PLANNING HEALTH FACILITY
Reinforced emphasis on patient (self-) education in the hospital setting. Based upon these more or less
incomprehensible and exponential changes in clinical services, operational trends and advancements in technology - the diverse facilities, hailed as state-of-the-art two decades ago, are fast becoming obsolete long before the life of their building shell comes to an end. Narrow floor plans, too many solid walls and low floor-to-ceiling heights do not permit the expansion and renewal of healthcare facilities that is the need of the time.
THE quEsTIon Should the driving force be the cost of operating services rather than the cost of the building? As you ponder over that one, I will briefly describe the more traditional approaches to flexibility.
THE pLAnnIng proCEss When planning a healthcare facility, or any facility for that matter, there are the following broad phases of work: Strategic planning Master programming and master planning Functional programming. In the traditional development process,
this is followed by design development and contract documentation, but these aspects are beyond the scope of this feature story. During these phases, all those concerned
with the planning process are responsible for inspecting the ‘possibilities of the flexibility relevant to that phase’ and have a clear vision of what the following phase entails. The overall planning process, in this endeavor, rebuilds as the capital planning process, to which there is the operational planning process working in parallel. This, when linked to the facility planning process, will ensure that the planned facility is financially feasible.
FLExIBILITY In sTrATEgIC pLAnnIng Hospitals never develop into what we think they will. The corporate strategic plan, mission and vision statements will define the long-term role of the organization, yet they ought to be fluid and changeable. They should anticipate changes in the programme and service delivery. In short, the strategic plan is a living document. Consider the following questions during the strategic planning phase:
Do we manage our way through changing service demands or design out of them? Historically, the approach to developing projections has been a straight-line graph. It never seems to plateau! New approaches focus on whether different service delivery approaches might allow the organisation to gradually adapt with regard to demand.
Do current trends create opportunities or barriers? A specialised service on a single site will create an opportunity to maintain and develop specialist expertise. But it can create a discord, if the quality of service is not seen as worth going the extra mile to access the service. Asked another way: Do alternate ways
of clustering services within a facility create opportunities or limitations, in responding to long range demands and pressures? For example, will a paediatric strategic plan include paediatric rehabilitation, or will the rehabilitation plan include adult and paediatric rehabilitation? Where is the pressure for flexibility likely to be greater? The range of questions regarding flexibility will tend to recur in every phase, but the way in which this flexibility is to be achieved will become more narrowly defined and more tangible with each subsequent planning and design phase.
FLExIBILITY In mAsTEr progrAmmIng And mAsTEr pLAnnIng
This is the first planning phase moving towards the design of the physical hospital plan. It is developed based on the strategic plan and describes programmes and services at an outlining level, and it involves compiling basic workload and staffing projections. This information is then used to develop broad- brush estimates of space requirements and the relationships between them. At the same time detailed information
is gathered about possible site(s) for development of the facility. This site should be, among other things, of sufficient acreage to provide for any future expansion that may be necessary. Various other technical data about the possible site(s) is then compiled, which helps the architects and planners identify the constraints and opportunities offered by that site. A vade mecum to master plan the massing and construction phasing options, and preliminary capital cost estimates. A master plan is a living document and will require continual review and updating to
Hospital Build Issue 4 2011 17
IN SHORT
■The range of questions regarding flexibility will tend to recur in every phase, but the way in which this flexibility is to be achieved will become more narrowly defined and more tangible with each subsequent planning and design phase
■ Planning a new healthcare facility affords an opportunity to create a dynamic and long-term solution in a manner that will allow the hospital to explore innovative and exciting ways to deliver healthcare to its community
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