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Transcript of “The Prentice Story” Prentice Move Phases and Evaluation April 9, 2008.
“The Prentice Story”
Prentice Move Phases and Evaluation
April 9, 2008
“Activation & Readiness Planning”
Prentice Women’s HospitalTransition Planning Model
Op
erat
ion
s R
ead
ine
ssF
acility Read
iness
StabilizationPatient Move
People Commissioning
Program
OperatingAssumptions
OperatingWork Flows
OperatingBudget
Recruitment
Communications&
Events
BuildingReadiness
TechnologyReadiness
BuildingLoad
DepartmentReadiness
Migration
DesignConstruction
FFE
Transition Planning Campus Development
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/GalterLessons 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
• 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
Unique challenges existed with the Prentice Transition plan
Transition Plan
• 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.
A well defined plan assured smooth activation of the new Prentice.
Transition PlanThe move and activation plans were consistent with
Northwestern Memorial Hospital’s mission and strategic plan initiatives.
Best Patient Experience
Best People Exceptional Financial
Performance
Assure patient safety and high standards of quality service are maintained throughout the move.
X
Provide staff and physicians with the time and training needed to acclimate to the new facility.
X
Seize opportunities to enhance operations. X X X
Support patients, family members and visitors throughout the move X
Transition Planning
Op
erat
ion
s R
ead
ine
ssF
acility Read
iness
StabilizationPatient Move
People Commissioning
Program
OperatingAssumptions
OperatingWork Flows
OperatingBudget
Recruitment
Communications&
Events
BuildingReadiness
TechnologyReadiness
BuildingLoad
DepartmentReadiness
Migration
DesignConstruction
FFE
Transition Planning Campus Development
Building Readiness
Technology Readiness
Department Readiness
Staff Readiness
Prentice Women’s Hospital2007: Move Preparation
Prentice Women’s Hospital2007: Move Preparation
• Equipment Procurement and Pilots
• Staff and Physician Training
• Development of Move Plan
• Move Simulation and Mock Move
Transition Planning
Director
Kirk McKie
Transition Planning Manager
Sara Hayes/Heather Daas
Transition Planning Manager
Nick Wojciechowski
Transition Planning Manager
Roberta Clairmont
Transition Planning Manager
Mary Fran Molitor
Organization StructureTransition Planning Team coordinated and facilitated all activities
related to the activation and move.
Chief Operating Officer
Executive Vice President
Dennis Murphy
IT Project Director
Paula Elliott
Consultant
Kerry Shannon
Steve Straka
ProfessionalServices
-D. Woods –S. Hayes
Patient SupportServices
-G. Fennessy –N. Wojciechowski
Move Logistics-J. Przybylek –
N. Wojciechowski
InformationTechnology
-T. Zoph –P. Elliott
FF&EBuilding Load
-G. Fennessy –N. Wojciechowski
Communication &
Events-H. Salls –
R. Clairmont
BuildingReadiness-Jim Bicak –
S. Hayes
Best People-D. Manheimer –
MF Molitor
Transition PlanVP Sponsored Task Forces and Activation Teams addressed the scope of
activities required to execute the overall Transition Plan.
