When clients hire TRO Jung|Brannen (TROJB) to design a renovation or new facility, they expect the end result to be not only new space, but space that improves care and helps them leap beyond their competition. Improved healthcare can be achieved through a variety of measures—higher outcomes; lower costs; higher patient, family, and staff satisfaction; more comprehensive service lines; or more efficient operations. Typically, all of these parameters contribute to a client’s definition of improvement, and hence all are relevant in determining a project’s success.
Understanding how healthcare facilities operate is essential for designers. In fact, since many healthcare designers work for multiple clients across wide geographic areas, TROJB develops a knowledge base of current processes and emerging trends that is valuable to clients. The firm brings “what’s out there” to individual clients; helps them evaluate alternative ways of providing care; and designs a facility that optimizes the best practice operations they choose to adopt, consonant with their unique culture.
Building a new project is a natural opportunity for a client to explore what they do well and where they can improve. As we facilitate the design process, we work with our clients to define their care delivery model and back-of-house operations, as each of these systems influence the design.
In order to ensure that the operational assumptions underlying a design are developed in a clear, strategic way, TROJB has developed a comprehensive array of Lean process improvement tools that are utilized throughout the design process.
Some of these tools are integral to our basic services, others are specialty events. We can facilitate many of them in-house through our Lean and Six Sigma trained staff, while others we facilitate in conjunction with our client’s process improvement departments or independent consultants. We work with each client to determine which Lean offerings are most appropriate for their project based on scope, schedule, and level of staff interaction.
Four-step approach
1. Establish vision and scope. We adapt a Lean point of view in establishing the project vision, scope, and critical success factors. This requires collecting and analyzing existing data, benchmarks, and facility projections to establish the project definition and developing a function-based, rather than department-based, program.
2. Lean 2P/3P events. We define and facilitate Lean 2P/3P events to model operations in the proposed facility. This includes Lean training for the principal clinical user groups; facility-wide flow diagrams for patients, staff, information, supplies, and waste; 2-D layout exercises to test options; PFMEA (Process Failure Mode Effects Analysis) of proposed solutions; and real-time simulations of 3-D mock-ups of key process areas based on anticipated workflow drawn from relevant data.
3. Target events. We facilitate focused target events to address specific operational concerns. These may be rapid improvement events, current-versus-future-state value stream mapping exercises, or “card trick” simulations of proposed layouts.
4. Integrate with global Lean initiatives. The services outlined above are relevant to a particular design project. Often, clients are also engaged in developing system-wide approaches to Lean process improvement. There may be system-wide initiatives that we want to incorporate in the new facility, or opportunities developed for the new facility may merit wider implementation. In either direction, TROJB interfaces with in-house or independent Lean consultants to incorporate system-wide Lean initiatives.
Establish vision and scope
Establishing the project vision and scope, as well as determining critical success targets, involves one or more group visioning sessions, data collection, benchmark research, and synthesizing the results to create a unique project vision.
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