Download TL5-B - Prentice Move phases and evaluation

“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
Migration
Recruitment
Department
Readiness
Operating
Budget
Building
Load
Operating
Work Flows
Technology
Readiness
Operating
Assumptions
Building
Readiness
Program
Design
Construction
FFE
Transition Planning
Campus Development
Facility Readiness
Operations Readiness
Communications
&
Events
Feinberg/Galter
Lessons 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
Feinberg/Galter
Lessons 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
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
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.
Transition Plan
The move and activation plans were consistent with
Northwestern Memorial Hospital’s mission and strategic plan initiatives.
Best Patient
Experience
Assure patient safety and high
standards of quality service are
maintained throughout the move.
Best People
Exceptional
Financial
Performance
X
Provide staff and physicians with the
time and training needed to acclimate
to the new facility.
X
Seize opportunities to enhance
operations.
X
Support patients, family members and
visitors throughout the move
X
X
X
Transition Planning
Stabilization
Patient Move
People Commissioning
Migration
Recruitment
Department
Readiness
Operating
Budget
Building
Load
Operating
Work Flows
Technology
Readiness
Operating
Assumptions
Building
Readiness
Program
Design
Construction
FFE
Transition Planning
Campus Development
Facility Readiness
Operations Readiness
Communications
&
Events
Prentice Women’s Hospital
2007: Move Preparation
 Building Readiness
 Technology Readiness
 Department Readiness
 Staff Readiness
Prentice Women’s Hospital
2007: Move Preparation
•
Equipment Procurement
and Pilots
•
Staff and Physician
Training
•
Development of Move Plan
• Move Simulation and
Mock Move
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
Transition Planning
Kerry Shannon
Director
Steve Straka
Kirk McKie
IT Project Director
Paula Elliott
Transition Planning
Manager
Transition Planning
Manager
Transition Planning
Manager
Transition Planning
Manager
Sara Hayes/Heather
Daas
Nick Wojciechowski
Roberta Clairmont
Mary Fran Molitor
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
Professional
Services
Patient Support
Services
-D. Woods –
S. Hayes
-G. Fennessy –
N. Wojciechowski
Move Logistics
-J. Przybylek –
N. Wojciechowski
Best People
-D. Manheimer –
MF Molitor
Activation Teams
-geographically focused/
department specific
assumptions/workflows
Building
Readiness
-Jim Bicak –
S. Hayes
FF&E
Building Load
-G. Fennessy –
N. Wojciechowski
Information
Technology
-T. Zoph –
P. Elliott
Communication
&
Events
-H. Salls –
R. Clairmont
Task Forces
-assumptions/work flows
that cross department
Transition Plan
A three year process from planning through execution and stabilization
Recruit 2
Project Managers
Preliminary
Operating
Budget Review
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
Homestretch Coordination
Stabilization
TP Transfer
to Operations
2005
2005
2006
2006
2006
2006
2007
2007
2007
2007
2008
2008
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Building Readiness
Objective
Prepare the physical facility and assure building systems were tested and
functioning for the opening of the new Prentice
Facilities
Management
•Transition to support
building operations
(i.e. automation of MEP)
•Building commissioning
•City requirements
•Statement of conditions (JCAHO)
Security
Services
•Validate updated security system
and procedures
(e.g. Code pink)
•Transition to support pre-operating
building access and opening
operations
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
Environmental
Services
•Implement plan for each building
clean phase : post-construction,
post-load, terminal clean, and
patient ready clean
•Transition to support building
operations
Technology Readiness
Objective
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
Technology Readiness
Process
Commissioning
Infrastructure
Application
•Designed infrastructure with
flexibility to accommodate changes
in technology for 25 years
•Full wireless capabilities, housewide
•Built infrastructure off site, tested,
then loaded closets
•Conducted workflow sessions
•Mapped processes to applications
•Piloted new technology in existing
facility
•Built and tested applications in
production environment
•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
Activation Teams – Task Forces – Department User Groups
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
Integrated Building Load
Project Elements
The complexity of the following pre-occupancy elements
prompted the need for a fully integrated planning and
execution structure.
