Criteria Facility Planning for a Family Clinic - Business Plan Example

Running Head: CRITERIA FACILITY PLANING Criteria Facility Planning for a Family Clinic Name Institution Date (Part 1) 1.0 Background Clinics, just like hospitals can be complex facilities depending on the range of services offered. Each Clinic consists of a wide range of interrelated components of services and operational service delivery units which include; health care diagnostic and treatment functions such as laboratories, imaging, emergency rooms and surgery; hospitality functions such as food service and housekeeping; and the basic care of inpatients and functions related to bed. This is a diversity that is always reflected in the extensiveness of the distinctive nature of rules, regulations and codes of conducts and the overseeing of the hospital construction and management. Concerned parties must therefore ensure that they acquire the right knowledge of the design process and right design features in order to realize safety, effectiveness and wellness of patients (S.K. & Stichler, 2009). Each of the broad scope and constantly changing functions of a Clinic are also inclusive of complex electrical mechanical and telecommunication systems that necessitate for expert know-how (Hayward, 2006) No single person can claim to have a complete know-how and that’s where experts come in planning and design of such facilities. The functional units of a Clinic can have reasonably contending parts and imports. Therefore, there should be a balance between the state of affairs in such facilities and preferences of individual persons in the backdrop of a compulsory wants, actual purposeful needs (such as management of internal traffic), inter-departmental relations and monetary standing of the organization. Besides a wide range of services that a Clinic must sustain, it must also play the role of supporting different stakeholders and users. The ideal design process involves a number of players among them the Clinic owners and staff. The designer of such a facility must also consider other groups who do not necessarily have a direct relationship with the Clinic such as visitors and support groups and / or staff, suppliers and / or service providers to the Clinic and patients from the beginning. The demand for creation or growth of a Health facility must be a deliberate process that should involve an effort to combine human, managerial and financial capital for the central values of the Clinic and the communities they serve to thrive. The ultimate goal of this Planning of what I will herein refer to as THE FAMILY CLINIC will therefore be; “To reinvent the delivery of healthcare in to the surrounding community. The outcome intended in this process should be; a healthcare facility unmatched by any other in the surrounding areas; one that does not depend on the sickness of the members of the communities to earn its money, but one that functions on the basis of focusing on prevention, checkups, health education and comprehensive healthcare that puts each individual in charge of their wellbeing and giving guidance to the communities in order for them to feel better. It will be a facility that will combine the family healthcare practices and the complexities of expert Clinic and worldwide healthcare. “THE FAMILY CLINIC” will be an advocate of individual healthcare while turning them into their own final decision makers. 2.0 The population Our target population will be based on but not limited to the following assessment; -Current utilization rates of medical health facilities, (specifically clinics), among the general population which stood at about 6,085 medical users and 16,228 medical encounters in 2008. -Below poverty levels which stood at 46% in 2008 -100% - 200% of poverty levels which stood at 24% in 2008 -Over 200% poverty levels which stood at 30% in 2008 -Insurance status – those with no Insurance – 12% -Access to Medicare – 30% -Access to Medicaid – 28% -Access to Public Insurance -Private Insurance – 31% Based on this assessment therefore, our target population will comprise of but not limited to the following groups of people:% by race and ethnicity 41% - Hispanic, 41% Black, 35% - white, 21% - Asian, 13% and 35% - Hispanic whites, Native Americans respectively and others. Reasons for visit based on a percentage visit routine; Acute / Emergent Complaints – 46%, Chronic Health problems – 43%, Physical checkups – 28%, Regular receipt of particular medications – 20%, Others – 13%. These estimates are based on a survey carried out by Simpson and Long on student – run Health clinics in 2007. According to this survey, those that visited these clinics were grouped into various groups such as race per clinic per annum of which 31% of these were Hispanic, 31% - Black, 25% - White, 11% - Asian, 3% - Native American / Others (Simpson & Long, 2007). Therefore, considering the massive exposure to medical care and health issues in the US, we estimate that these numbers might have risen by about 10% between 2007 and now. 3.0 The Facility This description, drawings and documentation pertains to the design and construction projections of the new “THE FAMILY CLINIC” facility. The vision of this planning includes the construction of an additional new one floor to the family clinic, site improvements and interior remodeling (within one of the existing medical buildings). The current facility houses the whole Medicare facility, with specialty sections. However it is outdated and does not cater for adequate healthcare requirements. It also has a lack of space for the Clinic to operate efficiently and offer its