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“The Prentice Story” Prentice Move Phases and Evaluation . April 9, 2008. “Activation & Readiness Planning”. Prentice Women’s Hospital Transition Planning Model. Stabilization Patient Move People Commissioning. Communications & Events. Migration. Recruitment. Department Readiness.

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“The Prentice Story”

Prentice Move Phases and Evaluation

April 9, 2008



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Prentice Women’s HospitalTransition Planning Model

Stabilization

Patient Move

People Commissioning

Communications

&

Events

Migration

Recruitment

Department

Readiness

Operating

Budget

Facility Readiness

Operations Readiness

Building

Load

Operating

Work Flows

Technology

Readiness

Operating

Assumptions

Building

Readiness

Program

Design

Construction

FFE

Transition Planning

Campus Development


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Feinberg/GalterLessons Learned

  • Transition took longer than anticipated

  • Operational and department changes were unclear to staff

  • Expect and hire for full census

  • Pilot all new technology and assure staff have adequate training

  • Assure FFE is delivered to the appropriate department and remains in that department


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Feinberg/GalterLessons Learned (cont.)

  • Time between Facility Completion-Grand Opening Events-Move was too short for staff and vendors

    • Department Readiness

    • Staff Readiness

  • Clearly understand the scope of facility transition and the related impact on stabilization post move

    • Department Readiness

    • Technology Readiness

    • Staff Readiness

  • Assure PAR levels meet new patient demand

  • Vacated facilities represent operational and cost challenges


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Prentice Women’s Hospital

Unique challenges existed with the Prentice Transition plan

  • OB & NICU patient move plans would require different clinical assessments

  • More monitored patients would be moved (L&D and NICU)

  • More families would want to move with the patient (L&D, NICU and PP)

  • Opportunity existed to communicate the move plan to patients earlier

  • Support departments would need to focus on both Feinberg operations as well as Prentice move needs

  • Complexity and scope of technology had increased dramatically


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Transition Plan

A well defined plan assured smooth activation of the new Prentice.

  • The Transition Plan extended beyond Prentice Women’s Hospital and involved a majority of the Northwestern Memorial Hospital departments.

  • Each department/unit established a detailed plan highlighting the move-related activities the year of the move.


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Transition Plan

The move and activation plans were consistent with

Northwestern Memorial Hospital’s mission and strategic plan initiatives.


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Transition Planning

Stabilization

Patient Move

People Commissioning

Communications

&

Events

Migration

Recruitment

Department

Readiness

Operating

Budget

Facility Readiness

Operations Readiness

Building

Load

Operating

Work Flows

Technology

Readiness

Operating

Assumptions

Building

Readiness

Program

Design

Construction

FFE

Transition Planning

Campus Development


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Prentice Women’s Hospital2007: Move Preparation

  • Building Readiness

  • Technology Readiness

  • Department Readiness

  • Staff Readiness


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Prentice Women’s Hospital2007: Move Preparation

Equipment Procurement and Pilots

Staff and Physician Training

Development of Move Plan

Move Simulation and Mock Move


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Organization Structure

Transition Planning Team coordinated and facilitated all activities

related to the activation and move.

Chief Operating Officer

Executive Vice President

Dennis Murphy

Consultant

Kerry Shannon

Steve Straka

Transition Planning

Director

Kirk McKie

IT Project Director

Paula Elliott

Transition Planning Manager

Nick Wojciechowski

Transition Planning Manager

Roberta Clairmont

Transition Planning Manager

Sara Hayes/Heather Daas

Transition Planning Manager

Mary Fran Molitor


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Transition Plan

VP Sponsored Task Forces and Activation Teams addressed the scope of activities required to execute the overall Transition Plan.

Prentice AIP

Dennis Murphy

Kirk McKie

  • Department

  • Activation

  • Teams

  • Dept VP’s –

  • MF. Molitor

  • All TP

  • Move Logistics

  • J. Przybylek –

  • N. Wojciechowski

  • Building

  • Readiness

  • Jim Bicak –

  • S. Hayes

  • FF&E

  • Building Load

  • G. Fennessy –

  • N. Wojciechowski

  • Patient Support

  • Services

  • G. Fennessy –

  • N. Wojciechowski

  • Information

  • Technology

  • T. Zoph –

  • P. Elliott

  • Professional

  • Services

  • D. Woods –

  • S. Hayes

  • Best People

  • D. Manheimer –

  • MF Molitor

  • Communication

  • &

  • Events

  • H. Salls –

  • R. Clairmont

  • Activation Teams

  • geographically focused/

  • department specific

  • assumptions/workflows

  • Task Forces

  • assumptions/work flows

  • that cross department


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Transition PlanA three year process from planning through execution and stabilization