DepartmentActivation
Teams-Dept VP’s –MF. Molitor
All TP
Prentice AIP
Dennis Murphy
Kirk McKie
Task Forces-assumptions/work flows that cross department
Activation Teams-geographically focused/department specificassumptions/workflows
Transition PlanA three year process from planning through execution and stabilization
2005
Q3
Consultant RFPPlanning Support
Activation Team Activity
2005
Q4
2006
Q1
2006
Q2
2008
Q1
2007
Q4
2007
Q3
2007
Q2
2006
Q3
2006
Q4
2008
Q2
2007
Q1
Plan DevelopmentPlan, Process &
ScheduleBudgetReview/
Approval
Recruit 2Project Managers
Recruit 2Project Managers
Task Force Activity
Confirm Charter/VP Sponsorship
Plan/Assumptions/Work Flows
Validate & ApprovePlans/Assumptions/Work Flows
Implementation
Confirm Charter/VP Sponsorship
Preliminary Operating
Budget Review
Plan/Assumptions/Work Flows
StabilizationTP Transfer
to Operations
Implementation
OpeningPatient Move
Homestretch Coordination
Building Readiness Objective
Security Services
• Validate updated security system and procedures (e.g. Code pink)
• Transition to support pre-operating building access and
opening operations
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
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
Facilities Management
• Transition to support building operations
(i.e. automation of MEP)• Building commissioning
• City requirements• Statement of conditions
(JCAHO)
Facilities Management
• Transition to support building operations
(i.e. automation of MEP)• Building commissioning
• City requirements• Statement of conditions
(JCAHO)
Environmental Services
• Implement plan for each building clean phase : post-construction, post-load, terminal clean, and
patient ready clean• Transition to support building
operations
Environmental Services
• Implement plan for each building clean phase : post-construction, post-load, terminal clean, and
patient ready clean• Transition to support building
operations
Prepare the physical facility and assure building systems were tested and functioning for the opening of the new Prentice
Technology ReadinessObjective
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 cableWired Devices – 4727 PC’s, printers & phonesWireless Devices – 550 PC’s & phonesBiomedical Equipment – 2650 devicesApplications – 76 applications cross referenced to 50 processesPilots – 6 pilots of new technology
Technology Readiness Process
Application
• Conducted workflow sessions• Mapped processes to
applications• Piloted new technology in
existing facility• Built and tested applications in
production environment
Application
• Conducted workflow sessions• Mapped processes to
applications• Piloted new technology in
existing facility• Built and tested applications in
production environment
Commissioning
• 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
Commissioning
• 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
Infrastructure
• Designed infrastructure with flexibility to accommodate
changes in technology for 25 years
• Full wireless capabilities, house-wide
• Built infrastructure off site, tested, then loaded closets
Infrastructure
• Designed infrastructure with flexibility to accommodate
changes in technology for 25 years
• Full wireless capabilities, house-wide
• Built infrastructure off site, tested, then loaded closets
Activation Teams – Task Forces – Department User GroupsActivation 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 equipment11,000 pieces of furniture7,500 Information technology devices703 hours of loading activity
The complexity of the following pre-occupancy elements prompted the need for a fully integrated planning and
execution structure.
Construction
• Regulatory Inspections• MEP Commissioning
• Design-Deferred Construction• Punchlist Construction
Construction
• Regulatory Inspections• MEP Commissioning
• Design-Deferred Construction• Punchlist Construction
Systems Readiness
• Cleaning• Training and orientation• Environmental Testing
• Technology Commissioning• Equipment installation and testing
Systems Readiness
• Cleaning• Training and orientation• Environmental Testing
• Technology Commissioning• Equipment installation and testing
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
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
Integrated Building LoadProject Elements
Video Endoscopy system (8)
Camera, Video/Surgical (x5)(new)
Cart, Fiberoptic(2 new)
PACS
In-room camera (x2)
OR Video Integration(new x8)
Printer (x8)
Ceiling-mounted Flat Panel Display (x24)
Load Sequence (Sample)
PC (standard charting at documentation station)
Wall-mounted display (x2)
Video teleconferenceCoder/Decoder (x2)
Outsideworld
OR Conference
ConferenceCenter
Gateway
Delivery Installation Biomedical
Certification TechnologyCommissioning
Staff Training
FirstUse
Each system and piece of equipment required analysis to reveal the dependencies, activation duration and sequence.
