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Planning Your Retrofit – Information for Facility Managers in the Healthcare Field


Healthcare Facilities

Managing healthcare facilities, including hospitals, clinics, pharmacies, labs, home healthcare facilities and institutions has become a lesson in managing the needs of multiple stakeholders. Guidelines like those identified in the USP 797 Design Program (which stipulates physical and environmental design criteria – encompassing all interior surfaces, windows, doors, and light fixtures, along with air pressure, filtration, particulates, and temperature and humidity controls) need to be implemented, while balancing patient care and access to the facilities for staff, not to mention managing costs!

Our team has worked with many Facility Managers. We recommend the following considerations when in the planning phases of your project:

  1. Identify your team and establish their roles, and when their approval will be necessary along the project’s lifecycle. Do all team members understand their roles and responsibilities? Have timelines been identified? Has the scope of the project been articulated clearly? We recommend setting up a central location where progress can be tracked, information stored where it can be easily accessed, plans are filed, and contact information logged. This can either be an office onsite for which everyone has real-time access to, or an online “cloud” based project management system.
  2. Have staff and patients been surveyed to solicit their opinions of the space? Are staff frequently being asked to get additional blankets for waiting patients because the temperature of the room is frequently too cool? Are there areas in the building where staff feel there is no air movement, or that the air movement changes throughout the day and is inconsistent? If necessary, spend a day with the staff and get a sense of their use of the space.
  3. Think like a patient – It’s your workplace, but it’s the place they go when they’re ill and could be experiencing feelings of anxiety or fear. Keep this in mind when preparing for your renovation. How will your presence in that environment affect the patients? How will your tone and language impact their time as they occupy the space with you?
  4. Has scheduling of patient appointments or movements been clearly communicated and adjusted? Will the movement of patients be impacted, and if so, have plans been put in place to accommodate this inconvenience? Has additional signage been placed to identify temporary changes? Have you built in enough downtime in order to accommodate unforeseen delays?
  5. Have you identified pre-work than can be accomplished with little or no impact on patients and staff that could eliminate downtime? Have you weighed after-hours work from a timeline/patient impact perspective with the costs of overtime?

Most of all, have you consulted with current legislation that is either in place now (i.e. USP 797), or proposed in the near future that establishes guidelines for medical facilities? Creating a plan that encompasses not only current guidelines, but goes beyond the existing guidelines to include those that are pending will serve to create a healthier environment for all stakeholders. We often recommend that Facility Managers visit other healthcare institutions and gain insight from the experiences of others.

The old adage of measure twice, cut once, is often applied to project management at this level – except what we say is to plan twice (or more!). Find colleagues who can poke holes in your plans and will provide you with constructive criticism.

Resource: Guidelines for Design and Construction of Healthcare Facilities