Preliminary

Operating Budget Review

Recruit 2

Project Managers

Recruit 2

Project Managers

Opening

Patient Move

Consultant RFP

Planning

Support

Plan Development

Plan, Process &

Schedule

Budget

Review/

Approval

Task Force Activity

Confirm Charter/

VP Sponsorship

Implementation

Plan/Assumptions/

Work Flows

Validate & Approve

Plans/Assumptions/Work Flows

Activation Team Activity

Confirm Charter/

VP Sponsorship

Plan/Assumptions/

Work Flows

Implementation

Stabilization

Homestretch Coordination

TP Transfer

to Operations

2005

Q3

2005

Q4

2006

Q1

2006

Q2

2006

Q3

2006

Q4

2007

Q1

2007

Q2

2007

Q3

2007

Q4

2008

Q1

2008

Q2


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Building Readiness Objective

Prepare the physical facility and assure building systems were tested and functioning for the opening of the new Prentice

  • Environmental

  • Services

  • Implement plan for each building clean phase : post-construction, post-load, terminal clean, and patient ready clean

  • Transition to support building operations

  • Security

  • Services

  • Validate updated security system and procedures

  • (e.g. Code pink)

  • Transition to support pre-operating building access and opening operations

  • Facilities

  • Management

  • Transition to support

  • building operations

  • (i.e. automation of MEP)

  • Building commissioning

  • City requirements

  • Statement of conditions (JCAHO)

  • Safety and Infection Control

  • Training of 2200 employees and vendors of pre-move safety procedures

  • Environmental testing of facility to ensure air and surface quality meet defined criteria

  • Service Disruption Team


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Technology ReadinessObjective

To assure that all technology works, and works together in advance of opening the new facility to mitigate risks associated with technology failure, information flow and end-user acceptance.

Scope:

Infrastructure – 1076 miles of cable

Wired Devices – 4727 PC’s, printers & phones

Wireless Devices – 550 PC’s & phones

Biomedical Equipment – 2650 devices

Applications – 76 applications cross referenced to 50 processes

Pilots – 6 pilots of new technology


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Technology Readiness Process

  • Commissioning

  • Confirmed commissioning as preferred approach

  • Focus Commissioning to confirm process and methods

  • Building load sequenced to support commissioning activities

  • Created “floor captain” role to facilitate commissioning

  • Executed

  • SWAT approach for remediation

  • Infrastructure

  • Designed infrastructure with flexibility to accommodate changes in technology for 25 years

  • Full wireless capabilities, house-wide

  • Built infrastructure off site, tested, then loaded closets

  • Application

  • Conducted workflow sessions

  • Mapped processes to applications

  • Piloted new technology in existing facility

  • Built and tested applications in production environment

Activation Teams – Task Forces – Department User Groups


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Building Load Objective

Develop a process and management structure that leverages the organization’s operational strengths to ensure the placement, functionality and retention of all new Prentice Women’s Hospital items in the right place at the right time, in coordination with all pre-occupancy activities.

Scope:

45,000 pieces of medical and general equipment

11,000 pieces of furniture

7,500 Information technology devices

703 hours of loading activity


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Integrated Building Load

Project Elements

The complexity of the following pre-occupancy elements prompted the need for a fully integrated planning and execution structure.

  • Construction

  • Regulatory Inspections

  • MEP Commissioning

  • Design-Deferred Construction

  • Punchlist Construction

  • Systems Readiness

  • Cleaning

  • Training and orientation

  • Environmental Testing

  • Technology Commissioning

  • Equipment installation and testing

  • Loading

  • Group 1 Equipment

  • Group 2 Equipment

  • Furniture

  • Artwork and Signage

  • IT Devices

  • Supplies, medications and food

  • Grand Opening Materials

  • Relocated FF&E and materials


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Load Sequence (Sample)

Each system and piece of equipment required analysis to reveal the dependencies, activation duration and sequence.