Department Readiness AssessmentObjective
• Shake Down: Leverage of existing issue reporting system (Sentact) to report track and resolve issues
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• Department Readiness Assessment Validation: Leverage of existing building load database and multidisciplinary support services rounding group to assess environment to validate readiness state
Scope:3019 pre-move issues reported
62% resolved pre-move148 move day issues reported236 stabilization issues reported – 3 weeks95% issues resolved to date
Scope:1000 rooms assessed pre-move56,000 FFE items validated16 hours – average assessment time100% 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
Call 6-8888
OR
Reports
Number of Reported Issues Per Week
0
2040
6080
100120
140160
180
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8
# of Open Move Critical Items # of Move Critical Resolved
# of Open Other Items # of Other Items Resolved
Department Readiness AssessmentDepartment 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
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
Team Members•Safety
•Bio Medical Engineering•EVS
•Materials Management•Facilities
•Pharmacy•Construction/Renovation
•Infection Control
Many project resources and organizational structures were leveraged to streamline the migration process.
Implementation Planning
• 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
Implementation Planning
• 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
Move
• Labels Distributed to Departments for Box Identification and Relocation
• Vendors Engaged to Assist with Complicated Migration Items
• Master Migration Plan Established
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
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
MigrationProject Elements
Sept 24 Oct 29 Nov 12Nov 5Oct 22Oct 15Oct 8Oct 1
MOVE
Screening Center in 676 Closes
Galter 13 Operates at Half Capacity
Galter 13 Closes
New Prentice Opens with 3 Diagnostic Pods and a Screening Pod
Operate at Full Capacity
Move remaining Mammo Units from Galter 13 to New Prentice for Installation and Commissioning
Sample Migration PlanBreast Imaging
Move Half of the Mammo Units from Galter 13 to New Prentice for Installation and Commissioning
Screening Center Equipment to New Prentice for Installation and Commissioning
Operating Program - Assumptions - Work Flow
Objectives
Task Forces
To develop operating assumptions and
workflows that cross departments in
Prentice – e.g. Pharmacy.
Activation Teams
To develop geographically
focused/department specific
operating assumptions and
Workflows – e.g. NICU.
Scope:8 Task Forces160 Staff & Physicians
Scope:16 Activation Teams300 Staff & Physicians
Operating Program - Assumptions - Work FlowStructure
Task Forces• Building Readiness
• Technology Readiness
• Patient Support Services
• Professional Services
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
VP SponsorDirector Oversight
Selection Of Membership
Kick – OffMonthly MeetingsFormal Minutes
Review Department
Specific Program
Validate Staffing Models
Develop Operating
Assumptions & Workflows
Participate in the
Development of the Move
Plan
Provide Input to Training
Plans
Operating Program - Assumptions - Work FlowProcess
• Projected Volume
• Facility Design & Size
• New Programs
• Service Enhancements
• Regulatory Requirements
Provide Input to
Technology Device &
Application Plans
Key Factors
Work Flow SampleOB 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
KeycardReader
Kronos ReportConference
LoungePatient
CareStation
ReceptionDesk
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 contractors7124 Total participants (2514 unique individuals)474 Physicians18,537 Training Hours Delivered102.5 Training Hours Developed
New Prentice Women’s Hospital
• 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
Training: Our Staff
• 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
New Prentice Women’s Hospital
Training: Our Attending and Resident Physicians
People Commissioning Process
Plan Development
Administration
Development Process
Plan Development
Administration
Development Process
Implementation
On-Line Training
General Orientation
Department Training
Implementation
On-Line Training
General Orientation
Department Training
ScopeValidation
Needs Assessment
Strategy
Budget
ScopeValidation
Needs Assessment
Strategy
Budget
Evaluation
Follow-Up
Remediation
Evaluation
Follow-Up
Remediation
Process for DevelopingUnit Specific Transition Training
Conduct Needs
AnalysisUnit & General
Identify & Prioritize Training Needs
Evaluation & Follow-Up
NPWH:Process for
Training Development
Develop Training
ApproachDevelop
Scenarios
Develop Evaluation
Plan
Develop Training Materials
Identify Subject Matter
Experts (SMEs)
Finalize & Communicate
ScheduleIdentify & Prepare Trainers
Conduct Training
Quality Checks
Certification Process
“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 patients8 laboring mothers49 critical care neonatesDuration: 5 hours
Prentice Women’s HospitalPrentice Women’s HospitalThe Move: October 20, 2007The 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 – ResourcesOver 500 staff and volunteers supported the move
• Patient Movement
• Materials Movement
• Move Route Security & Facilities
• Care Stations
• Diagnostics & Therapeutics
• Communications & Media Relations
• Visitor Management
• Concierge (Orientation to Patient Room & Technology)
• Patient Move Gift Distribution
• Ongoing Operational Support
• Data Management
The Move Plan: Move Sequence Simulated Duration – 5 Hours, 44 minutes
Antepartum (15)est. 9-10 pts.
