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  Healthcare Design Conference 2016
  Sponsored by HealthCare Institute
  Facilities Management Track Key Takeaways
One-on-One with Senior Leadership
-Ray Pentecost (left), President of ACHA 2017, Director/Center for Health Systems & Design, Texas A&M University
-Jeff Kent (center), Managing Director of Facilities, Nemours Foundation, and Vice President of the Health Care Institute
-Michael Wood (right), President of the Health Care Institute, and Director of Healthcare, Oldcastle
  • Predictions on the biggest changes coming:
    • “[The consumer’s] current attitude is medicine will fix it. This will shift in focus from ‘medicine’ to ‘health’.”
    • “There’ll be a shift from a facilities-based healthcare experience to a virtual patient encounter”
    • “There’ll need to be a shift from patient irresponsibility to patient accountability for their health”
  • The new buzzword: Asset Life Expectation
  • “You need to think creatively to add value to the health systems’ revenue stream … We have to become a business partner – not just an architect, engineer, or operations managers.”
  • Biggest challenge facing healthcare administrators: “Discovering how to be financially viable in the next marketplace focused on health, and finding a way to remain financially viable during this transition.”
  • “As soon as the 2040s, it is possible that humans will be predominantly non-biological. And the non-biological part will be so smart it will fully understand and be able to model and simulate the biological part.”

Playing in the ACO Arena: How to Bring Game-Changers to the Table
-Todd Wilkening (at right), CEO/Principal, FM Advantage, LLC
-Bill Howden, Manager of Facilities and Construction, Regions Hospital
  • Audience members learned about the hidden benefits of construction and facilities management in support of the Affordable Care Act, providing key strategies for senior leaders to improve upon their Hospital Consumer Assessment of Healthcare Providers and Systems.
  • “FMs can immediately become major contributors of true value-based purchasing. This includes the use of Building Information Modeling, Internet of Things, and the pure patient bedside experience.”
  • “Facility managers, architects, and contractors can provide an improved patient care experience on a spiritual level. That understanding can influence greater value to the patient’s perception of an Accountable Care Organization.”
  • “The billions of dollars needed to lower the cost of care will not only come from the reimbursement level, but primarily through micro cost accounting at the ACO’s support and service line levels.”

Mergers and Acquisitions: Identifying, Avoiding and Rectifying Pitfalls at the Facility Level

      -Frederic Lastar (left), VP Healthcare Solutions, JLL

      -Dave Cottle (right), VP/Planning, Development and Construction, Phoenix Children’s Hospital

  • “M is for Merger or (impending) Mess.”
  • “C-suite’s M&A decisions are often based on business needs, not the conditions of the buildings they’re buying.”
  • “Not understanding the building conditions can be costly. Too often C-suite negotiators overlook the condition of real estate and financial impact of operating the buildings being bought.”
  • “Branding and signage are the hardest obstacles to overcome in a merger or acquisition.”
  • “Watch out for minutiae in leases. Case example: You might not be able to paint the colors you want in buildings you just inherited.”
  • “Be alert for false economies. The seller often stops spending money on maintenance at the inception of negotiations.”
  • Potential pitfall: “Are both organizations accredited by the same agency?”

Dodging Design, Construction, Regulatory, and Operational Hazards When Dealing with Leased Medical Facilities

-Alan Whitson (left), President of Corporate, Realty, Design & Management Institute

-Eric Johnson (center), National Director for Transwestern’s Healthcare Advisory Group
-Douglas Carney (right), Senior VP of Facilities, Design, Construction & Real Estate, Children’s Hospital of Pennsylvania

  • “The lease document is a rulebook for the relationship between tenant and landlord.”
  • Rent Escalation:
    • “Landlord wants to see appreciation. If there are no annual increases in rent, it impacts the value of the building.”
    • “Escalations range 1-3% annually.”
    • “Children’s Hospital prefers annual, fixed rate increases rather than increases tied to indexes such as CPI.”
  • “We [Children’s] sell buildings when they’re no longer strategic assets.”
  • “We need our outpatient facilities to be within a 1-hour commute by our physicians.”
  • “Retraining your patients to go to a different facility is very difficult.”

Rebuilding From Within: Minimizing Construction’s Impact on the Patient

-Sid Sanders (left), SVP, Facilities and Construction, Real Estate, Houston Methodist
-Maggie Duplantis (center), Director, Clinical Planning and Design, Houston Methodist
-Jim Hicks (right), VP, Capital Planning, Facilities and Construction, Houston Methodist

Game of Dominos – Expanding a Busy Emergency Department within an Older Hospital:

  • “Involvement with the ED staff during planning and phasing discussions is critical.”

  • “It requires a series of moves through a sequence of mini-renovations.”

  • “Insist that key personnel for the contractor have demonstrated experience with similar work. The bull-in-china shop approach will not work.”