Video Endoscopy

system (8)

Ceiling-mounted

Flat Panel Display (x24)

Camera, Video/Surgical (x5)

(new)

Cart, Fiberoptic

(2 new)

Printer (x8)

OR Video Integration

(new x8)

PACS

Wall-mounted

display (x2)

Outside

world

Gateway

Video teleconference

Coder/Decoder (x2)

OR

Conference

In-room camera

(x2)

Conference

Center

PC (standard charting at

documentation station)

Delivery

Installation

Biomedical

Certification

Technology

Commissioning

Staff

Training

First

Use


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Shake Down: Leverage of existing issue reporting system (Sentact) to report track and resolve issues

Department Readiness AssessmentObjective

Define and Implement process to identify, report, resolve and track issues to assure the planned environment is ready to receive patients and can continue to support patient care following the move

  • Department Readiness Assessment Validation: Leverage of existing building load database and multidisciplinary support services rounding group to assess environment to validate readiness state

  • Scope:

  • 3019 pre-move issues reported

    • 62% resolved pre-move

  • 148 move day issues reported

  • 236 stabilization issues reported – 3 weeks

  • 95% issues resolved to date

Scope:

1000 rooms assessed pre-move

56,000 FFE items validated

16 hours – average assessment time

100% rooms approved to open


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Shake Down Leverage Sentact To Support Issue Reporting/Prioritization And Issue Resolution Before, During And Immediately Following The Move To The New Prentice

Training

Issue Entry

OR

Reports

Call 6-8888


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Department Readiness AssessmentDepartment assessment of loaded and commissioned equipment by department managers utilizing Task Management Tool

Deliverables

  • Report of % of items:

    • Loaded/installed

    • Commissioned

    • Certified

  • List of open items to begin focused issue resolution inserted within the “add comment” field

  • Go No-Go Decision


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Department Readiness Assessment EOC ReviewMultidisciplinary support services rounds accompanied by department manager to validate department’s environment is ready to accept patients

Deliverables

  • Sentact Shake Down report of all identified issues

  • Report of % of EOC rounds completed

  • Go No-Go Decision

  • Team Members

  • Safety

  • Bio Medical Engineering

  • EVS

  • Materials Management

  • Facilities

  • Pharmacy

  • Construction/Renovation

  • Infection Control


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Migration

Project Elements

Many project resources and organizational structures were leveraged to streamline the migration process.

  • Implementation Planning

  • Activation Teams Identified Dependencies and Items Needed for First Day of Operations

  • Department Assessment Conducted to Label All Migrating Assets

  • Bid and awarded commercial mover contract

  • Move

  • Labels Distributed to Departments for Box Identification and Relocation

  • Vendors Engaged to Assist with Complicated Migration Items

  • Master Migration Plan Established

  • Planning

  • FF&E Group Established New Asset Master List

  • Gap Analysis Completed; Migration List Created

  • Migration Guiding Principles Established and Distributed

  • Activation Teams Validated Migration List and Established the Migration and Commissioning Plan


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Sample Migration Plan

Breast Imaging

MOVE

Screening Center in 676 Closes

Screening Center Equipment to New Prentice for Installation and Commissioning

Galter 13 Operates at Half Capacity

Move Half of the Mammo Units from Galter 13 to New Prentice for Installation and Commissioning

Galter 13 Closes

Move remaining Mammo Units from Galter 13 to New Prentice for Installation and Commissioning

New Prentice Opens with 3 Diagnostic Pods and a Screening Pod

Operate at Full Capacity

Oct 1

Oct 8

Oct 29

Sept 24

Oct 15

Oct 22

Nov 5

Nov 12


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Operating Program - Assumptions - Work FlowObjectives

Activation Teams

To develop geographically

focused/department specific

operating assumptions and

Workflows – e.g. NICU.

Task Forces

To develop operating assumptions and

workflows that cross departments in

Prentice – e.g. Pharmacy.

Scope:

8 Task Forces

160 Staff & Physicians

Scope:

16 Activation Teams

300 Staff & Physicians


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Operating Program - Assumptions - Work FlowStructure

Task Forces

  • Building Readiness

  • Technology Readiness

  • Patient Support Services

  • Professional Services

VP Sponsor

Director Oversight

Selection Of Membership

Kick – Off

Monthly Meetings

Formal Minutes

  • Activation Teams

  • Inpatient

    • Labor & Delivery

    • Ante/Post Partum

    • NICU

    • Women’s Care Unit

    • Hematology Oncology

  • Diagnostic & Therapeutics

    • Radiology

    • Breast Imaging

    • Ultrasound

    • Surgery

  • Support Services

  • Professional Services


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Operating Program - Assumptions - Work FlowProcess

  • Projected Volume

  • Facility Design & Size

  • New Programs

  • Service Enhancements

  • Regulatory Requirements

Provide Input to Technology Device & Application Plans

Provide Input to Training Plans

Develop Operating Assumptions & Workflows

Review Department Specific Program

Participate in the Development of the Move Plan

Validate Staffing Models

Key Factors


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Work Flow Sample

OB Triage

  • Swipe Employee Badge at Kronos Station on floor which staff is assigned.

