My name is Bryan Daylor, and I am Vice President of Ancillary and Support Services at Eden Medical Center. I’m also on the “user” team that has had significant input on the design of the new Sutter Medical Center Castro Valley. Those of us who head up different functional areas at Eden worked collaboratively with our respective teams (consisting of managers, supervisors, staff and physicians) to determine the best way to improve the delivery of patient care in the new hospital by implementing industry “Best Practices.”
Our focus is on patient safety and quality of care, efficient patient flow and effective use of skilled resources. This work was an important opportunity to design a building that supports the process of care and enhances the experience for patients and caregivers. We were challenged with the puzzle of creating work space and flow in a new building, but in the end we feel we have achieved an excellent design for the new hospital.
It’s noteworthy that the replacement hospital for Eden will serve as a prototype for “best practices” operating models to be deployed to other Sutter Health affiliates that are building new hospitals of similar size and scope.
In the beginning…
When our user teams initially convened, the project size and scope had already been defined. We were challenged to look at how we do things today, and then be creative in how we could design this building to improve they way we provide care in the future. Some of the key goals of these teams were to look at quality and safety of care, efficiency for providers and an enhanced experience for the patient. All of these concepts had to be balanced with ways to drive down the operational cost of the hospital—hence efficiency! We looked at things like distances traveled by providers, adjacency of departments and services that work together, etc.
Acting as stewards of already-scarce resources, we decided that the hospital building would be designed for predominately clinical and direct patient care services, while almost all administrative functions would be housed in the adjoining medical office building. Hospital space costs more than twice that of regular medical office space to build and operate. So, our goal was to maximize clinical areas within the hospital and minimize the administrative functions. With the convenience of the connecting medical office building, placing the administrative services there helped us meet our budget goals without compromising the project or the future operations of the organization.
We deployed twelve different teams representing the various functional areas of the hospital, each looking at their role along the patient continuum of care and planning the layout of the hospital to support the care process. The user group contributed a wealth of knowledge that was invaluable to the development of the design of functional spaces for patient care.
Staff from all functional areas, including nursing, interventional services (surgery), sterile processing, radiology and imaging, women’s health, emergency and trauma, cardio-diagnostic testing, therapeutics, pharmacy, laboratory, and support services such as plant operations, facilities, food service, housekeeping and shipping & receiving, worked on the design of their respective units and then determined which services fit together. Efficient processing, and patient flow and experience, were key factors considered in these collaborative design sessions. Physicians from the emergency department, surgery, medicine, obstetrics and radiology also participated in the design discussions to ensure the efficiency of their part of the care process.
We worked with architects from The Devenney Group on the rough design of these areas, examining the most effective alternatives for organizing these services with consideration of services that are complementary to one another. The teams worked through several iterations of plans, building on the previous ideas and concepts from team members. The architects revised these layouts several times in draft form before a final schematic design was reached. This collaborative approach brought together years of healthcare delivery experience, as well as years of hospital and operational design experience to result in an efficient and aesthetically pleasing design that met Sutter Health’s project and budget goals.
The management team and physicians are proud of the work they have done and are excited to be a part of building the health care services of the future. Please feel free to comment here, or email me if you have any questions about the internal layout of the new medical center.
Digby Christian
My name is Digby—which tends to be a name that people remember and depending on the context that can be a good or a bad thing. There is probably no escaping the fact that people close to this project will have a hard time forgetting that the project manager’s name was Digby and he had a bit of a British accent.
I am the Senior Project Manager for Facility Planning & Development at Sutter Health.
For the Sutter Medical Center Castro Valley project, I am what’s known as the “Owner’s Representative Project Manager,” which means, for my sins, I have day to day responsibility for ensuring that the project:
1) Provides a best-in-class level clinical care concept for absolutely every function required in the acute care setting, as well as the physical design of the buildings (Scope!)
2) Opens for business on January 1, 2013 (Schedule!)
3) Costs not a penny more than the $320 million dollars that have been allocated by Sutter Health. (Budget!)
It’s an interesting balancing act…
While the estimate for the project may evoke responses from the community like, “Costs not a penny more than the, what? Three hundred and twenty MILLION dollars, are you kidding? WOW!” All I can say in reaction are two things:
1) Hospitals are incredibly complex buildings, (you might think your iPhone is complicated but let me tell you, it’s nothing compared to a hospital), built in a way that complies with 10,000 county, state and federal building codes and licensing regulations … building an incredibly complex building that is a half-mile from an earthquake fault-line considered to be “Most Likely to Fail” years and years in a row. So we must build it very very very carefully and very very very well. And that takes a lot of things, but one of them is definitely money.
And…
2) It’s not nearly as much as $700 Billion, and despite that, once it’s spent, you’ll actually have something really nice (and big) to point to and say “oh, so that’s where the money went!”
The $320M is the full cost of the project, fully escalated out to 2013. As well as the new hospital, it covers the cost of the furniture, most of the medical equipment, all of the finishes and all of the exterior landscaping, and the cost of deconstructing and where possible re-using the material of Eden Medical Center. It does not cover the cost of moving everyone from the old hospital to the new, it does not cover the cost of the medical office building.
All three of the overarching goals (Scope; Schedule; Budget) can be problematic for large-scale construction projects. It’s a regrettable fact of life that such projects are typically late, over budget and provide less than what was asked for at the outset.
It is meeting all three goals simultaneously that is my central challenge on this project. Sutter Health has brought together an astonishingly skilled and experienced team of design and construction professionals to allow such a complex building to be designed.
I have no role to play in telling such a team what air conditioning system to pick, what kind of computer cable to run, what the floors need to look like. That is not my role. My role is to assist the team in figuring out how to work together as a fully integrated single team that has the same primary goals of Sutter Health (which I handily summarized above). In doing so I work with the team to pick such diverse beasts as data cabling, ceiling tiles, air handlers, pneumatic tube system, trauma elevators, patient lift system, light fixtures, hi-efficiency windows, CT Scanners, clinical flow efficiencies and on and on so that the primary goals are met. Construction is not a business-as-usual kind of business, let alone healthcare construction.
In the next post I’ll say more about what is so fundamentally groundbreaking about the way in which this project is being designed, and will be constructed. Here’s a preview: one of the interesting techniques that has been brought to bear on this project is keeping the team focused on what’s important, i.e., why do you want this building; what do you want it to do…then having the team figure out what will be needed to meet the goals. This is a very efficient way of keeping a team focused on what’s important, and frankly, oftentimes, to keep me, “the owner” from meddling in stuff I really shouldn’t.
Please ask me questions about construction, design, project management or anything else you think I might be able to answer. Or what you’d like me to blog about. I’d really like to hear from you!
The Future Site. A rendering of the future campus once the new hospital is open and the old building is removed.
Eden Hospital in 1954. The original hospital opened on November 14, 1954 at a total construction cost of $2.9 million
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