Wholesale Repurposing Project:

  • Key to success: “Ensure upfront that you have the [necessary] infrastructure capacity within the building.”
  • Big challenge: “The 1960/1970s era buildings have limited ceiling heights and aging infrastructure.”
  • “It important to schedule noisy work during daytime hours and schedule debris removal and construction material stocking during night due to lack of dedicated service elevator in building.”

When Beginning with a Clean Slate:

  • “This type of rebuilding is the least invasive but requires advanced planning from the inception of a facility.”
  • “Designing in of shell space for future expansion and pre-planned construction access are required.”

Smoothing the Transition from Planning, Design and Construction to Operations
-Kenneth Kaiser, Rhumb Line LLC, formerly at Northwestern Medicine
-Michael Mostardi, Regional Director, Healthcare, Advanced Technologies Group Inc.
  • A project’s commissioning, owner training, close-out, turnover and warrantee period activities must all be part of an owner-driven transition process. This will promote consistency over time and across multiple projects in terms of the type, quality and format of operational information provided to the owner.
  • The content, type, timing and format of information, documentation and training to be provided at the close of construction should all be defined in the project’s design, consulting and construction contracts, as well as a BIM execution plan.
  • To hit the ground running on the first patient day, the Facilities Operations team must be an active participant throughout the design and construction phases of a capital program.
  • Early in the design phase the Facilities Operations team needs to identify which types and categories of components/assets, of the millions that go into a capital project, will need to be managed/actively maintained over time. The quantity or uniqueness, as well as the level of maintenance, of these components must be defined.
  • To be useful and assessable in the future, data that will be critical to Facilities Operations must be captured in a standardized format, such as COBie/COBie lite; be refined and augmented rather than re-entered during design and construction; and be keyed for integration across multiple datasets and systems (BIM models, databases, CMMS, CAFM, inventory and asset management, etc.).

The Changing Faces of Ambulatory Care Models
-Jennifer Aliber (left), Principal, Shepley Bulfinch
-Nicholas Ro (right), VP of Strategic & Legal Affairs, Kelsey-Seybold Clinic
  • “Providers will search out the most profitable reimbursement alternatives and they’ll find it.”
  • “Least regulated states for EDs are Texas, Colorado and Arizona.”
  • “There’s a medical arms race for outpatient services.”
  • Trend to watch: “Urgent care centers undercutting rates of freestanding ERs.”
  • “Thirty percent of healthcare spending is wasted due to unnecessary surgeries, duplicate tests, etc. The wasteful providers will go out of business.”
  • Trending down: physicians in private practice.
  • Trending up: physicians in hospital owned practices.

A Year of Lessons Learned: The Special Isolation Unit at Texas Children’s Hospital
-Allison Muth (left), Director of Facilities Planning and Development, Texas Children’s Hospital
-Kurt Neubek (right),
Director of Healthcare, Page
  • Key contributors to the success of the Special Isolation Unit at Texas Children’s Hospital West Campus include:
    • An inclusive design process, including a full scale patient room mock-up and running a clinical simulation in the mock-up. The pass-through in the patient isolation rooms sprang from the simulation.
    • Designing for flexibility, so the unit can handle a variety of non-isolation, isolation and special isolation patients. Biocontainment is handled by pairs or rooms, not by isolating the entire unit.
    • Having a BSL-3 Lab and Biohazardous Waste Sterilization on the unit.
    • Testing materials ahead of time to confirm durability under harsh cleaning conditions.
    • Parent/Child Skype connection.
    • Design and flow for biohazardous waste.
  • When a condition might lead to a customized technical solution, it is better to err toward a simple solution. For example, off-the-shelf baby monitors turned out to be an excellent solution to improve communications between the patient isolation room and the adjacent clinical substation.
  • Communication — with family members, the community, county, city and state — and continuous training are key.
  • Create flexibility with solutions such as modular furniture and equipment, dual function patient care rooms, large and open patient rooms, and solutions that are dialysis and telemedicine capable.
  Facilities Management Track Quick Reference Guide
  • Dates: 12 - 15 Nov, 2016
  • Location: Houston, TX

Saturday, November 12

3:15-5:15 pm

Session W07- Managing Tight Project Budgets 
Learn about cost management tools being used to develop and manage budgets at several of the nation's largest acute care healthcare systems such as Dignity Health, Kaiser Permanente, and Providence Health & Services. Through several case studies, you will see how these tools can aid not only a variety of different types of projects in times of tightening capital budgets, but also an overall portfolio of projects. Get inside details on the tools and processes these organizations are using in planning and design that result in projects that are on-budget and insure future financial success.