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
Construction
Systems Readiness
•Regulatory Inspections
•MEP Commissioning
•Design-Deferred Construction
•Punchlist Construction
•Cleaning
•Training and orientation
•Environmental Testing
•Technology Commissioning
•Equipment installation and testing
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)
PACS
Wall-mounted
display (x2)
OR Video Integration
(new x8)
Video teleconference
Coder/Decoder (x2)
In-room camera
(x2)
Installation
Outside
world
OR
Conference
Conference
Center
PC (standard charting at
documentation station)
Delivery
Gateway
Biomedical
Certification
Technology
Commissioning
Staff
Training
First
Use
Department Readiness Assessment
Objective
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
•
Shake Down: Leverage of existing issue
reporting system (Sentact) to report
track and resolve issues
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
•
Department Readiness Assessment
Validation: Leverage of existing building load
database and multidisciplinary support services
rounding group to assess environment to
validate readiness state
Scope:
1000 rooms assessed pre-move
56,000 FFE items validated
16 hours – average assessment time
100% rooms approved to open
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
Num ber of Reported Issues Per Week
180
160
140
120
100
80
60
40
20
0
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
# of Open Move Critical Items
# of Move Critical Resolved
# of Open Other Items
# of Other Items Resolved
Week 8
Department Readiness Assessment
Department 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
Department Readiness Assessment
EOC Review
Multidisciplinary support services rounds accompanied by department
manager to validate department’s environment is ready to accept patients
Team Members
•Safety
•Bio Medical Engineering
•EVS
•Materials Management
•Facilities
•Pharmacy
•Construction/Renovation
•Infection Control
•
•
•
Deliverables
Sentact Shake Down report of
all identified issues
Report of % of EOC rounds
completed
Go No-Go Decision
Unit
Estimated Length of Rounds
Patient Care
90 minutes
Support Services
30 minutes
Public & Office Spaces
15 minutes
Migration
Project Elements
Many project resources and organizational structures were
leveraged to streamline the migration process.
Planning
Implementation
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
•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
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
Sept 24
Oct 1
Oct 8
Oct 15
Oct 22
Oct 29
Nov 5
Operate at Full
Capacity
Nov 12
Operating Program - Assumptions - Work
Flow
Objectives
Task Forces
To develop operating assumptions
and
workflows that cross departments in
Prentice – e.g. Pharmacy.
Scope:
8 Task Forces
160 Staff & Physicians
Activation Teams
To develop geographically
focused/department specific
operating assumptions and
Workflows – e.g. NICU.
Scope:
16 Activation Teams
300 Staff & Physicians
Operating Program - Assumptions - Work
Flow
Structure
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
Operating Program - Assumptions - Work
Flow
Process
Review
Department
Specific
Program
Develop
Operating
Assumptions &
Workflows
Key Factors
•
•
•
•
•
Projected Volume
Facility Design & Size
New Programs
Service Enhancements
Regulatory
Requirements
Validate
Staffing
Models
Provide Input
to Technology
Device &
Application
Plans
Provide Input
to Training
Plans
Participate in
the
Development of
the Move Plan
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
Keycard
Reader
Kronos
Lounge
Report
Conference
Patient
Care
Station
Reception
Desk
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
New Prentice Women’s Hospital
Training: Our Staff
• 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
New Prentice Women’s Hospital
Training: Our Attending and Resident Physicians
•
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
People Commissioning
Process
Scope
Validation
Plan Development
Implementation
Needs Assessment
Administration
On-Line Training
Strategy
Development Process
General Orientation
Budget
Department Training
Evaluation
Follow-Up
Remediation
Process for Developing
Unit Specific Transition Training
Conduct
Needs
Analysis
Unit & General
Identify &
Prioritize
Training
Needs
Develop
Training
Approach
Develop
Scenarios
Identify
Subject Matter
Experts
(SMEs)
Develop
Evaluation
Plan
NPWH:
Process for
Training
Development
Evaluation &
Follow-Up
Develop
Training
Materials
Certification
Process
Quality
Checks
Conduct
Training
Identify &
Prepare
Trainers
Finalize &
Communicate
Schedule
“Patient Move”
Move Logistics
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
Prentice Women’s Hospital
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
Patient Move – Resources
Over 500 staff and volunteers supported the move
• Patient Movement
• Visitor Management
• Materials Movement
• Concierge (Orientation to Patient
• Move Route Security & Facilities
• Care Stations
• Diagnostics & Therapeutics
• Communications & Media
Relations
Room & Technology)
• Patient Move Gift Distribution
• Ongoing Operational Support
• Data Management
The Move Plan: Move Sequence
Simulated Duration – 5 Hours, 44 minutes
7:30A
8:00A
8:30A
9:00A
9:30A
10:00P
10:30A
11:00A
11:30A
12:00P
12:30P
13:00P
13:30P
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)
Transfer early labor patients
from current L&D to new
PWH L&D
Deliver and recover remaining
patients at current PWH
Close Current
L&D
Post Partum Admissions – 9 New Prentice
(Admitting Unit for deliveries occurring in current/new L&D during the move)
Antepartum (15)
est. 9-10 pts.
