.


8:40–9:40 a.m.
Concurrent Session: Regulatory Issues
How Will the 2012 Editions of NFPA 101 and NFPA 99 Impact Design Projects?
Jennifer Frecker, Manager/ Fire Protection Engineer, Koffel Associates, Inc.

The resounding question in the design community is: “How will applying the changes to NFPA 101 and NFPA 99 affect our design project?” With the possibility of adoption of NFPA 101 and NFPA 99 in the coming years the application of these changes to current design is a must. This presentation will provide an outline of the changes while providing application suggestions and pitfalls. This session will enable attendees to:

List reasons why design teams and owners should apply the newer editions of NFPA 101 and NFPA 99.
Point out differences in the current code and standard versus the changes in the new editions.
Discuss how the changes to the code and standard might negatively affect a design.
Apply changes in NFPA 101 and NFPA 99 to current design projects.


9:50–10:50 a.m.
Concurrent Session: Fundamentals of PDC
AHA Sustainability Roadmap Improves Financial, Patient Care, and the Environmental Bottom Line without Capital Expenditures.
Steven Cutter, CHFM, MBA, Director - Bio-Medical & Facilities Engineering, Dartmouth-Hitchcock Medical Center, Lebanon, N.H.; Bob Gance, CHFM, Director of Engineering, Children's Hospital Dallas, Dallas, Tex.; Michael Hatton, MBA, RPA, SMA, CHFM, SASHE, System Executive, Memorial Hermann, Houston, Tex.; Dick Moeller, PE, SASHE, HFDP, CHC, LEED AP, Principal-in-Charge, CDi Engineers, Lynwood, Wash.

Members of ASHE’s Sustainability Task Force will share stories of energy, water, and waste stream management and other sustainable programs that have improved the bottom line and created a culture of change with surprising impacts beyond savings on utility bills. Learn how to use the AHA Sustainability Roadmap’s comprehensive set of projects to guide you through each project from creating the right teams, codes and standards compliance, using calculators, identifying LEED synergies, and more. This session will enable attendees to:

Learn about the Sustainability Roadmap and the tools provided to then also know how to contribute to it and become a part of the solution.
Define ASHE’s new and improved E2C Chapter Challenge (Battle of the Buildings) program.
Integrate the tools of commissioning and retro-commissioning into your facility’s operating strategies.
Understand the importance and how-to of basic benchmarking and data management to better operate your facility’s performance.


9:50–10:50 a.m.
Concurrent Session: Innovation in Design
Are There Holes in Your Safety Net?
Jain Malkin, CID, AAHID, EDAC, President, Jain Malkin Inc., San Diego, Calif.

Health care leaders are facing huge challenges that demand a fresh and innovative strategy to deliver high quality care in response to as yet undefined reimbursement and quality performance measurements in the ambulatory setting. This presentation will challenge the traditional ways we view the design of ambulatory care facilites. This session will enable attendees to:

Identify best practices and national models of "safety net" community health centers.
Understand the evidence-based research for design of ambulatory care facilities.
Learn about new models of care being implemented by physicians as they try to respond to the new normal of reduced reimbursement, the steady increase and complexity of chronic disease management, the focus on prevention, and the tsunami of the newly insured.
Discover how the baby boomer demographic will influence facility design.


9:50–10:50 a.m.
Concurrent Session: Performance Metrics
Developing a Framework for Health Care Facility Management Data Collection to Support Lifecycle Building Information Modeling
Allan Chasey, PhD, PE, LEED AP, Professor, Arizona State University; Arundhati Ghosh, Graduate Research Assistant, Arizona State University, Scott Root, AIA, LEED AP, VDC Director - Healthcare, Kitchell Contractors

The link between data collection and the use of the information is still an open question for facility operators. There is either too much or too little information or there exists an undefined process. The accuracy of the data collected is a defining factor of how successful this integration can be. This session addresses a structure for determining the appropriate information that should be available for data mining by facility managers. This session will enable attendees to:

Identify the data needs of a facility operator.
Identify the sources of data and how to organize facility data for efficient and effective use by a facility manager.
Assess the impact of BIM on the collection and organization of data.
Describe accurate and appropriate data collection process for use at project turnover.


9:50–10:50 a.m.
Concurrent Session: Performance Metrics
Lean Application for All Project Delivery Methods
Mark Linenberger, Vice President/Division General Manager, Linbeck; Spencer Seals, Senior Construction Project Manager, Cook Children’s Medical Center; and Stewart Trapino, Vice President of Learning & People Development, Linbeck

Lean application is the removal of any form of waste from an operating system. In our typical project delivery processes, waste takes on many forms (discrete, synergistic, systemic), which have been instilled in us over the past century. Our industry must recognize and act on the need to change these habits as we strive to create real value for our clients and for ourselves. This session will explore and identify opportunities to begin effectively using Lean principles in health care project development and project delivery. The type of owner agreement used for a project is secondary to the opportunities for the AEC team to increase their productively and effectiveness through use of Lean principles. This session will enable attendees to:

Identify opportunities to remove wasteful efforts from their projects.
Start applying Lean principles (defining value, value mapping, achieving flow of work, responding to pull, seeking perfection).
Discuss the advantages of employing pull scheduling as part of the project delivery process.
Describe how the Last Planner System can be applied to health care facility design and construction projects.


9:50–10:50 a.m.
Concurrent Session: Regulatory Issues
New Theories on Plumbing and HVAC Systems
Bob Gulick, PE, LEED AP, Principal, Mazzetti & Associates, Portland, Ore.; Rick Hermans, PE, HFDP, Director of Training & Advanced Applications, McQuay International

The 2014 Guidelines for Health Care Facilities: Design and Construction of Hospitals and Outpatient Facilities is proposing to add language that will permit hand-washing stations to be supplied by water at a constant temperature between 70°F and 85°F using a single-pipe supply. This change will assist in reducing Legionella, saving energy, and reduce first cost installation. This session will also highlight the major ventilation changes of ASHRAE 170 Ventilation of Health Care Facilities. This session will enable attendees to:

Discuss solutions to designing water supplies for hand-washing facilities that can be cost-effective and assist in reducing energy consumption.
Configure HVAC systems to deliver high-quality ventilation, heating, and cooling services at reasonable cost with low energy consumption.
Develop an understanding on the clinical aspects of providing tempered water to hand-washing stations.
List various changes to the national standards on ventilation systems in health care facilities.


9:50–10:50 a.m.
Concurrent Session: Regulatory Issues
Student Competition: Evaluation and Planning for Improvement of the Environment of Care
A team of students was invited to evaluate a hospital's compliance with Joint Commission environment of care (EOC) guidelines. Attendees will hear how students evaluated the projected, created a gap analysis, and a report of their plans for improvement. This session will enable attendees to:

Describe the approach taken to identify areas of improvement for EOC compliance
Assess student findings and consider new EOC compliance practices for implementation