service to the community. The new upper floor of the clinic will provide the community with a modern facility twice as large as the former clinic; this will be a more efficient building in terms of layout; with more examination sections and increased number of patients served and more privacy. This will provide an environment better suited for provision of efficient and much needed healthcare. The Existing Clinic (Drawing) 4.0 Part II 4.1Regulatory requirements and their impact on the design and equipment Efficient Clinic space should have a proper layout in order to promote; - Staff efficiency through minimizing of necessary distance of travel between number of travel and spaces used. -Easy supervision of both patients and staff. -provision of effective organizational systems such as elevators automated carts etc, for effective handling of food and supplies, waste management recycling and soiled materials. -Effective usage of space -Effective outpatient functions for better operations and accessibility -grouping of related functional units to promote efficiency in inter-unit functions -Optimum functionality in general from the standpoint of staff, patients and suppliers Efficiency and cost effectiveness In order to manage change in the needs and modes of treatment, the clinic will endeavor to; -Put into consideration integrated concepts of planning of space and layout -Use standardized sizes for room as opposed to highly specific ones -Make use of easily accessed sectional mechanical and electrical systems that are easy to modify -Make use of the VA Hospital Building System which uses interstitial walk-through spaces between floors for proper distribution of electrical, plumbing and mechanical delivery. Be open-ended with properly planned directions in case of future expansions. Therapeutic Environment Patients are mostly confused and fearful, which may be an impediment to recovery. therefore, we will endeavor to make the clinic as comfortable and as stress free as possible though; -The use of familiar and as culturally applicable materials as possible in consistency with sanitation and other needs related to functionality -The use of cheerful colors and textures keeping in mind that the same colors can be an impediment to properly assessing a patient’s skin and pallor tones -Admission of enough natural light where feasibility allows and making use of interiors with color-corrected lighting spaces which normally approximate daylight correctly -Provision of views of outdoors by use of windows and / or murals where the outdoor views are not available. -Design of a way-finding process into the project in order to make places within the premises easy to find. All building elements should therefore give pointers as well as signage and artworks (VA Signage Design Guide). Cleanliness and Sanitation The clinic must be easy to clean and maintain. This will be made so through; -Proper finishes which are durable for each functional space -Detailed description of features such as casework, doorframes and transitions between finishes in order to prevent hard to clean dirt retaining joints and crevices. -adequate easy to find housekeeping spaces. -use of special materials details and finishes for spaces which are to be kept sterile. -O$M practices that emphasize Indoor Environmental quality (IEQ). Accessibility The clinic will; -Conform to the minimum prerequisites of the Americans with Disability Act (ADA), -Be designed for easy use by patients with disability -Have grades that are flat enough to cater for easy movements and sidewalks and corridors wide enough to allow for two wheelchairs to pass through easily. -Have entrances wide enough to allow patients with slow adaptation rates to light and dark, marking glass doors and windows and making their presence obvious Controlled Circulation -Well defined outpatient routes that are simple. -Direct and simple route for visitors -distinction between patients and visitors from industrial / logistical floors -proper outflow of garbage soiled materials and recyclables which should be separated from the movement of food, and clean supplies and also separate from the route used by patients and visitors -Service elevators for deliveries, maintenance services and food Aesthetics This is also related to therapeutic environment though closely related to creating homelike surroundings that are attractive for purposes of public image and is an important marketing tool for the clinic. It is also a good way of boosting the morale of staff and promoting patient care. In order for a design to succeed the designer must consider the needs of users of the interiors; First the owner, in this case the facility’s management, second, the employees, in this case doctors, nurses, orderlies, interns, etc and thirdly customers in this case the Clinic’s patients. Lastly, the designer must understand the kind of business the client is involved in this care of sick people and their well-being. (C. & Rodgers, 2007) Aesthetics therefore is all about; -Proper use of natural light, materials and textures -Incorporation of artworks such as paintings, sculptures ceramics, potted plants, etc -Consideration of proportions scale, color and details -Open and bright generously scaled public spaces -Intimate and homely patient rooms, consultation room offices and day rooms. -Exteriors that are well attuned with the physical environment. Security and Safety Apart from general safety concerns related to building and construction, the following concerns specifically related to hospitals and in extension clinics must be addressed; -Safeguarding of the clinic’s assets