Deconstructing the Construction of a New Facility

The success of building a new clinical location is dependent on many factors and people working collaboratively and in sync.  Some tips for a successful outcome include:

Time – One can never start planning too early.  Prior to construction and during construction, take time to understand and document wants vs. needs vs. must haves.  You can narrow and prioritize the list at a later date.  Changes to the design during construction can result in additional costs.

People – Consult the users of the space.  This includes all stakeholders including providers, front desk, billing, clinical staff, ancillary services and your administrative team.  Observe the work in the current space and verify all of the key workflows.  Ensure barriers to productivity are resolved.  As you design the new space, consider opportunities to enhance efficiency, patient and staff and physician satisfaction.

Communication – Consider building “touchdown space” in the clinical area and optimize your flow.  Many designs now have co-located shared space with providers and support staff, which is known to improve communication and teamwork.

Voice of the Patient – The voice of the patient is key when constructing and problem solving; not to mention when creating a patient centered environment.  Interview patients to obtain their input.  Consider surveys, on-site interviews, focus groups and outreach calls to gather information.

Practice – Test out the new workflows and create a mock-up of the exam room.  Map out your table, stools, cabinets, sharps boxes, locations for disposable supplies such as gloves, door, curtain, etc. Simulate how the team members and patients will move within the space.  A fun and effective exercise in the initial planning stage is to put together a cross functional team to create the ideal layout using post-its!  This helps to surface workflows but can also point out differences in opinion among the team.

Team Meetings – Consider if you will need space for teaching or team meetings.  With the implementation of value-based care, a shared administrative space may prove to be essential for your PCMH.  Don’t forget about staff meetings or educational programming, which is required by licensure or recommended by leadership.  If you are a teaching program, consider the needs of students, fellows, residents and instructors.

Technology – Consider your current level of technology.  Will the construction include new features of your current software or upgrades or a completely new system?  This is a good time to review your Electronic Health Record (EHR) and Practice Management System (PM) or Radiology PACS, and identify change opportunities to allow time to plan.  For example, my current client is using it as a vehicle to redesign and optimize their clinical capabilities.  Instead of assigning each student a designated workspace (i.e., Exam rooms 1 and 2), they are using the rooms as resources, which will allow for other users to utilize the exam room when the Monday and Wednesday provider is on vacation.  This change will allow a 36% opportunity to increase production.

Construction is exciting, but identifying a lead project manager can be essential to a successful outcome.

Jill Berger-Fiffy , MHA, FACMPE
Senior Consultant

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