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Planning Solutions by Design: Reuniting Healthcare Programming and Design

Planning Solutions by Design: Reuniting Healthcare Programming and Design. Noah Epstein, M.Arch ., NSAA – William Nycum & Associates Limited, Halifax NS Mark Patterson, AIA, ACHA, EDAC, LEED AP BD+C – SmithGroupJJR, Phoenix AZ.

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Planning Solutions by Design: Reuniting Healthcare Programming and Design

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  1. Planning Solutions by Design: Reuniting Healthcare Programming and Design • Noah Epstein, M.Arch., NSAA – William Nycum & Associates Limited, Halifax NS • Mark Patterson, AIA, ACHA, EDAC, LEED AP BD+C – SmithGroupJJR, Phoenix AZ

  2. “One foremost truth I believe: It is the responsibility of the owner to ensure that a comprehensive program is provided to the design team prior to the commencement of design.” The Role of the Architect in Healthcare Facilities Programming: The Hospital Administrator’s Point of View Janet Adams RAIC Seminar, 24 May 1990

  3. Background Traditional Model / How It Developed Application to Healthcare Projects Timelines

  4. Traditional Model / Timeline 4-18 mo. 6 mo. 0 -12 mo. 3 - 8 mo. 8 mo. 1 - 3 mo. 12 - 24 mo. 3 mo. 24 - 36 mo. 35 yrs + 4-6 YEARS

  5. History Healthcare Programming evolved through a need to organize the project before starting design. Why? Where? What? How Much? How Many? How? When? How Long?

  6. Factors That Drive This Model PROFESSIONAL: RAIC Canadian Handbook of Practice: • Programming and Planning part of PreDesign, undertaken as a discreet phase apart from Schematic Design • Often tied to feasibility studies, financing requests and business case evaluation/preparation BUDGET: Desire for Early Financial Planning / Cost Estimates SCOPE DEFINITION: Don’t want to go too far down a path before needing to change course or delay. BENCHMARKS:Want ability to compare with past/other projects early in a project’s life. REGULATORY:Jurisdictional Requirements and Procurement Guidelines.

  7. Traditional Concept Go/No-Go Cost Check Cost Check Project Brief/ Basic Arch. Program DD… Programming/Planning Schematic Design Contract 1 or In-house Contract 2 Contract 3 SIMPLIFIED PERCEPTION

  8. Downsides to this Model UNDERSTANDING CHANGE vs. STATUS QUO DISCONTINUITY BUDGET TIME TRANSLATION

  9. “A general precept seems to be that programming should not predetermine design solutions. Exactly where programming should end and design begin is unclear.” The Role of the Architect in Healthcare Facilities Programming: The Hospital Administrator’s Point of View Janet Adams RAIC Seminar, 24 May 1990

  10. Traditional Concept Go/No-Go Cost Check Cost Check Project Brief/ Basic Arch. Program DD… Programming/Planning Schematic Design ? ? ? Contract 2 Contract 1 or In-house Contract 3 SOMEWHATIMPROVEDITERATION

  11. Traditional Concept Project Brief/ Basic Arch. Program Scope Ambiguity DD… Programming/Planning Schematic Design Contract 2 Contract 1 or In-house Contract 3

  12. Traditional Concept Approval to Proceed Go/No-Go Cost Check / Value Analysis Review/Submission/ Approval/Procurement Review/submission/ Approval/Procurement !!! !!! Project Brief/ Basic Arch. Program Programming/Planning Schematic Design DD Contract 1 or In-house ??? Contract 2 ??? Contract 3 Transition Continuity. Rare, especially as time elapses. ALL-TOO-COMMON REALITY

  13. Reuniting Programming and Design Technologies Benefits Drawbacks

  14. Technologies REPRESENTATION BUILDING INFORMATION MODELING (BIM) WEB-BASED COLLABORATION TOOLS AND TELEHEALTH ELECTRONIC SURVEYS SOCIAL MEDIA COMMUNICATION METRICS, STANDARDS, EVIDENCE BASED DESIGN PROCESSES

  15. Merged Concept Approval to Proceed Cost Check & Go/No-Go Review/Submission/ Approval/Procurement Review/submission/ Approval/Procurement !!! !!! Project Brief/ Basic Arch. Program DD Schematic Design Programming/Planning Contract 1 or In-house Contract 2 Contract 3 ??? ???

  16. Benefits to this Model VISUALIZATION RAPID CONCEPT TESTING SPATIAL REALITIES INNOVATIVE THINKING ENGINEERING INTEGRATION COSTING ACCURACY SUPPORTS CHANGE CONTINUITY OF VISION ENGAGEMENT & UNDERSTANDING SPEED ENJOYMENT!

  17. Drawbacks to this Model “FOREIGN” PROCESS • Cart before the horse? • Looser Design Sequence TENDENCY TOWARD DETAIL EMOTION / ATTACHMENT • Drawings seen early REQUIRES FREQUENT REASSURANCE

  18. Precedents Innovative Care Flexible Facilities Project, Halifax NS Banner Page Hospital, Page AZ

  19. ICFF Project TIME: Very tight timelines REGULATORY: Strict Procurement and Public Tendering Policies/Regulations OBJECTIVES: • Organizational Change & Efficiency • Patient-Centredand Cost Effective Solutions • Alignment with Concurrent Clinical Services Planning work • Collaborative, Humble Process • In-depth User Input and Buy-in • Public Engagement

  20. ICFF Project

  21. Banner Page Hospital

  22. Conclusions • Blurred Lines of the Process = Continuity due to technology and techniques • Evidence-based Design (EBD) facilitates the process, as current best-practices are disseminated and adopted more quickly. • Planning & design standards (e.g. CSA Z8000) provide a framework for critical discussion of programming. • Not purely a tool to shorten timelines

  23. Conclusions Combined process leads to enhanced stakeholder participation and buy-in.

  24. Thank you! Noah Epstein: nepstein@nycum.com Mark Patterson: mark.patterson@smithgroupjjr.com

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