healthcare property briefing: simon bourke, buro happold

THE TITLE OF YOUR PRESENTATION GOES HEre

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Evidence based design and effective operations to save costs.

Dublin Airport, IrelandProcess driven environments

Operationally efficient hospitals

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How will this space work in operation?



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We dont design urban realms, sports stadia and airports without a virtual modelling and validation of peoples experience.

Why not design every hospital this way?


What went wrong here?

Can we predict and mitigate this?


COPYRIGHT 1976-2014 BUROHAPPOLD ENGINEERING. ALL RIGHTS RESERVEDHow do you know 5

People centre design

PeoplePlaceProcessEffectivenessExperienceEfficiency

COPYRIGHT 1976-2014 BUROHAPPOLD ENGINEERING. ALL RIGHTS RESERVED6Were offering a service that looks at holistic performance of buildings, optimising spaces and operations for people.

Build more or operate better?Royal united hospitalEvidence based design and effective operations to save costs.


Were too busy! Need more space!!

Opthalmalogy

Gastro

Pain

DiabetesOutpatients departmentRoyal United Hospital, BathBuild more or operate better?

COPYRIGHT 1976-2014 BUROHAPPOLD ENGINEERING. ALL RIGHTS RESERVED8The hospital has 14+ outpatient departments distributed across the site (clinical villages not centralised outpatient department)

When asked, all departments will report that they need more space, more consulting rooms, more waiting space

This is not concurrent with the view of the estates director.. What is really going on? And how do we get to the bottom of it?

evidence not guessworkAverage 34% observed utilisation during peakAverage 16% observed utilisation during off peak


Inform design brief

Operational planning and virtual testingReconfigureRevise Clinic timesReview ProcessesCo-locate7 day clinics


Benefits

Facilitate closureEnhance space utilisationReduce need for new build

Saved >3mn through optimised strategies and operations.

Howard JonesRUH Bath


Savings achieved:

2.5m build cost

200k per annum opex

COPYRIGHT 1976-2014 BUROHAPPOLD ENGINEERING. ALL RIGHTS RESERVEDBy improving clinical adjacencies and relocating existing departments that work well together.They work on a clinical village model, as opposed to a centralised OPD, with each department having their own reception desk. By improving timetabling we were able to merge departments, sharing space which reduce the number of waiting areas and reception.

When we translate this to costs

Construction costs average 2500/m2, Operating costs (energy, capital charge) 200/m2/pa.Our work at RUH saved 1000m2 by using changes to clinic times and co-joining of services.

This equates to savings of:

2.5m build cost saved

200k per annum opex

Optimising Process Efficiency

Emergency Department Queens Hospital, Romford


process optioneerinG

RegisterDoctorTestsWaitingRapid Assess & Treat processBedsRegisterTriageTestsDoctorTestsWaitingTriage processBedsQueens Hospital A&E (ED)

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process optioneerinGRegisterTriageTestsDoctorTestsRegisterDoctorTestsWaitingWaitingTriage processRAT processBedsBeds

COPYRIGHT 1976-2014 BUROHAPPOLD ENGINEERING. ALL RIGHTS RESERVED15Overall Patient visit time reduced and bed use reduced

Existing Patient #s + Triage Nurse 25% Increase in Patient #s + Triage Nurse 25% Increase in Patient #s + RAT doctorBenefitsConfidence in business caseTest alternative processesAddress over-crowded waiting area


COPYRIGHT 1976-2014 BUROHAPPOLD ENGINEERING. ALL RIGHTS RESERVED17Benefits and value addedSignificant reduction in corridor widths (and energy use) by designing single bed width corridors with passing bays (testing with likely conflicts)Confidence in the design to provide optimum level of comfort to patient, staff, and visitors

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healthcare property briefing: simon bourke, buro happold

Design