Move
Final
NICU PP
Mothers
Hematology/Oncology Units (15E, 15W then 16E)
Women’s Care
Unit
Post Partum Units (12, 11 then 9)
New PWH – Patient Move Route
Chicago Avenue
- Minor Care Stations
- Major Care Stations
N
- Patient Move Route
New PWH
- Doorways (requiring support)
- Privacy Curtains
- Return Route
PWH Return Route
Superior Street
PWH
Feinberg return
Route
Elevator
to
basemen
t level
Olson Pavilion
Across
drive
under
tent
Elevator
to ground
level
L&D
NICU
Lurie Research
(Note: Incline of Lurie Bridge)
Huron Street
- Bridges and 2/3 floor corridors
Feinberg/Galter
Pavilions
- Tunnels & Lower Concourse Corridors
- Elevators
New Prentice Women’s Hospital
Mock Move: August 2007
Coordination 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
New Prentice Women’s Hospital
Mock Move
Successfully completed the move of
34 patients ahead of schedule!!!
New Prentice Women’s Hospital
Mock Move: Lessons Learned
• Allow unit managers control and flexibility
for patient move sequence
• Provide route signage and move staff
identifiers
New Prentice Women’s Hospital
Mock Move: Lessons Learned
• Scripting of messages to patients/families
• Keep infants in view of Mother
• Separate return route for resources &
equipment
New Prentice Women’s Hospital
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
Patient Move Simulation
The Simul8 application allowed for the definition of resource
requirements and the implications of assumption adjustments
The Last Baby Born at Old Prentice
Born: 11:43 AM
It’s a boy!
The First Baby Born in New Prentice
Born: 11:48 AM
It’s a girl!
“Stabilization”
Stabilization
Objective
Support Prentice Women’s Hospital departments through the initial
stabilization of the facility and operations.
Stabilization
October 20 – December 31
Operations
- Optimization -
Post Occupancy
Assessment
January 1 - Ongoing
Spring 2008
Stabilization
Initial Dashboard
Overall
FACILITY
Detail
Follow-Up
BIC
Room Temp
1.
Elevators
Doors
Engineering Solution successfully testing in one NICU
pod and successfully implemented throughout.
CSS elevator is staying on floor-automatic override
currently not available. FM has ordered part.
Doors on 15, 16, employee entrance at Chicago Ave.
Push-button door hardware on 14-16 clean utility
rooms
D.
Stout
Alarm data from former Prentice facility establish
baseline for normal false alarming
NICU code pages were not received by staff in areas on
L&D
Telephone rollover between 16N and 16S is not
reflecting the separate operation of the units
D.
Dahmen
C.
Colande
r
1.
Training regarding the location on bed storage room in
the lower concourse
D. Stout
1.
Missing linen cart on 15 to support Patient Escort
1.
Identify status of L&D multidisciplinary rooms
2.
3.
4.
Locks
SYSTEMS
Infant Security (HUGS)
Paging
1.
2.
3.
Phones
FFE
Equipment
SUPPLIES/LINEN
B.