  • Keycard Reader Access to the Staff Lounge. Place personal belongings/purse in purse locker within the Staff Lounge

  • Staff will then participate in Assignments/Report on a one to one basis in the conference area adjacent to the private patient care workstation

  • Wireless devices will be stored in the private patient care workstation area and will be picked up there at the beginning of the shift.

  • Paper charts will be stored at the patient care workstation

  • The Clinical Coordinator will use their shared office on “office days” and be at the patient care station other times.

  • The unit secretary will work in the Patient Care station at the PC closest to the Nurse Call master station.

  • Purse lockers will have keys – Staff will use locker only during shift returning key and emptying purse locker at the end of shift

  • After report the receiving nurse will sign in the the Rauland Nurse Call System

PatientCareStation

Keycard

Reader

Reception

Desk

Report

Conference

Kronos

Lounge


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People Commissioning Objective

Working with organizational resources to ensure that all staff and

Physicians have novice competency to work effectively and safely with the

New Prentice building, equipment, systems and workflows and to verify

same to senior management.

Practically this means the ability to locate, access, retrieve and use spaces,

systems, equipment and supplies with no delays, no adverse events and

with minimal assistance in urgent situations.

Note: Clinical competence is outside the scope of this charter.

Scope:

16 Staff and contractors

7124 Total participants (2514 unique individuals)

474 Physicians

18,537 Training Hours Delivered

102.5 Training Hours Developed


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New Prentice Women’s Hospital

100% of employees completed mandatory training

600 training sessions held in September and October

Training scheduled 6 days/week, 15 hours/day

138 trainers participated (primarily patient care staff)

Over 1300 employees completed 4-18 hours of training

Electronic Learning Management System used to track enrollment and completion in real time

Training: Our Staff


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Over 300 providers from multiple specialties completed building orientation

Building tours tailored to individual provider’s specialty and focused on navigating new environment

L&D and NICU: Multidisciplinary simulation exercises conducted to practice emergency responses in new environment

New Prentice Women’s Hospital

Training: Our Attending and Resident Physicians


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People Commissioning building orientation Process

Evaluation

Follow-Up

Remediation

  • Plan Development

  • Administration

  • Development Process

Scope

Validation

Needs Assessment

Strategy

Budget

Implementation

On-Line Training

General Orientation

Department Training


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Identify & Prioritize Training Needs building orientation

Develop Training Approach

Conduct Needs Analysis

Unit & General

Develop Scenarios

Identify Subject Matter Experts (SMEs)

Develop Evaluation

Plan

NPWH:

Process for Training Development

Evaluation & Follow-Up

Develop Training Materials

Certification Process

Finalize & Communicate Schedule

Quality

Checks

Conduct Training

Identify & Prepare Trainers

Process for DevelopingUnit Specific Transition Training


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“Patient Move” building orientation


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Move Logistics building orientation Objective

Develop and implement a move plan that takes occupancy of the new Prentice in the most efficient, safe and cost effective manner for the patients, visitors, staff and physicians.

Scope:

208 total patients

8 laboring mothers

49 critical care neonates

Duration: 5 hours


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Prentice Women’s Hospital building orientation The Move: October 20, 2007

Move Statistics

  • Move start –7:43 am

  • Average trip –12 minutes

  • Patient moved every 2 minutes

  • 208 adults and infants moved, including 49 NICU Infants

  • Move duration: 5 hours, 1 minute

All patients moved safely with no untoward incidents


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Patient Move – Resources building orientation Over 500 staff and volunteers supported the move

Patient Movement

Materials Movement

Move Route Security & Facilities

Care Stations

Diagnostics & Therapeutics

Communications & Media Relations

Visitor Management

Concierge (Orientation to Patient Room & Technology)

Patient Move Gift Distribution

Ongoing Operational Support

Data Management


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The Move Plan: Move Sequence building orientation Simulated Duration – 5 Hours, 44 minutes

13:30P

12:30P

7:30A

8:00A

8:30A

9:00A

9:30A

10:00P

10:30A

11:00A

11:30A

12:00P

13:00P

Close

Current LDOU

12:00AM

(All patients to L&D)

Neonatal Intensive Care Unit

Open New L&D and OB Triage

(Point of entry all

OB pts. during the move)

Close Current

L&D

Transfer early labor patients

from current L&D to new

PWH L&D

Deliver and recover remaining

patients at current PWH

Post Partum Admissions – 9 New Prentice

(Admitting Unit for deliveries occurring in current/new L&D during the move)

Move

Final

Antepartum (15)

est. 9-10 pts.