Post Partum Admissions – 9 New Prentice(Admitting Unit for deliveries occurring in current/new L&D during the move)
Open New L&D and OB Triage(Point of entry all
OB pts. during the move)
Hematology/Oncology Units (15E, 15W then 16E)
Neonatal Intensive Care Unit
NICU PPMothers
Women’s Care Unit
Post Partum Units (12, 11 then 9)
Close CurrentL&D
Close Current LDOU
12:00AM(All patients to L&D)
7:30A
Transfer early labor patients from current L&D to new
PWH L&D
8:00A 9:00A 9:30A 10:00P 11:00A 12:00P8:30A
Deliver and recover remaining patients at current PWH
11:30A10:30A 12:30P 13:00P 13:30P
MoveFinal
Olson Pavilion
New PWH
PWH
Feinberg/GalterPavilions
Chicago Avenue
Superior Street
Huron Street
- Bridges and 2/3 floor corridors
- Tunnels & Lower Concourse Corridors
- Elevators
- Major Care Stations
- Patient Move Route
N
(Note: Incline of Lurie Bridge)
New PWH – Patient Move Route
L&D
NICU
- Doorways (requiring support)
- Privacy Curtains
- Minor Care Stations
- Return Route
Feinberg return Route
PWH Return Route
Lurie Research
Elevator to
basement level
Elevator to ground
level
Across drive
under tent
New Prentice Women’s HospitalMock 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 HospitalMock Move
Successfully completed the move of
34 patients ahead of schedule!!!
• Allow unit managers control and flexibility
for patient move sequence
• Provide route signage and move staff
identifiers
New Prentice Women’s HospitalMock 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 HospitalMock Move: Lessons Learned
New Prentice Women’s HospitalMock 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 SimulationThe 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.
Operations - Optimization -
January 1 - Ongoing
Operations - Optimization -
January 1 - Ongoing
Post Occupancy Assessment
Spring 2008
Post Occupancy Assessment
Spring 2008
Stabilization
October 20 – December 31
Stabilization
October 20 – December 31
StabilizationInitial Dashboard
FACILITY Room Temp
Elevators
Doors
Locks
1. Engineering Solution successfully testing in one NICU pod and successfully implemented throughout.
2. CSS elevator is staying on floor-automatic override currently not available. FM has ordered part.
3. Doors on 15, 16, employee entrance at Chicago Ave.
4. Push-button door hardware on 14-16 clean utility rooms
D.
Stout
SYSTEMS Infant Security (HUGS)
Paging
Phones
1. Alarm data from former Prentice facility establish baseline for normal false alarming
2. NICU code pages were not received by staff in areas on L&D
3. Telephone rollover between 16N and 16S is not reflecting the separate operation of the units
D. Dahmen
C. Colande
r
FFE Equipment 1. Training regarding the location on bed storage room in the lower concourse
D. Stout
SUPPLIES/LINEN 1. Missing linen cart on 15 to support Patient Escort B. Stepien
PHARMACY
FOOD SERVICE
EVS
PATIENT CARE
MD TRANSITION L&D 1. Identify status of L&D multidisciplinary roomsBF
Post Move Operations Stone Stabilization
Overall Detail Follow-Up BIC
Physical Facility• Scope of issues decreasing each week• Open items may require funding to address
Technology• Scope limited to the following systems:
• HUGS• Wireless Devices - Dead Zones• Nurse Call - Emergent & Urgent Notification
Security• Scope limited to the following:
• Floor Access• Infant Security
Supplies & Linen• Scope of issues decreasing each week
• PAR Levels• Size of Clean Utility Rooms
StabilizationOperating issues that exist as a result of the move to Prentice
Women’s Hospital
Environmental Services• Scope primarily focused on operations:
• Room turn• Cleanliness
Food Service• Minimal issues
• Tray Pick-Up
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 PlanningOver 60 Vice Presidents, Directors and Managers provided feedback
on the Transition Planning Model/Process
Role:Not
Successful Successful
Critical Success Factors
"What was done well and should be replicated/?”
