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HospitalProject PlanningBenchmarks
ICEC 2004, Capetown
HospitalProject PlanningBenchmarks
ICEC 2004, Capetown
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Peter Cox and Lyndal Rofe
PRESENTERS
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AGENDA
Definitions & Objectives Australian BM study
Functional, Area & Cost Benchmarks
Example of BM applications
Outcomes & Conclusions
Applications to other sectors & countries
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AGENDA
Definitions & Objectives
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WHAT IS BENCHMARKING?
A standard or point of reference against which things may becompared or assessed TheOxford Dictionary
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OBJECTIVES OF BENCHMARKING(Hospital planning)
Promotes the equitable distribution of (limited) public capitalresources
Provides a basis for setting realistic forward program budgets
Provides a basis for setting realistic individual project budgets
Provides a defensible basis for setting departmental space andcost targets
Provides a tool for comparing project performamnce
Provides a tool for examining the utilisation of existing facilities
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OUTLINEPROPOSALS
Project Planning & Development CycleProject Planning & Development CycleA B C D E F
BRIEFPLANNING
SKETCHDESIGN
DOCUMENT CONSTRUCTPOSTOCCUPANCY
Budget SettingBenchmarking
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AGENDA
Definitions & Objectives
Australian BM study
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DEPARTMENT OF HUMAN SERVICESVICTORIA, AUSTRALIADEPARTMENT OF HUMAN SERVICESVICTORIA, AUSTRALIA
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DEPARTMENT OF HUMAN SERVICES
Approx 150 hospital campuses
Approx 15,000 beds
Approx 1million patient separations annually
Approx AU$250m (US$187m) capital works annually
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Rural Health (Seymour)Rural Health (Seymour)
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CBD Tertiary/Referral Hospital (The Alfred)CBD Tertiary/Referral Hospital (The Alfred)
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STUDY TEAM
Department of Human Services (DHS)Capital Development Managers
Acute & Rural Health Program Managers
Silver Thomas Hanley (Architects & Health Planners)
Steven Grimes (Project Manager)
Padghams (Cost Managers)
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STUDY PROCESS
National & International Research Analysis of selected completed projects (12 in detail)
Development of Benchmark Model Plan
Development of Proposed BMs
Function
Floor Area
Cost (Building & Equipment)
Testing model against completed projects
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INITIAL RESEARCH FINDINGS
Area based Cost BMs in common use
(Nationally/Internationally)
Departmental (functional unit) Cost BMs used
No evidence of Integrated - Service/Functional/Area/Cost
planning BMs
No evidence of Activity - Linked BMs
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INITIAL ANALYSIS CONCLUSIONS
Cost per bed results - varied by up to 250%
Individual department Cost per floor area unit (m2)results - varied by approx 150%
Comparable Department Cost per floor area unit (m2)
results - varied by up to 34%
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ANALYSIS CONCLUSIONS
Key Cost Drivers
Type of Hospital (Complexity - Role Deliniation)
Type of Department (Functional unit)
Type of Patients (Same Day or Multi Day)
Building configuration (no of floors etc)
Type of works (new build, refurbishment) etc
Standards & quality of materials & equipment
Locality of site/Timing of Project/Procurement method
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Service Function Area
(Space)
Cost
How many andwhat type ofservices are
required?
How manyfunctional unitsare required to
deliver that
number & typeof services?
What area isrequired to
accommodatethat number &
type of functionalunit?
What is thecapital cost ofproviding that
accommodation?
Service Plan Functional
PlanArea Plan Cost Plan
Planning Process (Four Main Elements)Planning Process (Four Main Elements)
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METHODOLOGY
Numberof Units
Area
ServiceAnalysis
FunctionalAnalysis
AreaAnalysis
CostAnalysis
Services p.a.
Service Plan(OoS etc)
Functional Plan(Beds, Theatres
etc)
Area Plan(m2)
Cost Plan($)
Demographic& Policy Data
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METHODOLOGY
Demographic/Service BM
Functional BMs(Services/Unit)
Area BM(M2/unit)
Numberof Units
Cost BM($/m2)
Area
Service
Analysis
Functional
Analysis
Area
Analysis
Cost
Analysis
Services p.a.
Service Plan(OoS etc)
Functional Plan(Beds, Theatres
etc)
Area Plan(m2)
Cost Plan($)
Demographic& Policy Data
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METHODOLOGY
Demographic/Service BM
Functional BMs(Services/Unit)
Area BM(M2/unit)
Numberof Units
Cost BM($/m2)
Area
Service
Analysis
Functional
Analysis
Area
Analysis
Cost
Analysis
Services p.a.