NICU PP

Mothers

Hematology/Oncology Units (15E, 15W then 16E)

Women’s Care

Unit

Post Partum Units (12, 11 then 9)


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New PWH – Patient Move Route building orientation

ChicagoAvenue

- Minor Care Stations

- Major Care Stations

N

- Patient Move Route

New PWH

- Doorways (requiring support)

- Privacy Curtains

- Return Route

PWH Return Route

Superior Street

Olson Pavilion

PWH

L&D

Feinberg return Route

Elevator to basement level

NICU

Across drive under

tent

Elevator to ground level

Lurie Research

(Note: Incline of Lurie Bridge)

Huron Street

- Bridges and 2/3 floor corridors

Feinberg/Galter

Pavilions

-Tunnels & Lower Concourse Corridors

- Elevators


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New Prentice Women’s Hospital building orientation Mock Move: August 2007Coordination of resources to validate the department move plans, move sequence - timing and move route

Mock Move Roles

Patients

Family Members

Patient Care Staff - RN’s/PCT’s

Physicians

Unit Secretaries

Patient Escort

Volunteers - Movement of Personal Belongings

EVS - Equipment Cleaning

Elevator Operators

ADT/Navicare Data Input

Move Leads

Command Center Members


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New Prentice Women’s Hospital building orientation Mock Move

Successfully completed the move of

34 patients ahead of schedule!!!


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New Prentice Women’s Hospital building orientation Mock Move: Lessons Learned

  • Allow unit managers control and flexibility for patient move sequence

  • Provide route signage and move staff identifiers


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New Prentice Women’s Hospital building orientation Mock Move: Lessons Learned

  • Scripting of messages to patients/families

  • Keep infants in view of Mother

  • Separate return route for resources & equipment


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New Prentice Women’s Hospital building orientation Mock Move: Lessons Learned

Transporter fatigue – maintain consistent pace and provide breaks

Coordination of transportation equipment

  • Care Station strategy & locations

    • Major versus Minor

    • Distance between stations

    • Emergency Response within Tunnel


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Patient Move Simulation building orientation

The Simul8 application allowed for the definition of resource requirements and the implications of assumption adjustments


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The Last Baby Born at Old Prentice building orientation

Born: 11:43 AM

It’s a boy!


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The First Baby Born in New Prentice building orientation

  • Born: 11:48 AM

  • It’s a girl!


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“Stabilization” building orientation


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Stabilization building orientation Objective

Support Prentice Women’s Hospital departments through the initial stabilization of the facility and operations.

Stabilization

October 20 – December 31

Operations

- Optimization -

January 1 - Ongoing

Post Occupancy Assessment

Spring 2008


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Stabilization building orientation Initial Dashboard

Overall

Detail

Follow-Up

BIC


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Stabilization building orientation Operating issues that exist as a result of the move to Prentice Women’s Hospital

  • Physical Facility

  • Scope of issues decreasing each week

  • Open items may require funding to address

  • Technology

  • Scope limited to the following systems:

    • HUGS

    • Wireless Devices - Dead Zones

    • Nurse Call - Emergent & Urgent Notification

  • Security

  • Scope limited to the following:

    • Floor Access

    • Infant Security

  • Supplies & Linen

  • Scope of issues decreasing each week

    • PAR Levels

    • Size of Clean Utility Rooms

  • Environmental Services

  • Scope primarily focused on operations:

    • Room turn

    • Cleanliness

  • Food Service

  • Minimal issues

    • Tray Pick-Up

  • Pharmacy

  • No Issues

  • Work Flow

  • Reception Desk - Information Flow

  • Decentralized Patient Care Center - Work Flow & Information Flow

  • Patient Escort - Information Flow & Scope of Support

  • Labor & Delivery - Multidisciplinary Work Flow & Information Flow

  • Stone

  • Security


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“Lessons Learned” building orientation


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Transition Planning building orientation Over 60 Vice Presidents, Directors and Managers provided feedback on the Transition Planning Model/Process


Slide56 l.jpg

Prentice Women’s Hospital building orientation

Majority of users ranked the Transition Planning process favorably.

