1. Abbott Northwestern Hospital Emergency Department Scope Definition Study Project Kick-Off FreemanWhite Emergency Department Consulting Team 14 March 2014 2. What Separates FreemanWhite 280+ Emergency Departments 3. Introduction to FreemanWhite Development of a Comprehensive Healthcare Consulting & Design Firm A Focus on our Clients Business Success Strategy Strategists Strategic Planning Business Planning Market Analysis Operations Process Engineers Operational Analysis Process Improvement Staffing Analysis Technology Facilities Low Voltage Systems Communications / IT Medical Equipment Technology Planners Planning Design Interior Architecture Engineering Architects Engineers ED Consulting Team 4. Welcome and Introductions FreemanWhite Team Jon Huddy, AIA, Managing Principal, Lead Programming, Planning Jim Jepson, AIA, Senior ED Designer Kristyna Culp, MBA, Data and Process Analyst Freda Lyon, RN, BSN, CEN, ED Clinical Specialist Michaud Cooley Erickson Greg Trende, PE, Engineering Systems Analyst Architectural, Engineering and Process Analysis Team 5. Objectives The objective of this Study is to define the long term facility needs for the Emergency Department. A key component to identifying the physical needs for the department will be quantifying future ED volumes and the analysis of current workflow and identification of future streamlined, lean operations. The final physical planning recommendation will be based on your unique strategic goals, estimated patient volumes, streamlined operations, efficient staffing patterns, specific MEP (mechanical, electrical and plumbing) criteria, and identified technology applications. 6. Scope of Study 1. Review and understanding of the strategic goals and objectives for emergency services 2. Analysis of the ED patient market and quantification of future volumes through the year 2024 3. Analysis of current workflow and identification of areas for improvement 4. Development of future workflow and staffing patterns based on best practice targets 5. Development of a computer simulation model that will test and quantify the benefits of each proposed concept plan 6. Development of room-by-room schematic floor plans that support future workflow, staffing and capacity needs 7. Analysis of infrastructure systems in support of future concept plan 8. Quantification of project costs in a proposed budget that identifies construction costs (architectural and MEP/Infrastructure) and soft costs for a proposed project 9. Preliminary phasing plans that allow project to be implemented while maintaining consistent operations in the current emergency department Items necessary to set the scope of your future ED project 7. ED DesignFlexible Efficient Physical Design Solution Four Step Process to Success The task of designing your physical environment is the opportunity to create the way that you will deliver care in the future. Analysis Strategies Patients Operations (lean) Technology Facilities Future Vision Define lean Operations, Technology, And Customer Service Patterns Project Scope Definition Early Design Concepts 1 2 3 4 March 13 March 24-25 April 10-11 April 22-23 March 13 (20 or 23?) 8. Todays Agenda One Day Session Start Time Duration End Time Participants and Topics Meet with Choy Leow to tour prior to meeting for update 8:00 AM 1:00 hrs 9:00 AM Choy Leow, others as invited Update on schedule, expectations KICK OFF MEETING 9:00 AM 1:30 hrs 10:30 AM FreemanWhite, Northwestern Memorial Representatives 1. Kick-Off and Introductions 2. Goals for a successful project 3. Data Review 4. Early Concept Discussion, Prior Planning Studies 5. Agendas and Project Schedule 6. Wrap Up and Next Steps Facilities Meeting 10:30 AM 1:00 hrs 11:30 AM FreemanWhite, ANW Facilities and Engineers Discuss existing conditions and expansion areas Friday, March 14, 2014 9. Welcoming & Holistic Environments 10. Efficiency & Ergonomics Mind and Body 11. Pediatric, Geriatric, Bariatric Sensitive Planning 12. Patient & Family Focused