Designing for Workflow Efficiency
As mentioned in my last blog post, at the recent Built Environment Network meeting (what's the Built Environment Network? Click here to read more!), the Lean process was a prominent topic. Two different presentations were made under the heading "Application of Lean Principles"; The first "Integrated Design Build Project Delivery Model" from David Jarrett, System Director for Design and Construction for Dignity Health, looked in-depth at how that 40-member hospital system based in California, Arizona, and Nevada applies Lean thinking to its delivery methods to align teams both within and outside of the organization to deliver the right projects at the right place, cost, and time. The second presentation from Chip Cogswell and Jeff Williams of Turner Construction Company, "Lean is a Mindset," examined Lean project delivery in a much more general sense, presenting the "Ten Commandments of Lean Delivery."
While I'm not going to recap all of the "Ten Commandments" here, one of the points in Cogswell and Williams' presentation really struck me as an idea that could use some reinforcement: If the point of Lean project delivery is to design and build for ultimate clinical workflow efficiency, it logically follows that the best plan to achieve that is to design the form of the building around the most effective workflow. If you "Lean" out the process before you design the space, that makes the definition of that most effective workflow that much easier to establish.
It sounds like such a simple concept, and yet, we wind up with a fair number of inefficent spaces regardless. I'm quite sure that no one purposefully designs space to function poorly, however, a great many factors (money, space restraints, personnel changes, changing technology, and more) and lots of voices can change the best intentions of an efficient design into something that hardly resembles what was initially planned to be the most effective way to plan a space.
Keeping the entire team, especially leadership at the top, on the same page with the why and how a space is being designed a certain way is the best and most effective method to ensure the best results; but as we all know, that's easier said than done. But if the Lean movement is really going to effectively change the industry as many are predicting it will, the teams responsible for designing and building our healthcare facilities will need to come to the above conclusion one way or the other. Hopefully, it will not be by trial and error.