Stepien
PHARMACY
FOOD SERVICE
EVS
PATIENT CARE
MD TRANSITION
L&D
Post Move Operations
Stone Stabilization
BF
Stabilization
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
Environmental Services
• Scope primarily focused on
operations:
• Room turn
• Cleanliness
Technology
• Scope limited to the following
systems:
• HUGS
• Wireless Devices - Dead
Zones
• Nurse Call - Emergent &
Urgent Notification
Food Service
• Minimal issues
• Tray Pick-Up
Security
• Scope limited to the following:
• Floor Access
• Infant Security
Supplies & Linen
• Scope of issues decreasing each
week
• PAR Levels
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
“Lessons Learned”
Transition Planning
Over 60 Vice Presidents, Directors and Managers provided feedback
on the Transition Planning Model/Process
Role:
Not
Successful
Date:
1
Department Readiness
Technology Readiness
Operations Readiness
Staff Readiness
Patient Move
Stabilization
Successful
2
3
4
5
Critical Success
Factors
"What was done well
and should be
replicated/?”
Lessons Learned
"What should we do
differently?"
Prentice Women’s Hospital
Majority of users ranked the Transition Planning process favorably.
46%
160.0
140.0
120.0
81% Rated 4
or Above
27%
100.0
80.0
60.0
40.0
20.0
0.0
11%
1%
0%
1%
2%
1
1.5
2
2.5
8%
5%
3
3.5
4
4.5
Not Successful
5
Successful
Successes
Opportunities
• Executive sponsorship of Task Forces and Activation
• Appreciate implications of new design and recognize
Teams highlighted TP as an organizational priority
impact of “change” on users
• TP activities aligned with existing organization structures
• Department infrastructures need to be solid to support daily
• TP structure included individuals involved in earlier planning
operations so Directors/Managers can focus on TP activities
efforts (strategy/program/design)
• Appreciate the scope of user involvement during the six
• Overall, consistent management structure from design
months prior to opening (estimate 20 hours/week)
through TP
• Strong attention to detail and coordination
• Operating Pilots/Training/Migration – Patient Move Planning
• Department buy-in to TP process optimizes outcomes
Department Readiness
Preparing the environment for patient care/operations
48%
30.0
79% Rated 4
or Above
25.0
20.0
24%
15.0
14%
10.0
5.0
2%
0%
2%
0%
2
2.5
7%
3%
0.0
1
1.5
3
3.5
4
4.5
Not Successful
Successes
5
Successful
Opportunities
• Early access to the facility to support department transition
• Department Readiness Assessment Tools were too
& readiness
cumbersome for users
• Adequate time to prepare the facility for operations (3
• Accurate data-base of open issues to focus resources and
months)
follow-up (e.g. delayed Sentact issue close out)
• Scope of equipment/furniture migration was minimal
• Clearly define purpose of Environmental Testing and what the
• Strong attention to detail and coordination
strategy will be to respond to results
• Focus on PAR level planning – understand staff behavior
related to supply management
• Audiovisual coordination and installation
Department Readiness
Building Readiness
Successes
Opportunities
• Campus Development oversight and leadership of building
• Clarification and consistent use of definition of “patient
commissioning in developing plan for operation of facility and
ready’ state following IDPH
related systems.
• Trigger operations to support patient environment –
• Earlier department transition provided heightened state of
e.g. implement OR restrictions, ICRA standards, etc…
control, ownership and awareness of facility
• Leverage planned security systems to enhance control pre-
• Environmental Services oversight/implementation of building
move (e.g. activate key card readers and individual employee
clean phases (post construction to patient ready cleans)
key card privileges)
• Dedicated NMH Security to oversee access control and
• Maintain access control throughout evolving phases of
respond to staff/vendors/contractors
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
Department Readiness
FFE
Successes
Opportunities
• Continuity of staff and knowledge
• Assign dedicated staff to invoice payment
• Planning to Procurement to Installation
• Assignment to other tasks may impact the
• Consultants, FFE team, TP team
prioritization of invoice payment
• Importance of teamwork
• Focus on common goal (patients first & schedule)
• Appreciate the disposable supplies required for the selected
equipment
• Clearly defined schedule, budget & related requirements
• Supply changes are needed to support updated
• Executive sponsorship
models of same equipment (e.g. fetal monitor probes)
• 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
• Build inventory to support availability of supplies for
operational opening
• Understand potential increases in supply cost
• Pursue earlier training for new equipment
Department Readiness
Building Load
Successes
Opportunities
• Team Integration (FFE/Tech/Biomed/Security/
• Earlier user engagement with the data and tools to better
Consultants/Campus Development…)
mitigate changes and improve readiness assessment
• Bridge between procurement team and load
• Sustained AE engagement through equipment procurement
team
to respond to infrastructure and architectural layout
Procurement Data
Installment Support/Management
implications of equipment selection
• Early integration of IT into the load planning process
• Clearer and earlier understanding of FF&E regulatory
