A master plan aligned with the ‘Triple Aim’ must include detailed systems needed to sustain the facility.
When new buildings are proposed or building expansions are planned, a health care organization often engages an architectural firm to assist in creating a master plan to implement the current and future needs as well as the vision of the organization.
A complete master plan that fulfills the “triple aim” of improving the patient experience of care, improving the health of populations and reducing the per capita cost of health care must include examination and consideration of the detailed engineering system needs.
This is even more important given the enhanced requirements of emergency preparedness to address not only day-to-day operations but also natural and manmade disasters.
Understanding the type of engineering systems necessary to sustain the facility functional and performance goals helps inform space requirements and adjacencies for the engineering systems to maximize system effectiveness and minimize system operational and capital costs.
This effort progresses on a parallel path to the programming, operational and master planning steps of predesign.
The current state
It is important to identify the current state of the project before the future state can be achieved. Whether the project is an addition or replacement, there is immense value in understanding the perspective from which the client and their staff is starting.
Working to understand the current state helps to build empathy between the design team and client users and enhances trust early in the project.
Through this process, the engineering team familiarizes themselves with the existing setting, gets leveled in project parameters such as program, schedule, phasing and budget, and asks focused questions to understand the health care organization’s goals and aspirations.
This approach helps to gain consensus of the future state “wants” for the project.
Knowing where the organization starts and where it wants to end up, combined with the desire for innovation in project design, lends itself well to an integrated master planning process. Setting realistic and achievable goals at the start of a project process sets the stage for a successful outcome.
The way to achieve this is by including all impacted team members, which allows the project to be viewed from many different vantage points. This effort will then shape the project priorities and goals.
Benchmarking the best
Innovation and creativity are great if they can be feasibly implemented — and the engineering team is key to the process, with all of the appropriate stakeholders taking an active role to create buy-in for the final outcome.
Finding the right answer is never an easy or direct endeavor, but it can be achieved through a thoughtful design process that begins with benchmarking best practice design solutions for each building system. This approach seeks to ground all team members in what’s possible today as a starting point from which to innovate toward stretch goals and align scope, quality and budget. Best practice considerations will include factors such as energy efficiency, sustainability, reliability, maintainability and resiliency goals.
The result of this effort is documented as the owner’s project requirements (OPR), a tool that the commissioning industry uses as a way of verifying that the installed infrastructure systems meet the owner’s intent. By reviewing energy efficiency, sustainability, reliability, maintenance and resiliency goals at the start of the project, the entire team can understand the objectives and how they affect the master plan.
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Krista Biason, P.E., Mark Bultman, Associate AIA, and Jeff Harris, P.E., LEED AP co-wrote this article.
Read the full article at ASHE Health Facilities Management online and in ASHE Health Facilities Management magazine.