Comfortable and Confidential 13. Technologically Advanced 14. Next Gas: 15 Miles Next Design: 15 Years 15. Discussion Topics This project will be a tremendous success if Success 16. Discussion Topics Are there any hospital or system specific strategic objectives that will change the way you work in the future, change your service offerings, or change your patient types/acuities? Strategy 17. Preliminary Data Review 18. Projections 19. Census by Month/Year 20. Daily Census 21. Day of the Week Patient Census Distribution 22. Patient Arrival by Hour of the Day 23. Patient Mode of Arrival by Year 24. Patient Gender Distribution by Year 25. Patient Age Distribution by Year 26. Patient Acuity by Year 27. Patient Hour of Arrival by Acuity (2013) 28. Acuity Distribution by Mode of Arrival (2013) 29. Patient Treatment Location by Year 30. Treatment Location by Mode of Arrival by Year 31. Treatment Location by Acuity by Year 32. Percent of Patients Receiving EKGs by Acuity 33. Percent of Patients Receiving Labs by Acuity 34. Ancillary Turn Around Times by Shift 35. Imaging Studies by Study Type (2013) 36. Imaging Process Times 37. Patient Disposition by Year 38. Patient Disposition by Mode of Arrival (2013) 39. Acuity by Patient Disposition (2013) 40. Patient Treatment Location by Disposition (2013) 41. Average Length of Stay by Mode of Arrival 42. Average Length of Stay by Acuity by Year 43. Average Length of Stay by Location by Year 44. Average Length of Stay by Disposition by Year 45. Average Length of Stay by Month 46. Average Length of Stay by Day 47. Process Times: Door to Triage/Room/Physician 48. Process Times by Mode of Arrival 49. Process Times by Acuity 50. Process Times by Location 51. Process Times by Disposition 52. Process Times by Day 53. Billing Charge Level v. Acuity Level 54. What currently works well in the ED? What doesnt? 55. Next Visit: March 24-25 Onsite Visit 2: Existing Operations Questions: Please call Jon Huddy, FreemanWhite: (803) 517-7522 Day One Start Time Duration End Time Participants and Topics Meet with Choy Leow prior to meeting for update 12:00 PM 0:30 hrs 12:30 PM Choy Leow, others as invited Update on schedule, expectations Tour ED 12:30 PM 0:30 hrs 1:00 PM FreemanWhite Clinical Team tours ED Data Update 1:00 PM 1:00 hrs 2:00 PM ED Committee and Steering Committee Topic: Discuss visit agenda and meetings, review and validate data Ancillary Departments Meeting 2:00 PM 1:30 hrs 3:30 PM ED Committee; Ancillary Department Directors/Managers from key departments that interact regularly w ith the ED, such as Imaging, Laboratory, Security, Admitting, Bed Control, Housekeeping, Surgery, Nursing Supervisors, Materials Management, Pharmacy, Risk Management, Information Systems, Medical Records, Respiratory Therapy, key medical services, etc. Topic: Brief 5 minute discussion w ith each Ancillary Department Director/Manager regarding processes that w ork w ell betw een ED and their department, processess that do not w ork w ell and need improvement and key strategic initiatives that may impact the ED in the future. Each Director/Manager should bring the questionnaire completed to the meeting to leave w ith FreemanWhite staff. Introduction to Operational Analysis and Flow charting of existing ED patient flow 3:30 PM 2:00 hrs 5:30 PM ED Committee Topic:Creation of process map/flow charting and step-by-step documentation of existing ED operational patient w orkflow . Observation in the ED 5:30 PM FreemanWhite Team observes operations in the ED Day Two Continued: Operational Analysis and Flow charting of existing ED patient flow 8:00 AM 2:00 hrs 10:00 AM ED Committee Continued from Previous Day Operational Change: Implementing the Future 10:00 AM 1:00 hrs 11:00 AM ED Committee Topic: Discuss best practices, ideas for improvement Visit 1 Wrap Up 11:00 AM 0:30 hrs 11:30 AM ED Committee and Steering Committee Topic Project update, review next meeting time and agenda. Monday, March 24, 2014 Tuesday, March 25, 2014 56. Open Discussion