  -Gary Brett, Vice President Healthcare Cost Management, Cumming  

-Kim McHugh, Senior Construction Manager, Providence Health & Services

  -Jean Mah, Healthcare Global Practice Leader, Perkins + Will   -Alan Whitson, President, Corporate Real Estate & Design    

Sunday, November 13

9:30-10:30 am
Session E10- One-on-One with Senior Leadership

This session presents a rare opportunity to listen to three senior leaders who are intimately involved in the mission of healthcare in the U.S. as they openly compare their views and predictions for the future of healthcare delivery. Each of these leaders have spent their professional careers in the service of providing the environment of care, experiencing the emergence of DRGs to USD Code 10, overlapping building codes, increased regulations, the recurring cycles of revenue challenges, the dramatic shifts to providers and places where that care is delivered. Jumble all of this into the stated and unstated impacts of the 2010 PPACA legislation as it looks in 2016 and beyond, and what’s the takeaway? Come listen and learn what U.S. healthcare 2025 might look like.

  -Jeff Kent, Managing Director of Facilities, Nemours Foundation   -Ray Pentecost, AIA, FASHE, FAIA, President of ACHA, Professor of Practice, College of Architecture, Texas A&M University   -Michael Wood, MD, CHC, MSM, ARRT, OSRT, President of IFMA Health Care Institute, Director of Healthcare, Oldcastle    

Sunday, November 13

10:45-11:45 am
Session E20- Playing in the ACO Arena: How to Bring Game-Changers to the Table

Few facility managers wonder how to actively engage in helping a health system’s vision as an Accountable Care Organization. However, FMs can provide countless opportunities to maximize an organization’s performance with efficiency that supports an improved patient experience. Through this presentation, you will hear real life examples of how healthcare FMs are influencing every aspect of care — and in the process are finding greater meaning through their impact on the patient and the organization’s mission.

  -Bill Howden, Manager of Facilities and Construction, Regions Hospital  

-Todd Wilkening, CEO/Principal, FM Advantage, LLC





Sunday, November 13

1:45-2:45 pm
Session E30- Mergers and Acquisitions: Identifying, Avoiding and Rectifying Pitfalls at the Facility Level
Recent research indicates that the industry has seen an average of 95 hospital mergers and acquisitions since 2007, and experts predict that the overall volume of M&A activity will remain high in the near future. System scale will be necessary to compete and sustain independence in the future marketplace. But before being able to address the broader issues of creating scale and improving profitability, it is essential that individuals at the ground level — especially those in facility management — understand exactly what real estate will be acquired and the condition it is in. Neglecting an assessment could mean the difference between profitability and insolvency. These experts will explain how identify potential pitfalls and the financial and operational implications that they can have on a health system.

  -Michael Chisholm, VP Compliance, Healthcare solutions, JLL   -Dave Cottle, VP/Planning, Development and Construction, Phoenix Children’s Hospital   -Frederic Lastar, VP Healthcare Solutions, JLL  

Sunday, November 13

3:00-4:00 pm
Session E40- Protecting Your Client’s Bottom Line: Navigating the Hidden Costs of Retail Re-Use
When considering the conversion of retail space for healthcare use, healthcare providers are challenged with balancing the economics of the project with the long-term investment impacts. While these spaces may first seem like diamonds in the rough, there are often hidden site challenges, added infrastructure or operating costs, and challenges licensing a practice at the location, among other issues. Moreover, the typical retail space lease is written to favor the landlord, unlike typical MOB leases, which means a likelihood of increased project and operating costs. This team of speakers has developed tools to minimize these hidden costs and assist in successful lease negotiations. Learn how to put their processes to use to level the playing field during lease negotiation.

  -Scott Huff, Senior Associate, Buildings Sector Leader, Stantec   -Tom Hummel, Senior Vice President, NAI Geis Realty Group, Inc.   -John Patten, CIPE, LEED AP, Principal, Stantec  

Monday, November 14
9:45-10:45 am

Session E50- Dodging Design, Construction, Regulatory, and Operational Hazards When Dealing with Leased Medical Facilities

The explosive growth in outpatient care facilities is reshaping the healthcare real estate market. Leasing is becoming the preferred model for healthcare providers because of healthcare’s changing economics and the capital demand for mergers and acquisition. Whether one is leasing all or part of an existing building, doing a build-to-suit or a sale-leaseback, a staggering number of design, construction, regulatory and operational issues need to be addressed during the lease negotiations. Learn how healthcare providers, designers, contractors, and building owners can avoid the pitfalls, omissions, and outright mistakes when dealing with leased medical facilities.