Lessons Learned"What should we do
differently?"
Date: 1 2 3 4 5
Department Readiness
Technology Readiness
Operations Readiness
Staff Readiness
Patient Move
Stabilization
Prentice Women’s HospitalMajority of users ranked the Transition Planning process favorably.
Successes
• Executive sponsorship of Task Forces and Activation
Teams highlighted TP as an organizational priority
• TP activities aligned with existing organization structures
• TP structure included individuals involved in earlier planning
efforts (strategy/program/design)
• Overall, consistent management structure from design
through TP
• Strong attention to detail and coordination
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
1 1.5 2 2.5 3 3.5 4 4.5 5
1% 0% 1%
11%
2%5%
46%
8%
27%
81% Rated 4 or Above
Not Successful Successful
Opportunities
• Appreciate implications of new design and recognize
impact of “change” on users
• Department infrastructures need to be solid to support daily
operations so Directors/Managers can focus on TP activities
• Appreciate the scope of user involvement during the six
months prior to opening (estimate 20 hours/week)
• Operating Pilots/Training/Migration – Patient Move Planning
• Department buy-in to TP process optimizes outcomes
0.0
5.0
10.0
15.0
20.0
25.0
30.0
1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful
Department ReadinessPreparing the environment for patient care/operations
2% 0%
14%
3%
48%
7%
24%
0%2%
79% Rated 4 or Above
Successes
• Early access to the facility to support department transition
& readiness
• Adequate time to prepare the facility for operations (3
months)
• Scope of equipment/furniture migration was minimal
• Strong attention to detail and coordination
Opportunities
• Department Readiness Assessment Tools were too
cumbersome for users
• Accurate data-base of open issues to focus resources and
follow-up (e.g. delayed Sentact issue close out)
• Clearly define purpose of Environmental Testing and what the
strategy will be to respond to results
• Focus on PAR level planning – understand staff behavior
related to supply management
• Audiovisual coordination and installation
Department ReadinessBuilding Readiness
Successes
• Campus Development oversight and leadership of building
commissioning in developing plan for operation of facility and
related systems.