81% Rated 4

or Above

46%

27%

11%

8%

5%

2%

1%

0%

1%

Not Successful Successful

  • Opportunities

  • Appreciate implications of new design and recognize impact of “change” on users

  • Department infrastructures need to be solid to support daily operations so Directors/Managers can focus on TP activities

  • Appreciate the scope of user involvement during the six months prior to opening (estimate 20 hours/week)

    • Operating Pilots/Training/Migration – Patient Move Planning

  • Department buy-in to TP process optimizes outcomes

  • Successes

  • Executive sponsorship of Task Forces and Activation Teams highlighted TP as an organizational priority

  • TP activities aligned with existing organization structures

  • TP structure included individuals involved in earlier planning efforts (strategy/program/design)

  • Overall, consistent management structure from design through TP

  • Strong attention to detail and coordination


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Department Readiness building orientation

Preparing the environment for patient care/operations

79% Rated 4

or Above

48%

24%

14%

7%

3%

2%

2%

0%

0%

Not Successful Successful

  • Opportunities

  • Department Readiness Assessment Tools were too cumbersome for users

  • Accurate data-base of open issues to focus resources and follow-up (e.g. delayed Sentact issue close out)

  • Clearly define purpose of Environmental Testing and what the strategy will be to respond to results

  • Focus on PAR level planning – understand staff behavior related to supply management

  • Audiovisual coordination and installation

  • Successes

  • Early access to the facility to support department transition & readiness

  • Adequate time to prepare the facility for operations (3 months)

  • Scope of equipment/furniture migration was minimal

  • Strong attention to detail and coordination


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Department Readiness building orientation Building Readiness

  • Successes

  • Campus Development oversight and leadership of building commissioning in developing plan for operation of facility and related systems.

  • Earlier department transition provided heightened state of control, ownership and awareness of facility

  • Environmental Services oversight/implementation of building clean phases (post construction to patient ready cleans)

  • Dedicated NMH Security to oversee access control and respond to staff/vendors/contractors

  • Opportunities

  • Clarification and consistent use of definition of “patient ready’ state following IDPH

    • Trigger operations to support patient environment – e.g. implement OR restrictions, ICRA standards, etc…

  • Leverage planned security systems to enhance control pre-move (e.g. activate key card readers and individual employee key card privileges)

  • Maintain access control throughout evolving phases of readiness

    • Clearly define access criteria and assure organizational support of this criteria during each phase (e.g. building readiness, department readiness, staff readiness and patient readiness)

  • Coordinated key strategy consistent through design, construction and activation phases

    • Building standard key strategy to support design

    • Simplified key structure (keys/tokens/punch lock…)

    • Appreciate resource intensity of key production/distribution


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Department Readiness building orientation FFE

  • Successes

  • Continuity of staff and knowledge

    • Planning to Procurement to Installation

    • Consultants, FFE team, TP team

  • Importance of teamwork

    • Focus on common goal (patients first & schedule)

  • Clearly defined schedule, budget & related requirements

  • Executive sponsorship

    • Monthly progress updates on issues/budget/schedule

  • Alignment with organization structures – strengths

    • Materials Management – Group Purchasing Organization

    • Maintenance Staff – Biomedical Engineering & Facilities Management

    • NMH relationship with vendors

  • Opportunities

  • Assign dedicated staff to invoice payment

    • Assignment to other tasks may impact the prioritization of invoice payment

  • Appreciate the disposable supplies required for the selected equipment

    • Supply changes are needed to support updated models of same equipment (e.g. fetal monitor probes)

    • Build inventory to support availability of supplies for operational opening

    • Understand potential increases in supply cost

  • Pursue earlier training for new equipment


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Department Readiness building orientation Building Load

  • Successes

  • Team Integration (FFE/Tech/Biomed/Security/ Consultants/Campus Development…)

    • Bridge between procurement team and load team

    • Procurement Data Installment Support/Management

    • Early integration of IT into the load planning process

    • Daily debrief and planning sessions during implementation

  • Clear turnover of building from CM at the time of substantial completion

  • Regulatory preparedness

  • Leverage of procurement data and readiness/load work plans to populate Department Readiness Assessment tool

  • Off-site warehousing and dedicated labor to support material movement

  • Disciplined approach to decision milestones related to procurement (e.g. May 31 decision deadline)

  • Centralize management of training

  • In-house Environmental Services team

  • Opportunities

  • Earlier user engagement with the data and tools to better mitigate changes and improve readiness assessment

  • Sustained AE engagement through equipment procurement to respond to infrastructure and architectural layout implications of equipment selection

  • Clearer and earlier understanding of FF&E regulatory readiness expectations (e.g. FF&E needed to support IDPH “patient ready” terminology)