• Daily debrief and planning sessions during
readiness expectations (e.g. FF&E needed to support IDPH
implementation
“patient ready” terminology)
• Clear turnover of building from CM at the time of substantial
• Ensure equal buy-in of integrated process by all
completion
stakeholders
• Regulatory preparedness
• Earlier Academy involvement for better new equipment
• Leverage of procurement data and readiness/load work
training coordination
plans to populate Department Readiness Assessment tool
• Management of early install (existing facilities) scope creep
• Off-site warehousing and dedicated labor to support material
should be more disciplined
movement
• Disciplined approach to decision milestones related to
procurement (e.g. May 31 decision deadline)
• Centralize management of training
• In-house Environmental Services team
Department Readiness
Migration
Successes
Opportunities
• Clear understanding of the scope of migrating items
• Inpatient move and migration was complex: more time
and the commissioning/certification needs
should be spent on migration
• 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
• Incorporate migration planning into user group
process
• Appreciate staff’s personal attachment to office contents
Department Readiness
Readiness Assessment
Successes
Opportunities
• Leverage of existing processes to report and respond
• Leverage opportunity to create a consistent database
to identified issues (e.g. Sentact)
throughout project design, activation and post move (e.g.
• Proactive issue identification/resolution in support of
room data sheets)
critical project milestones (e.g. regulatory review,
• Simplify assessment tool and process for users
environmental testing, patient move…)
• Provide sample of standard room layout for users to refer to
• Prioritization of issues resulted in development of
• Clearly define individuals and coordinate process to assure
focused resolution plans
issues are resolved in the most timely manner
• Reinforced staff comprehension to department
• Pursue consistent database for reporting and monitoring IT
environment
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
Technology Readiness
Assuring technology was ready to support patient care/operations
76% Rated 4
or Above
44%
30.0
25.0
24%
20.0
15%
15.0
10.0
5.0
2%
0%
0%
8%
3%
3%
0.0
1.5
Not1Successful
2
2.5
3
3.5
4
4.5 Successful
5
Successes
Opportunities
• No unproven technology – use of pilot project approach
• Manage scope of new technology
• Technology team support and their attention to detail
• Evaluate opportunity to phase implementation pre-
• Early decision making with user involvement
move/move/post-move
• Cross team communication
• Integration with Task Forces and Activation Teams
• Technology testing and pre-move sweep of devices
• 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
Technology Readiness (cont.)
Assuring technology was ready to support patient care/operations
Successes
Opportunities
• Technology engagement early and often
• Technology presence from programming – design –
• IT TP Director involved early and throughout
construction – activation (e.g. consistent floor captain
• Infrastructure design
involvement)
• End user workflow and activation team participation
• Pilot new technologies in lab environment (e.g. mock-ups) to
• Building commissioning
respond to limited infrastructure in existing facilities
• Building load (IS devices, FFE and biomedical
• Build flexibility into load/commissioning schedule to respond
equipment)
to coordination elements
• Move coordination
• Cross connects
• Stabilization availability and support
• More time for device load/install/biomed certification
• On site staging location for devices
• Test in production environment
• Technology leadership commitment during homestretch
• Less time for testing in new facility
• Clear network specifications to support FFE procurement
• Monitor vendor compliance
• Single point of contact to support coordination and
• Coordination of furniture delivery with device placement
integration of activities
process
• Technology Move War Room support model
• Flexibility and fluidity
• User review of device placement earlier in process
• Consistent documentation from design to
implementation
• Validate placement in situ prior to completing
installation
• Cable management
Operations Readiness
Confirming/validating operations and work flows
75% Rated 4
or Above
62%
40.0
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
7%
0%
0%
1
1.5
Not Successful
12%
7%
5%
0%
2
2.5
3
3.5
4
8
%
4.5
5
Successful
Successes
Opportunities
• Executive sponsorship
• Workflows and operating models should be clear prior to design
• Activation Team and Task Force structure
• Multidisciplinary involvement
• Early involvement of staff
• Stakeholder buy-in early with early focus on implementation
• Identify areas of risk and provide focused readiness attention
(e.g. emergency response, infant security…)
• Early access to facility to build/validate workflows
• Appreciate design impact on staff – “scope of change”
• Transition Planning team support
• Understand operating budget implications related to operating
• Attention to detail
assumptions/design earlier
• Benefit of detailed planning realized post-move
• Current service assessment facilitated development of future
service assumptions
• Define gap and work through prior to entering budget cycle to
facilitate recruitment initiatives
Operations Readiness (cont.)