and property such as drugs -Protection of patients and staff including incapacitated patients -Benign management of violent or unstable patients -Considerations of any vulnerability to terrorism activities which might be caused by nearness to high target areas. Sustainability There is need for sustainable design because facilities such as clinics are heavy users of energy and water and hence have a significant impact on the environment and the communities living around them. Related Issues The Health Insurance Portability and Accessibility (HIPAA) act of 1996 deals with issues of security and privacy of “Protected Health Information” (PHI) and electronic Protected Health Information (ePHI). These regulations stress on audio and visual privacy. These may also affect location and arrangement of workspaces and computer terminals that handle such records related to medical history of the clinic’s patients, or any other data on paper or electronic relating to patients. Emerging Issues Today, there are numerous new discoveries and trends that affect healthcare facility design among them; -Decrease in number of general practitioners compounded by increase in the use of emergency facilities in primary healthcare -Increase in use of highly complex diagnostic and treatment technology -Disaster management and the ability to function after and during crisis and / or disasters -State Laws governing earthquake resistance in design and retrofitting. -Prevention versus cure - an approach where health facilities should be the all – inclusive “wellness centers” -Use of computerized and handheld diagnostic equipment to allow for more devolved ways of caring for patients and a means of storing information. -Creating awareness among patients and visitors concerning building security as an act of balance. -Creating an all inclusive approach to patient - centered treatment in relation to environment issues. This might call for medical libraries and computers in order for patients to research their illnesses and treatment. Relevant Codes and Standards Health centers are some of the most regulated types of buildings, they must therefore comply with general local and/or state building codes. In order to be licensed by the state, design must be in compliance with the state’s licensing regulations. Most states go by the FGI Guidelines for Design and Construction of Hospital and Healthcare Facilities. The codes of specific state and local buildings are centered on the International Building code (IBC). Since the clinic will also be treating patients who are compensated by medicare, it must meet federal standards of the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) which generally refers to National Fire Protection Act (NFPA), model codes on fire such as Standards for Health Care Facilities (NFPA 99) and the Life Safety Code (NFPA 101). The American with Disabilities Act (ADA) goes for all public facilities as far as design and accessibility requirements are concerned. The Architectural Barriers Act Accessibility Guidelines (ABAAG) or GSA’s ABA Accessibility Standards apply to federal and federally funded facilities. Occupational Safety and Health Administration (OSHA) requirements also affect healthcare facility design and particularly laboratories. There are also special detailed standards that are designed by federal agencies that build healthcare facilities for the programming, design and construction of their facilities which also apply to non-governmental facilities. 4.2Equipments and Prices; -Clinical Microscopes- $1000 -Radiography-$ 10,000 -X-ray Unit-$140,000 -X-ray film processors and Accessories-$ 5,000 -Anesthesia machine and ventilators-$ 1,700 -Suction Apparatus-$ 600 -Gynecology Aspirators-$ 500 -Stretchers and Trolleys- $ 230 -Traction Device-$ 3,000 -Operating table-$ 3,000 -Sterilizer-$5,000 -Steam disinfector -$ 1,000 -Fetal and Maternal Monitor-$ 800 -Dopplers-$ 100 -Hospital beds-$ 350 -Operating Lamp-$ 8,000 -Electro-Apparatus-$ 150 -Incubator-$ 10,000 -Monitoring system-$ 6,000 -ICU Product-$ 9,000 -Lab Instruments-$ 2100 -Centrifuge $ 500 -Nebulizer-$ 30 -Electronic Spirometer- $ 2,000 -Dental Unit-$ 950 -Curing Lights-$ 650 -Ophthalmic Instruments-$ 600 -Fiberscopes-$ 5,300 -Cold light Source-$ 1,000 -Disinfector-$ 2,100 -ENT Instruments-$ 20,000 -Ultrasound scanner-$ 1,600 Total Cost of Equipment = $ 242260 NB: All the above equipments are based on single unit cost. Therefore where more than one unit is required the price will be multiplied by the cost of that unit. The prices are also subject to a 10% raise to to market added value taxes. The Role of Stakeholders Stakeholder involvement in this process is crucial to the initiative. When setting up of the initial internal process and building up support for the initiative services, you build up relationships with communities in the process in order to identify a broad team of stakeholders in your city. The following three areas are crucial at various levels of stakeholder’s involvement; assessing the need, outlining assets and taking an action plan. Stakeholders must have vested interest in the project in order for them to support the project at hand. In the case of this project, these will include; -Community groups -Health industry associates -Environmental groups -The local Government -Government health sector -Senior Citizen groups -Politicians -Residents They will all be involved in the building of the clinic through; -Forming of Advisory an Steering committees that will helping in guiding the work of the initiative -Working groups will be responsible in assessing the needs of the community and