  • Ensure equal buy-in of integrated process by all stakeholders

  • Earlier Academy involvement for better new equipment training coordination

  • Management of early install (existing facilities) scope creep should be more disciplined


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Department Readiness building orientation Migration

  • Successes

  • Clear understanding of the scope of migrating items and the commissioning/certification needs

    • Processes and schedule responded to this scope

  • Alignment of migration plans with the overall patient move plans – e.g. NICU physiology monitors

  • Leveraged equipment database and asset database to maximize quality

  • Opportunities

  • Inpatient move and migration was complex: more time should be spent on migration

    • Incorporate migration planning into user group process

  • Appreciate staff’s personal attachment to office contents


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Department Readiness building orientation Readiness Assessment

  • Successes

  • Leverage of existing processes to report and respond to identified issues (e.g. Sentact)

  • Proactive issue identification/resolution in support of critical project milestones (e.g. regulatory review, environmental testing, patient move…)

  • Prioritization of issues resulted in development of focused resolution plans

  • Reinforced staff comprehension to department environment

  • Opportunities

  • Leverage opportunity to create a consistent database throughout project design, activation and post move (e.g. room data sheets)

  • Simplify assessment tool and process for users

  • Provide sample of standard room layout for users to refer to

  • Clearly define individuals and coordinate process to assure issues are resolved in the most timely manner

  • Pursue consistent database for reporting and monitoring IT and support service related issues

  • Reinforcement of a consistently clear definition for “move critical” issues

  • Enforcement of existing operating procedures to close out issue tickets as they are resolved

    • Define “true” scope of issues

    • Target resources where needed

    • Provide users with a “source of truth” of issue status


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Technology Readiness building orientation

Assuring technology was ready to support patient care/operations

76% Rated 4

or Above

44%

24%

15%

8%

3%

2%

3%

0%

0%

Not Successful Successful

  • Successes

  • No unproven technology – use of pilot project approach

  • Technology team support and their attention to detail

  • Early decision making with user involvement

  • Cross team communication

    • Integration with Task Forces and Activation Teams

  • Technology testing and pre-move sweep of devices

  • Opportunities

  • Manage scope of new technology

    • Evaluate opportunity to phase implementation pre-move/move/post-move

  • Technology integration earlier in design process (e.g. systems, devices…)

  • Integration of building and technology systems and the operating impacts (e.g. HUGS, ASCOM)

  • Evaluate scope of operating dependencies on the scope of wireless technology

  • Increase scenario testing pre-move


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Technology Readiness (cont.) building orientation Assuring technology was ready to support patient care/operations

  • Successes

  • Technology engagement early and often

    • IT TP Director involved early and throughout

    • Infrastructure design

    • End user workflow and activation team participation

    • Building commissioning

    • Building load (IS devices, FFE and biomedical equipment)

    • Move coordination

    • Stabilization availability and support

  • On site staging location for devices

  • Test in production environment

  • Technology leadership commitment during homestretch

    • Single point of contact to support coordination and integration of activities

  • Technology Move War Room support model

  • Flexibility and fluidity

  • Opportunities

  • Technology presence from programming – design – construction – activation (e.g. consistent floor captain involvement)

  • Pilot new technologies in lab environment (e.g. mock-ups) to respond to limited infrastructure in existing facilities

  • Build flexibility into load/commissioning schedule to respond to coordination elements

    • Cross connects

    • More time for device load/install/biomed certification

    • Less time for testing in new facility

  • Clear network specifications to support FFE procurement

    • Monitor vendor compliance

  • Coordination of furniture delivery with device placement process

  • User review of device placement earlier in process

    • Consistent documentation from design to implementation

    • Validate placement in situ prior to completing installation

  • Cable management


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Operations Readiness building orientation

Confirming/validating operations and work flows

75% Rated 4 or Above

62%

12%

7%

7%

8%

5%

0%

0%

0%

Not Successful Successful

  • Successes

  • Executive sponsorship

  • Activation Team and Task Force structure

    • Multidisciplinary involvement

  • Early involvement of staff

  • Early access to facility to build/validate workflows

  • Transition Planning team support

  • Attention to detail

    • Benefit of detailed planning realized post-move

  • Current service assessment facilitated development of future service assumptions

  • Opportunities

  • Workflows and operating models should be clear prior to design

    • Stakeholder buy-in early with early focus on implementation

    • Identify areas of risk and provide focused readiness attention (e.g. emergency response, infant security…)

