Parkland Hospital Project for the Dallas Council of Engineering Companies

1. 0 Parkland Hospital Projectfor the Dallas Council of Engineering Companies Parkland Health & Hospital System Walter Jones, SVP Facilities Monday, September 29, 2008

2. 1 Agenda Background Project Scope Current Activities Next Steps

3. 2 BackgroundPARKLAND TODAY

4. 3 The hospital�s construction is based on the design of a hospital from an era that is inadequate for modern needs based on studies performed since 2001. Jonathan Bailey and Associates Odell Nash Lipsey Burch PwC HKS Centex SOM Carter Burgess Karlsberger BackgroundFACILITY EVALUATION

5. 4 The hospital�s construction is based on the design of a hospital from an era that is inadequate for modern needs. Structural grids are too small for optimal organization of workflow and to accommodate new technology Floor to floor heights too low for today�s standards Majority of building from 1950�s, latest area from 1985 Expansion in place and circulation options are limited by narrow width of floor plates Mechanical/electric/plumbing systems will need major replacement within 10 years Existing plumbing inadequate on inpatient units (communal showers and bathrooms) Existing directly adjacent land inadequate for expansion needs SOURCE HKS 2002 BackgroundFACILITY EVALUATION

6. 5 Limited access Visibility of key entrances is poor Complex site circulation Way finding unclear Inconvenient outpatient parking Parking and staging for ED is not efficient Patient and staff circulation is blended Major thoroughfares are small Elevator service is slow No clear hierarchy of circulation County prisoner management needs to be revamped Building zoning is fragmented SOURCE HKS 2002 BackgroundFACILITY EVALUATION

7. 6 July 2001 PHHS commenced planning effort with PwC, HKS, Centex Construction March 2002 Special Board Meeting (approved planning assumptions) October 2002 Special Board Meeting (selected Hospital Replacement as best alternative) November 2002 Board unanimously approved resolutions to replace hospital March 2003 Board approved RFP for detailed Master Plan services June 2003 Board approved the firm, Skidmore, Owings, & Merrill (SOM) for detailed master planning BackgroundTIMELINE OF EVENTS

8. 7 July 2004 SOM completes draft master facility plan July 2005 The Dallas County Commissioners Court established the Dallas County Hospital District Blue Ribbon Master Capital Plan Advisory Committee (Blue Ribbon Panel) July 2006 Parkland began a long range Strategic Planning effort to provide direction for the development of the services, operating model, best practices and facilities necessary to fulfill its mandate, mission and vision into the future. January 2007 The final strategic model was recommended by the Blue Ribbon Panel and approved by the Board March 2007 The operating model and assumptions were created BackgroundTIMELINE OF EVENTS

9. 8 June 2007 Blue Ribbon Panel recommended the replacement of Parkland Hospital to Commissioners Court July 2007 Board of Managers approved the plan for hospital replacement August 2007 Board of Managers presented their recommendation to the Commissioners Court September 2007 Skidmore Owings Merrill presented the 2004 draft Master Facility Plan to the Strategic Planning Committee of the Board November 2007 The Master Facility Plan was presented to the Core Strategy Group (liaison between the Blue Ribbon Panel and the Board) November 2007 The Master Facility Site Plan was approved by the Board BackgroundTIMELINE OF EVENTS

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11. 10 BackgroundMASTER FACILITY PLAN

12. 11 Project Scope

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15. 14 Current Activities Operational Planning � Karlsberger Healthcare Consultants Functional Programming - Karlsberger Healthcare Consultants

16. 15 Next Steps Bond Election � November 4, 2008 Select program manager Architect Construction manager Specialty consultants

17. 16 Background

18. 17 Master Facility Plan