• Earlier department transition provided heightened state of
control, ownership and awareness of facility
• Environmental Services oversight/implementation of building
clean phases (post construction to patient ready cleans)
• Dedicated NMH Security to oversee access control and
respond to staff/vendors/contractors
Opportunities
• Clarification and consistent use of definition of “patient
ready’ state following IDPH
• Trigger operations to support patient environment –
e.g. implement OR restrictions, ICRA standards, etc…
• Leverage planned security systems to enhance control pre-
move (e.g. activate key card readers and individual employee
key card privileges)
• Maintain access control throughout evolving phases of
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 ReadinessFFE
Successes
• Continuity of staff and knowledge
• Planning to Procurement to Installation
• Consultants, FFE team, TP team
• Importance of teamwork
• Focus on common goal (patients first & schedule)
• Clearly defined schedule, budget & related requirements
• Executive sponsorship
• 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
Opportunities
• Assign dedicated staff to invoice payment
• Assignment to other tasks may impact the
prioritization of invoice payment
• Appreciate the disposable supplies required for the selected
equipment
• Supply changes are needed to support updated
models of same equipment (e.g. fetal monitor probes)
• Build inventory to support availability of supplies for
operational opening
• Understand potential increases in supply cost
• Pursue earlier training for new equipment
Department ReadinessBuilding Load
Successes
• Team Integration (FFE/Tech/Biomed/Security/
Consultants/Campus Development…)
• Bridge between procurement team and load
team
Procurement Data Installment Support/Management
• Early integration of IT into the load planning process
• Daily debrief and planning sessions during
implementation
• Clear turnover of building from CM at the time of substantial
completion
• Regulatory preparedness
• Leverage of procurement data and readiness/load work
plans to populate Department Readiness Assessment tool
• Off-site warehousing and dedicated labor to support material
movement
• Disciplined approach to decision milestones related to
procurement (e.g. May 31 decision deadline)
• Centralize management of training
• In-house Environmental Services team
Opportunities
• Earlier user engagement with the data and tools to better
mitigate changes and improve readiness assessment
• Sustained AE engagement through equipment procurement
to respond to infrastructure and architectural layout
implications of equipment selection
• Clearer and earlier understanding of FF&E regulatory
readiness expectations (e.g. FF&E needed to support IDPH
“patient ready” terminology)
• Ensure equal buy-in of integrated process by all
stakeholders
• Earlier Academy involvement for better new equipment
training coordination
• Management of early install (existing facilities) scope creep
should be more disciplined
Department ReadinessMigration
Successes
• Clear understanding of the scope of migrating items
and the commissioning/certification needs
• 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
Opportunities
• Inpatient move and migration was complex: more time
should be spent on migration
• Incorporate migration planning into user group
process
• Appreciate staff’s personal attachment to office contents
Department ReadinessReadiness Assessment
Successes
• Leverage of existing processes to report and respond
to identified issues (e.g. Sentact)
• Proactive issue identification/resolution in support of
critical project milestones (e.g. regulatory review,
environmental testing, patient move…)
• Prioritization of issues resulted in development of
focused resolution plans
• Reinforced staff comprehension to department
environment
Opportunities
• Leverage opportunity to create a consistent database
throughout project design, activation and post move (e.g.
room data sheets)
• Simplify assessment tool and process for users
• Provide sample of standard room layout for users to refer to
• Clearly define individuals and coordinate process to assure
issues are resolved in the most timely manner
• Pursue consistent database for reporting and monitoring IT
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 ReadinessAssuring technology was ready to support patient care/operations
0.0
5.0
10.0
15.0
20.0
25.0
30.0
1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful
2% 0% 3%
15%
3%
44%
8%
24%
0%
76% Rated 4 or Above
Successes
• No unproven technology – use of pilot project approach
• Technology team support and their attention to detail
• Early decision making with user involvement
• Cross team communication
• Integration with Task Forces and Activation Teams
• Technology testing and pre-move sweep of devices
Opportunities
• Manage scope of new technology
• Evaluate opportunity to phase implementation
pre-move/move/post-move
• 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
• Technology engagement early and often
• IT TP Director involved early and throughout
• Infrastructure design
• End user workflow and activation team participation
• Building commissioning
• Building load (IS devices, FFE and biomedical
equipment)
• Move coordination
• Stabilization availability and support
• On site staging location for devices
• Test in production environment
• Technology leadership commitment during homestretch
• Single point of contact to support coordination and
integration of activities
• Technology Move War Room support model