  -Marshall Heins, Chief Facilities Officer, Memorial Hermann Healthcare System   -Eric Johnson, National Director for Transwestern’s Healthcare Advisory Group
  -Alan Whitson, RPA, President of Corporate, Realty, Design & Management Institute  

Monday, November 14

2:00-3:00 pm
Session E60- Rebuilding From Within: Minimizing Construction’s Impact on the Patient

Hospital construction presents a wide array of challenges, particularly when it requires working around staff and patients in an existing facility. This presentation will examine three projects in increasing degrees of invasiveness to demonstrate how thorough planning can lessen the impact of construction on on-going operations — and patient satisfaction. Learn how the team at Houston Methodist handled an expansion of a recently constructed building; added bed capacity by converting existing clinical and office space to an IMU unit; and expanded a busy Emergency Department within a large hospital.

  -Maggie Duplantis, Director, Clinical Planning and Design, Houston Methodist   -Jim Hicks, Vice President, Capital Planning, Facilities and Construction, Houston Methodist   -Sid Sanders, SVP, Facilities and Construction, Real Estate, Houston Methodist  

Monday, November 14

3:15-4:15 pm
Session E70- Preparing for the Next 50 Years of Discovery: How Design is Advancing Research at Cincinnati Children’s Hospital

The vision for the new Clinical Sciences Pavilion at Cincinnati Children’s Hospital was a lofty one: to facilitate groundbreaking research for the next 50 years and beyond. The design of the 15-story, 458,000-square-foot addition, completed in July 2015, responded to this vision by creating environments that enhance various research functions and the goals associated with each one. This session will explore how design solutions respond to and advance client goals, and describe the process of setting those goals and translating them into reality.

  -John Blignaut, Principal, GBBN Architects   -Kristine Justus, PhD, Vice President, Cincinnati Children’s Research Foundation & Associate Director, Research Operations   -Jack Randall, FMP, CAFM Project Manager, GBBN Architects  

Monday, November 14

4:30-5:30 pm
Session E80- Smoothing the Transition from Planning, Design and Construction to Operations

Hospital facilities need to function safely from the day they open. Yet too often operators have difficulty bridging the gap between when a building’s systems are developed, tested and evaluated and when those assets must perform to intended standards. If healthcare organizations accept the premise that turning over a building is a transition rather than a hand-off, then even complex new or renovated facilities can go from construction to operational control and management rapidly and accurately — thereby saving time and money. This session will help you to set goals and define success for this approach, and discuss the tools and technologies that can ease this transition.

  -Kenneth Kaiser, Independent Consultant, formerly at Northwestern Medicine   -Michael Mostardi, Regional Director, Healthcare, Advanced Technologies Group, Inc.

Tuesday, November 15
8:00-9:00 am

Session E90- Expecting the Unexpected: Planning for Challenges in Ambulatory Care Adaptive Re-Use

As health systems continue to expand their reach to consumers through outpatient services, it’s becoming increasingly popular to reuse existing buildings to create ambulatory care environments. These projects can present unexpected challenges as well as many community benefits. Through three case studies, the SmithGroupJJR team will discuss how to get creative with design solutions when challenged by adaptive re-use, the cost and time implications these projects present compared to new construction, and the programming and planning processes used to make strategic decisions when challenged by buildings not intended for healthcare.

  -Erica Fisher, Medical Planner, SmithGroupJJR   -Essen Otu, Senior Director, Diversity and Community Affairs, Mountain Park Health Center   -Lyle Steely, AIA, LEED AP, Architect, SmithGroupJJR  

Tuesday, November 15

9:15-10:15 am
Session E100- A Year of Lessons Learned: The Special Isolation Unit at Texas Children’s Hospital
The Special Isolation Unit at Texas Children’s Hospital in Houston is one of a small number of CDC-designated Ebola Treatment Centers in the country, and the first biocontainment facility for children in the world. At eight beds, it is also the largest unit in the country designed to handle Ebola and other contagious diseases, including MERS, SARS and measles. At the 2015 HCD Conference the speakers presented the design process for the unit, which opened in late 2015. This year’s presentation will focus on the lessons learned from the first year of operation: how was the facility used, how many (normal) acute care patients were seen, and how often the facility was used in special isolation mode. The speakers will also share their insight as to what they might do differently if they were designing this facility today.

  -Allison Muth, Director of Facilities Planning and Development, Texas Children’s Hospital   -Kurt Neubek, Director of Healthcare, Page      

Tuesday, November 15

1:15-2:15 pm
Session E110- The Changing Faces of Ambulatory Care Models

Financial and regulatory pressures — as well as patient expectations towards access and convenience — continue to shift healthcare delivery to less costly and more efficient ambulatory environments. Although there is some overlap in services among the wide variety of ambulatory care models, each has a specific market niche within the healthcare delivery ecosystem and serves a distinct purpose. This presentation will provide an overview of the evolving nature of these ambulatory care sites, their potential impact on ambulatory networks and healthcare systems, and what this evolving model may look like in the future.

  -Jennifer Aliber, Principal, Shepley Bulfinch   -Nicholas Ro, VP of Strategic/Legal Affairs
Kelsey-Seybold Clinic