While the term “team-based planning” is used in a variety of contexts, in healthcare design it implies an opportunity to go beyond traditional architect-owner collaboration and bring in key users, engineers, and contractors right from the start. The healthcare industry is already pushing to involve the entire project team at the start of a project, but project teams can start earlier by involving experts in the planning phase, resulting in improved accuracy and better outcomes. For example, working with construction managers early on can provide better cost and time accuracy, and involving clinical leaders will ensure projects include the work they really need.

Additionally, planning exercises such as visioning, goal creation, and programming can help foster conversations about solving, solving, and anticipating future problems. Team-based planning enables owners to address process and scope issues early, establish a real-world budget, and frame expectations before committing to a full design and build project. In other words, customers can test drive a design.

for a project Southern Ohio Medical Center (SOMC), Design Group (Columbus, Ohio) used a team-based planning process to refurbish its central sterile decontamination unit. The facility’s outdated wall construction and equipment resulted in performance issues within the department, including meeting proper pressurization and maintaining temperature control within the facility. Staff in full PPE travel in and out of the department to keep cool.

To begin addressing these issues, the project team, including owners, users, architects, engineers and contractors, conducted a vision exercise, guided by the insight of staff including SOMC Aseptic Processing Manager Julie Thornsberry, to Help determine project requirements. Key priorities include addressing pressurization issues, increasing employee comfort, and improving departmental processes/procedures. By having all team members in the room, the group was able to identify other priorities beyond traditional design concepts and began to explore questions such as “How to stage construction?” and “What other influences are needed to make this project work?”

Dennis Architecturethe construction partner for the project, engaged with the MEP trading partner, taking into account unknowns and other cost drivers, and engaging with the design engineering firm heavy engineeringit understands the facility’s systems and helps identify other unknowns, such as if plumbing for a new sink would disrupt another area or department.

The planning study aims to lay the groundwork so hospitals can plan their budget allocations for next year. However, a few months after the study was completed (at the start of the pandemic), a critical instrument failure required rapid implementation of the project. With a clear plan in place, the research team quickly mobilized to recruit new team members, which was especially challenging given the social distancing requirements at the time.

The biggest hurdle to implementation is how to keep the department running during construction. The central sterile room serves nine operating rooms, three cardiovascular operating rooms, eight endoscopy rooms, three catheterization laboratories, one obstetrics and gynecology department and countless other services. This means that out of service during construction is not an option. Likewise, the project’s small footprint—only 1,000 square feet of clean room and 1,500 square feet of total project refurbishment—has brought its own challenges to keeping the hospital up and running during construction.

One solution is to introduce a mobile decontamination unit and complete the entire project in one stage, but it is costly and creates unnecessary inefficiencies in the workflow of the aseptic processing department. Another idea is to deliver the project in two phases: the first phase refurbishes half of the rooms, and the second phase refurbishes the rest. While this process will take longer to build, it will keep the hospital functioning properly.

After three months of construction, the new clean room is in operation, with improved workflow, minimal disruption to hospital functions and a cooler work environment for staff. With the framework and roadmap in place, the core team delivered the project on time and on budget, while meeting expectations and keeping the department running.

“I think the overall highlight for me is that we delivered a complex construction project on time and on budget without compromising any operational throughput, while meeting every stated goal set forth by the stakeholder group,” Nan said. Justin Clark, director of plant operations at Ohio Medical Center.

Team-based planning allows owners to “test drive” designs and quickly implement them when appropriate – whether immediately after research, on the road years later, or even when equipment fails during a global pandemic.

Angela Kolosky, ACHA, AIA, NCARB, LEED AP BD+C, is an Associate Principal and Healthcare Planner at DesignGroup (Columbus, Ohio). She can be reached at [email protected]. Michael Forejt, AIA, NCARB, is Deputy Principal and Project Manager at DesignGroup (Columbus). He can be reached at [email protected].