priorities -Surveys to reach large parts of the community while needing little effort -newsletters to come up with mechanisms for keeping the community involved -Meetings which will be used by managers of the project to involve citizens at the community levels and to drum up support from them. 4.3 Implementation The project will be funded through a grant from health resources and the local community and has been divided into two phases; Phase I 1. Construction of a new single floor (7230 square feet) clinic building and related site improvements located at:- 2. Site improvements. Phase II Interior Improvements of an approximate 1700 square feet of the already existing ground floor of the clinic. The Strategy 1. Building the new floor of the clinic 2. Spreading all of the facility’s sections to the new floor 3. Provision of parking, landscape and hardscape at the site upon completion of the building Process 4. Remodeling of the space in the new facility. Location; Colorado The new floor will house the following; 1. Pharmacy at about 2000 ft. 2. Clinic at about 3000 ft 3. Common areas at about 1300 ft The pharmacy will include a patient waiting area. office space for operations coordinators and buyer / reimbursement specialist, private patient, consultation area, counter space for drug dispensation, sink, area for limited compounding, storage area and a ,bathroom. A symphony system plus ROBOTx is also being considered for easy dispensing of medicine. The health centre will consist mainly of; administrative offices for; social workers, counselors, nurses, nursing coordinator, medical providers, manager, business coordinator, a conference hall for staff and patients, training and board and staff meetings, restrooms, about three of them, a bathroom for staff, six examination rooms, intake room, a laboratory, a waiting room, a records room for medical records discharge area, laundry room, employee lounge, There will also be common areas such as mechanical electrical, janitor, data and phone areas and corridors. ACTION PLAN/GANTT CHART The following is a Gantt chart or an Action plan chart showing the sequence of events that will take place in carrying out this planning phase of the project. It will take 2 Months Action Plan/Gantt Chart Example (see also Index 5.1for a summarized version) Task Name May- July 1 / 5 1/12 1/19 1/26 2 / 2 2 / 9 2/16 1 Assemble a leadership team to start project 1 / 6 2 develop project plan 3 develop publicity plan 4 identify consultant 5 hold initial consult 6 develop consultants’ contract 7 invite team members from the Community 8 invite new team members 9 identify internal review team 1 0 put team info on homepage 11 develop News bulletin story 1 2 brief management 5.0 Part III The New Floor ­­ 5.1 Summary This planning process will flow in the following order as shown in the Gantt Chart in the previous section. (Index 4.3) 1. Assembling of the leadership Team. 2. Setting Vision, Mission and Goals. 3. Initial Planning Assessment; evaluating the condition of the existing facility and analyzing the Community’s Demographics. 4. Taking care of Governmental Relations ; Sharing of Information and garnering political support for the project 5. Report of the team From the beginning of this planning process, there has been no disorder. However some disorder might surface in the process of initiating the project during which its necessary to propel the project forward. As the ideas that have been outlined in this plan progress to a more definite stage, there will emerge a need to conceptualize and critic ideas. The by product will be chaos and the planning process will move from order into a state of chaos. It is in this chaos that more ideas emerge and are developed, but the chaos has to be recognized and assembled for deeper understanding in order to augment results in the implementation process. Through the chaos order will eventually emerge, materials will be erected, the building will stand, and the clinic will begin to run and function. It will be the final outcome. This will however require commitment on the part of relevant people, who can process information, integrate and come up with decisive ideas that are clear. This plan therefore is just a guideline pertaining to origin of the idea, but it not a blue print or a master plan. The only regret in this planning process is perhaps the realization that there Is a lack of application of proper and diverse research methodologies and which are very crucial in the process (Dwijayanti, 2010) and would have helped in optimizing the layout design; This has been contributed to by a limit in availability of resources such as time and money. References Streiss, A. (2005). Strategic facilities planning. Oxford: Lexington books. Piotrowski, C. & Rodgers, E. (2007). Designing Commercial Interiors. Hoboken: Wiley Publishers. Dwijayanti, D. (2010, March 17-19). A proposed study on facility Planning and Design in Manufacturing Process. Proceedings of the International Multi Conference of Engineers and Computer Scientists 2010 vol III , pp. 1-6. Hayward, C. (2006). Healthcare FacilityPlanning : thinking strategically. Chicago: Health Administration Press. Cesario, K, & Stichler, J. (2009, July 4). Designing health care environments: Part II. Preparing nurses to be design team members , pp. 324-328. Simpson, S. & Long, J. (2007). Medical Student-run health clinics: Important contributors to patient care and medical education. Journal of General Internal Medicine, , 22-23, 352- 356. Streiss. (2005). Strategic facilitiesplanning: capital budgetingand debt administration. Oxford: Lexington books. Read More