• Flexibility and fluidity
Opportunities
• Technology presence from programming – design –
construction – activation (e.g. consistent floor captain
involvement)
• Pilot new technologies in lab environment (e.g. mock-ups) to
respond to limited infrastructure in existing facilities
• Build flexibility into load/commissioning schedule to respond
to coordination elements
• Cross connects
• More time for device load/install/biomed certification
• Less time for testing in new facility
• Clear network specifications to support FFE procurement
• Monitor vendor compliance
• Coordination of furniture delivery with device placement
process
• 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 ReadinessConfirming/validating operations and work flows
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful
0%7%
12%7%
62%
5% 8%0% 0%
75% Rated 4 or Above
Successes
• Executive sponsorship
• Activation Team and Task Force structure
• Multidisciplinary involvement
• Early involvement of staff
• Early access to facility to build/validate workflows
• Transition Planning team support
• Attention to detail
• Benefit of detailed planning realized post-move
• Current service assessment facilitated development of future
service assumptions
Opportunities
• Workflows and operating models should be clear prior to design
• Stakeholder buy-in early with early focus on implementation
• Identify areas of risk and provide focused readiness attention
(e.g. emergency response, infant security…)
• Appreciate design impact on staff – “scope of change”
• Understand operating budget implications related to operating
assumptions/design earlier
• Define gap and work through prior to entering budget cycle to
facilitate recruitment initiatives
Operations Readiness (cont.)Confirming/validating operations and work flows
Successes
• Budget tool to project FTE’s based on new program,
expansion of existing programs, building design…
• Budget process fostered a sense of operating reality
with the planned/assumed work flows
Opportunities
• Appreciate flows will evolve post move and provide
supports to facilitate this process
• Monitor volumes annually and identify space/design
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
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful
People CommissioningPreparing staff to work in their new environment
0% 0% 3% 3%
59%
8%
24%
0% 2%
91% Rated 4 or Above
Successes
• Early Academy support and involvement
• Organizational support and resourcing of training effort
• Training expertise and systems infrastructure
• Model enable departments to drive unit specific training
• Technology/equipment incorporated into unit training
• Early access to facility
• Ability to use facility as a classroom
• Coordination: building load and technology readiness
• Appeal on cognitive and affective level
• Flexibility
Opportunities
• Appreciate design impact on staff – “scope of change”
• Physician involvement and engagement
• Success or failure dependent on infrastructure (inconsistent wireless device
function)
• Inconsistent vendor equipment training
• Pilot new systems in existing facility – or – test environment
• Increase communication throughout project with targeted communication 9-
12 months prior to move
Patient MovePlanning and executing the patient move to the new facility
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful
0% 2% 0%
14% 11%
73%
0% 0%0%
98% Rated 4 or Above
Successes
• Attention to detail
• Broad, inclusive planning process resulted in many experts
• Technology engagement
• Department and physician ownership of individual move
plans
• 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
Opportunities
• Reliable communication tools/systems used on move day –
inconsistent function (e.g. wireless devices, radios…)
• Artificiality of mock-move renders the execution extremely
challenging
• Appreciate the need for flexibility to support clinical decision making
• Deploy resources earlier on move day
• “Machine is large and slow to start”
Patient MoveCommand Center
Successes
• Integration of Facility Readiness/Operations
Readiness/Move Readiness into one oversight model
• Leveraged existing HEICS model
• Provided process to assure consistent issue reporting –
prioritization – resolution resourcing
• Design of communication focused users on their scope
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
Opportunities
• Maintain attention to detail and heightened focus until last
patient moves
• Natural instinct of staff to report issues directly into
Command Center - consider locating Department Readiness
issue reporting in Command Center versus decentralized
location
0.0
5.0
10.0
15.0
20.0
1 1.5 2 2.5 3 3.5 4 4.5 5
Not Successful Successful
StabilizationSupporting facilities/operations through issue reporting/resolution
15%
13%
38%
8%
21%
4% 2%0%0%
67% Rated 4 or Above
Successes
• Hospital operations structures and processes were aligned
with Transition Planning effort and therefore, were positioned
well for the early transfer of oversight
• Stabilization meetings provided users with sense of focused
issue resolution
• Senior Management engagement and support
Opportunities
• Structure should respond to facility/system issues as well
as operating/process issues
• Align Activation Team structure with stabilization activities
• Assess areas of high-risk and implement stabilization
processes prior to opening
• Communicate stabilization structure/process pre-move to
support VP/Director/Manager schedules post-move
• Anticipate capacity issues
Transition PlanningSummary
• 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