Service Plan(OoS etc)
Functional Plan(Beds, Theatres
etc)
Area Plan(m2)
Summary
Cost Plan($)
Demographic& Policy Data
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AGENDA
Definitions & Objectives
Australian BM study
Functional, Area & Cost Benchmarks
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Define levels of hospital complexity
Define Functional & Planning Units
Design the BM Model
Agree on Benchmarks
Benchmark Development Process
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Level of Complexity (Role Delineation)
Speciality Hospital eg
Paediatric, Cancer
Separations p. a -
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Functional Planning Units(Departments)
Total
2 + 7 Spec FPUsEngineering &Travel, Spec.
9
18 FPUsEducation,
Support
5
8
16 FPUsDay Areas4
30 FPUsClinical3
4 FPUsAdministration2
22 PFUsInpatient1
99 FPUs
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Functional Planning Units- Inpatient Areas
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ALTERNATIVE MODELS ADOPTED
Initial (Global data) Model
where early planning is undertaken but detailed throughputdata for each functional unit is not yet available (eg; totalpatient separations).
Developed (Specific data) Model
when detailed services throughput data is available for theindividual functional units (eg; separations for each speciality).
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Service Function Area Cost
Service Plan FunctionalPlan
Area Plan Cost Plan
Planning Process - Main ElementsPlanning Process - Main Elements
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2002001116
Number of Sub-acute Multi-day &Same-daySeparations per
annum
Ward Sub Acute(Rehab + GEM)
N/AN/A5550
Number of Medical &Surgical Multi-daySeparations perannum
Ward Acute -Medical/Surgical
INPATIENTDIVIDED BY BENCHMARK
Level5
Level6
Level5
Level6
SAME-DAYMULTI-DAY
FUNCTIONAL BENCHMARK
SERVICE PLANTHROUGHPUT
FUNCTIONAL/PLANNING UNIT
Functional Benchmark
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362002001116Multi-day=590
Number of Sub-acute Multi-day &Same-daySeparations per
annum
Ward Sub Acute(Rehab + GEM)
332N/AN/A555016507
Number of Medical &Surgical Multi-daySeparations perannum
Ward Acute -Medical/Surgical
INPATIENTDIVIDED BY BENCHMARK
Level5
Level6
Level5
Level6
SAME-DAYMULTI-DAYOUTPUT - No
of Beds
FUNCTIONAL BENCHMARK
INPUTDATA
(Service Plan)
SERVICE PLANTHROUGHPUT
FUNCTIONAL/PLANNING UNIT
Functional Plan
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Benchmark Development
Review standards & design guidelines
Review project area schedules National/International
Analysis & interpretation
Key assumptions
Agree Area Benchmarks
Area
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4343
Number of Sub-acuteMulti-day and Same-day Separations perannum
Ward Sub Acute(Rehab + GEM)
3031
Number of Medical &Surgical Multi-daySeparations perannum
Ward Acute -Medical/Surgical
INPATIENT
MULTIPLIED BYBENCHMARK
Level 5Level 6
AREA BM (m2/unit)
AREA BENCHMARK
FUNCTIONAL PLAN
THROUGHPUT
FUNCTIONAL/
PLANNING UNIT
Area Benchmark
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1545434336
Number of Sub-acuteMulti-day and Same-day Separations perannum
Ward Sub Acute(Rehab + GEM)
104163031332
Number of Medical &Surgical Multi-daySeparations perannum
Ward Acute -Medical/Surgical
INPATIENT
MULTIPLIED BYBENCHMARK
Level 5Level 6
AREA BM (m2/unit)OUTPUT - Total
m2
AREA BENCHMARK
INPUT - No ofFunctional
Units"SpaceDrivers"
FUNCTIONAL PLAN
THROUGHPUT
FUNCTIONAL/
PLANNING UNIT
Area Benchmark
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Benchmark Development
Definition of Capital Cost:
Building works & services (New or Altered)
Site works & project specifics
Furniture, furnishings, equipment & IT
Consultants, Authorities & client costs Contingencies & other risk provisions
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Benchmark Development
Methodology
Review of standards & guidelines
Review of cost data of selected recent projects
Analysis & interpretation
Review assumptions
Agree Cost Benchmarks
Agree specific variables & factors
Test model against built or planned examples
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$ 345$ 345$ 2,041$ 2,386Ward Sub Acute(Rehab + GEM)
