Overview
We see operational planning and programming as a disciplined planning process that establishes
an interface between the clinical service business planning and the design of new or renovated
healthcare spaces.  Successful operational programming requires expertise in clinical services
operations and the ability to translate how patient care will be delivered in the future into facility
requirements.  How an organization plans to develop, expand and improve its services when the
facility project has been completed will depend, to a great extent, on how its management, physicians
and staff can envision the future.  While the planning effort can be energized and led by external
parties (planners, consultants, architects, etc.) the outcomes have to be "owned" by those key
stakeholders within the organization.

The planning for new facilities provides an opportunity to examine how clinical services are currently
being provided and to envision how it might be provided in the future, challenging existing systems
and processes.  Such a process will ultimately lead to the following benefits:

  • Documentation and user sign-off on patient volume projections and space utilization goal
  • Implementation of changes in clinical practice and new technology
  • Opportunity to look at processes and identify opportunities for process improvements and cost
    savings
  • Smoother design process with operational parameters already determined for the design team
  • A "right-sized" facility to efficiently provide patient services
  • A planning process that "ties back" to the business plan
  • Achieve identified goals, i.e., improve patient access, improve patient satisfaction, reduce
    duplication of resources, etc.

The goal of the programming process is to discover and quantify the optimal patient care
environment.  This includes understanding patient and family needs, physician and staff best practice
philosophy, alignment of strategic business plan requirements and creating an opportunity for
resource conservation.

Process
In additional to the analytical processes of programming and operational planning, our approach is
firmly grounded in "listening" to the input of physicians, nursing, management, patients, family
members, and/or board members.  While we provide leadership and perspective for the entire
programming and operational planning process, we utilize a variety of techniques and tools to gain
the insight and input from the vast array of stakeholders.  Consistent with an inclusive process, we
successfully incorporate multidisciplinary cross-functional representatives vital to the definition of
organizational relationships, the interaction between functions and the overall integration of
processes across disciplines and functions.  Our objective is to understand work flow, practice
patterns organizational structures, space/workload utilization and future requirements utilizing human
centered design techniques and data analysis.  Through the collaborative arrangement we define
innovations for organizations while documenting the findings, trends and tactical implementation
opportunities for full coordination with the design team.

Operational Planning
Our approach to operational planning and the development of a functional concept is grounded in
each client's mission, strategy and concept mandates.  We believe facility planning and concept
development should first consider future oriented operational approaches, best appropriate practices
and projected activity workload and utilization targets to translate activities into detailed functional and
future facility requirements.  Essentially, concept planning describes in words, numbers and
diagrams the intra- and interdepartmental activities and adjacencies that dictate facility requirements.

Our concept facility approach is not a linear process; rather it continues to build upon ideas and
concepts developed in initial sessions culminating in a full description of recommended spaces
based upon optimal operational processes.  Additionally, our approach incorporates the "experiential"
aspects of the facility.

Our experience with operational planning and functional space programming repeatedly
demonstrates the need for a planning process that emphasizes and adheres to guiding principles
that enable creative thinking within a structured process.

We believe the planning process should be:
  • Objective and driven by factual information based on data and benchmarks aligned with the
    unique circumstances and needs of our client.  Ultimately, the Operational Plan and Functional
    Space Program for our client must have broad organizational ownership and support to foster
    the successful implementation and deployment of the findings.
  • Practical with clear solutions serving the needs of multiple constituencies, including
    governance, management, clinical practitioners, patients and the public.
  • Highly organized with clear role definitions to avoid duplication or conflicting perspectives.
  • Structured to insure the sequential completion of planning tasks that support subsequent
    planning analysis.
  • Aligned with a vision that clearly defines the desired end product and its anticipated uses.










Assessment
Create Vision-driven Operational Goals & Objectives:  Overall institutional goals and objectives are
compared to functional goals and objectives to assure consistency and continuity.  We establish
"measure to success" for each key patient process.

Define clear communication patterns:  Communication is fundamental to the success of the
process.  We actively listen and respond to the client.  A clear communication plan is developed to
facilitate positive team interaction.  Right time, right person in the right method.

Analysis
Evaluate Current Processes & Functions:  Several tools are used to analyze and evaluate existing
space, current processes, staffing patterns and technology to build upon successes and guide future
changes.

Establish Benchmarks:  We utilize both operational and space benchmarks to understand current
process and initiate the development of assumptions for future efficient and effective space needs.  
Clinical practice, operational enhancements and  technology innovations are thoroughly researched
and investigated.

Conduct Leadership & Physician Interviews:  One-on-one discussions with leadership and
physicians are a tool to gain quick insight into specific individual priorities and technology adoption
rates.

Complete Observation Activities:  We value time with our client's staff in their environments to learn
how they work today and begin to identify process opportunities.

Diagram Processes:  Functional relationships, care processes and service requirements are
identified and illustrated.  These serve as the basis for care environment adjacency, current and future
flow diagrams.  Circulation and traffic flows are analyzed in order to define the advantages of physical
closeness versus use of transport technologies.

Product
Develop initial workload projection and utilization requirements:  Projected volumes are translated
into gross room requirements through application of benchmark throughput assumptions.  Through a
collaborative process, we begin to define space needs based upon processes and throughput
expectations that meet the targeted performance of the client teams.

"Virtual" Site Tours:  To help illustrate "state-of-art" processes, technology, and/or organizational
concepts, we bring visual examples of "best in class" spaces or process to help staff, who have never
worked in progressive settings outside of their current departments, imagine new ideas or
understand recommended concepts.

Medical Equipment, Communication and Technology Implications:  Major medical, educational and
communication systems discussed/required for operational intent will be documented as they affect
space and capital requirements.

Incorporate Innovation & Performance Enhancement Opportunities:  Opportunities created by
planning for the future and enabling new or improved processes will be explored.  Major capital
projects provide the impetus for and can create new working environments that enable the owner to
challenge prior thinking related to staffing, supply chain, use of technology, role of family members,
interaction between students and educators.  The facility concept study process results in creation of
improvement opportunities to be implemented in a new facility.
Operational Planning & Programming
CREATIVE THINKING WITHIN A STRUCTURED PROCESS