  • Appreciate design impact on staff – “scope of change”

  • Understand operating budget implications related to operating assumptions/design earlier

    • Define gap and work through prior to entering budget cycle to facilitate recruitment initiatives


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Operations Readiness (cont.) building orientation Confirming/validating operations and work flows

  • Successes

  • Budget tool to project FTE’s based on new program, expansion of existing programs, building design…

  • Budget process fostered a sense of operating reality with the planned/assumed work flows

  • Opportunities

  • Appreciate flows will evolve post move and provide supports to facilitate this process

  • Monitor volumes annually and identify space/design implications

  • Appreciate Transition Planning structure cannot replace/ supplement operations structure

  • Overall engagement of physicians

  • Engage Campus Development representation on Activation Teams to support validation of design to recommended work flows


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People Commissioning building orientation

Preparing staff to work in their new environment

91% Rated 4 or Above

59%

24%

8%

2%

3%

3%

0%

0%

0%

Not Successful Successful

  • Successes

  • Early Academy support and involvement

  • Organizational support and resourcing of training effort

  • Training expertise and systems infrastructure

  • Model enable departments to drive unit specific training

  • Technology/equipment incorporated into unit training

  • Early access to facility

  • Ability to use facility as a classroom

  • Coordination: building load and technology readiness

  • Appeal on cognitive and affective level

  • Flexibility

  • Opportunities

  • Appreciate design impact on staff – “scope of change”

  • Physician involvement and engagement

  • Success or failure dependent on infrastructure (inconsistent wireless device function)

  • Inconsistent vendor equipment training

  • Pilot new systems in existing facility – or – test environment

  • Increase communication throughout project with targeted communication 9-12 months prior to move


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Patient Move building orientation

Planning and executing the patient move to the new facility

98% Rated 4

or Above

73%

14%

11%

2%

0%

0%

0%

0%

0%

Not Successful Successful

  • Successes

  • Attention to detail

  • Broad, inclusive planning process resulted in many experts

    • Technology engagement

    • Department and physician ownership of individual move plans

  • Mock moves and simulation

  • Consistent principles guided the entire move planning process and implementation

  • Leveraged existing processes and policies to the fullest extent

  • Family/Visitor awareness and support

  • Opportunities

  • Reliable communication tools/systems used on move day – inconsistent function (e.g. wireless devices, radios…)

  • Artificiality of mock-move renders the execution extremely challenging

  • Appreciate the need for flexibility to support clinical decision making

  • Deploy resources earlier on move day

    • “Machine is large and slow to start”


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Patient Move building orientation Command Center

  • Successes

  • Integration of Facility Readiness/Operations Readiness/Move Readiness into one oversight model

  • Leveraged existing HEICS model

  • Provided process to assure consistent issue reporting – prioritization – resolution resourcing

  • Design of communication focused users on their scope of responsibility – targeted distribution of information to individuals who had the authority to address/resolve

    • Limited problem solving in silos

  • Availability of on-line move dashboard displaying real-time data throughout move

  • Opportunities

  • Maintain attention to detail and heightened focus until last patient moves

  • Natural instinct of staff to report issues directly into Command Center - consider locating Department Readiness issue reporting in Command Center versus decentralized location


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Stabilization building orientation

Supporting facilities/operations through issue reporting/resolution

67% Rated 4

or Above

38%

21%

15%

13%

8%

4%

2%

0%

0%

Not Successful Successful

  • Opportunities

  • Structure should respond to facility/system issues as well as operating/process issues

  • Align Activation Team structure with stabilization activities

  • Assess areas of high-risk and implement stabilization processes prior to opening

  • Communicate stabilization structure/process pre-move to support VP/Director/Manager schedules post-move

  • Anticipate capacity issues

  • Successes

  • Hospital operations structures and processes were aligned with Transition Planning effort and therefore, were positioned well for the early transfer of oversight

  • Stabilization meetings provided users with sense of focused issue resolution

  • Senior Management engagement and support


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Transition Planning building orientation Summary

  • A detailed/comprehensive/integrated planning effort positions an organization for a successful opening

  • Leverage existing organization structures/processes/procedures – but…

    • Identify that there is a need to pursue consistency to assure success

      • Procurement

      • Training

      • Move Plans

  • Integrate “Activation” Readiness into Design and Facility Readiness effort to assure conceptual plans and assumptions are fully realized

    • Operating Assumptions/Work Flows

    • Operating Budget

    • Building Readiness

    • Technology Readiness

    • Department Readiness

    • Staff Readiness/Training


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