$ 460$ 465$ 2,150$ 2,512Ward Acute -Medical/Surgical
INPATIENT
MULITPLIED BYBENCHMARK
MULITPLIED BYBENCHMARK
Level5Level 6Level5Level 6
($/m2)($/m2)
F.F& E.BENCHMARK
BUILDING COSTBENCHMARK
FUNCTIONAL/
PLANNING UNIT
Cost (Building & FF&E) Benchmarks
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$ 532,886$ 345$ 345$ 3,152,522$ 2,041$ 2,3861545Ward Sub Acute(Rehab + GEM)
$ 4,843,349$ 460$ 465$ 26,164,499$ 2,150$ 2,51210416Ward Acute -Medical/Surgical
INPATIENT
MULITPLIED BYBENCHMARK
MULITPLIED BYBENCHMARK
Level5Level 6Level5Level 6
($/m2)($/m2)
OUTPUT - $
F.F& E.BENCHMARK
OUTPUT - $
BUILDING COSTBENCHMARK
INPUT -
Total m2
FUNCTIONAL/
PLANNING UNIT
Cost (Building & FF & E) Plan
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Building Configuration
New single storey
New low rise
New medium rise
New high rise
Refurbishment - low Refurbishment - medium
Refurbishment - high
No work
Index 100
Index 118
Index 126
Index 134
Index 15 Index 56
Index 80
Index 0
Cost Adjustment Factors
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Project Specific allowances
Central Energy Plant Site prep & siteworks
External services
Contingencies (D&C)
IT PM, Design & Cost Mgt
Authorities & client
Future cost escalation
Add 5.0%
Add 7.5%
Add 7.0%
Add 10.0%
Add 5.0% Add 12.0%
Add 2.5%
Add 3.5% p.a.
Cost Adjustment Factors
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AGENDA
Definitions, Objectives & Benefits
Australian BM study
Example of BM application
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Total Separations p. a
x Factor (0.7)
Level 6 Hospital Emergency Department
1,300 ED attendances per Treatment Place p.a.
Resuscitation Bays = 10% of Total Treatment Places
GDA Requirement:x m2 x No. of Treatment Places
Capital Cost Estimate:GDA x $m2 plus specific allowances
ED Attendances p. a
Example
Input
Model A
BM
Output
Model B
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AGENDA
Definitions, Objectives & Benefits
Australian BM study
Examples of BM application
Outcomes & Conclusions
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Study completed - 2002
Model now being adopted by State Health Ministries nationally
BMs being used for program and project planning
BMs also being used for evaluation of BOOT projects
Keen interest from other Health Ministries in the region
OUTCOMES
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Service Data availability/interpretation
Facility data- availability/reliability
Cost Data - fluctuations in market prices, locality
Translation of service data into facility requirements
Delineation of Hospital roles
Dealing with growth in clinical specialties (varying space needs)
Recognition of Regulatory Codes and Standards
CHALLENGES OF BENCHMARKING
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BENEFITS OF BENCHMARKING
Produces best value rather than lowest cost solutions
Encourages more effective/efficient designs
Controls excessive "user demands" for more space and moreinvestment...
Provides a tool for examining the utilisation of existing facilities
Avoids unexpected cost blowouts
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BENEFITS OF BENCHMARKING
And provides a foundation for successful project delivery,
But . must be seen as only a part of the total costmanagement process
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Project Planning & Development CycleProject Planning & Development Cycle
OUTLINEPROPOSALS
BABRIEFPLANNING
CSKETCHDESIGN
DDOCUMENT
ECONSTRUCT
FPOSTOCCUPANCY
Cost Management Process
Cost Planning Bills of Quantities,TenderEvaluation
CostControl&Reporting
Specialistservices;AnalysisAudits
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AGENDA
Definitions, Objectives & Benefits
Australian BM study
Examples of BM application
Outcomes & Conclusions
Applications to other countries & Discussion
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Relevance of Benchmarking to other
sectors and countries?
The need for BM is universal!
Applicable to Healthcare, Education, Commercial etc sectors
Applicable to Govt Ministries, Defence Depts & Corporations
Opportunity to develop appropriate BMs to suit local norms
Feedback invited from ICEC 2004 delegates!
Further questions - Email [email protected]
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