Confirming/validating operations and work flows
Successes
Opportunities
• Budget tool to project FTE’s based on new program,
• Appreciate flows will evolve post move and provide
expansion of existing programs, building design…
supports to facilitate this process
• Budget process fostered a sense of operating reality
• Monitor volumes annually and identify space/design
with the planned/assumed work flows
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
People Commissioning
Preparing staff to work in their new environment
91% Rated 4
or Above
59%
35.0
30.0
25.0
20.0
24%
15.0
10.0
5.0
8%
0%
0%
2%
0%
3%
3%
0.0
1
1.5
Not Successful
2
2.5
3
3.5
4
4.5
5
Successful
Successes
Opportunities
• Early Academy support and involvement
• Appreciate design impact on staff – “scope of change”
• Organizational support and resourcing of training effort
• Physician involvement and engagement
• Training expertise and systems infrastructure
• Success or failure dependent on infrastructure (inconsistent wireless device
• Model enable departments to drive unit specific training
function)
• Technology/equipment incorporated into unit training
• Inconsistent vendor equipment training
• Early access to facility
• Pilot new systems in existing facility – or – test environment
• Ability to use facility as a classroom
• Increase communication throughout project with targeted communication 9-
• Coordination: building load and technology readiness
12 months prior to move
• Appeal on cognitive and affective level
• Flexibility
Patient Move
Planning and executing the patient move to the new facility
98% Rated 4
or Above
73%
35.0
30.0
25.0
20.0
15.0
10.0
5.0
14%
0%
0%
0%
0%
2
2.5
2%
11%
0%
0.0
1
1.5
Not Successful
3
3.5
4
4.5
5
Successful
Successes
Opportunities
• Attention to detail
• Reliable communication tools/systems used on move day –
• Broad, inclusive planning process resulted in many experts
inconsistent function (e.g. wireless devices, radios…)
• Technology engagement
• Artificiality of mock-move renders the execution extremely
• Department and physician ownership of individual move
challenging
plans
• Appreciate the need for flexibility to support clinical decision making
• 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
• Deploy resources earlier on move day
• “Machine is large and slow to start”
Patient Move
Command Center
Successes
Opportunities
• Integration of Facility Readiness/Operations
• Maintain attention to detail and heightened focus until last
Readiness/Move Readiness into one oversight model
patient moves
• Leveraged existing HEICS model
• Natural instinct of staff to report issues directly into
• Provided process to assure consistent issue reporting –
Command Center - consider locating Department Readiness
prioritization – resolution resourcing
issue reporting in Command Center versus decentralized
• Design of communication focused users on their scope
location
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
Stabilization
Supporting facilities/operations through issue reporting/resolution
38%
67% Rated 4
or Above
20.0
15.0
21%
10.0
5.0
0%
0%
1
1.5
4
%
15
%
13%
3
3.5
8%
2%
0.0
2
2.5
4
4.5
Not Successful
5
Successful
Successes
Opportunities
• Hospital operations structures and processes were aligned
• Structure should respond to facility/system issues as well
with Transition Planning effort and therefore, were positioned
as operating/process issues
well for the early transfer of oversight
• Align Activation Team structure with stabilization activities
• Stabilization meetings provided users with sense of focused
• Assess areas of high-risk and implement stabilization
issue resolution
processes prior to opening
• Senior Management engagement and support
• Communicate stabilization structure/process pre-move to
support VP/Director/Manager schedules post-move
• Anticipate capacity issues
Transition Planning
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