The Center for Health Design’s Built Environment Network (BEN) event held Monday, Nov. 5, 2012, in Phoenix, Ariz., at the 2012 HEALTHCARE DESIGN conference gave attendees the opportunity gain a perspective into what the BEN is about and how the information and experience that is gathered by the members of this group, relates to design, operations, construction, and more in the healthcare built environment.

BEN is a collegial network of executive-level professionals who are committed to improving safety, quality, and sustainability through the built environment of healthcare by engaging in open discussions about its direction and future. It aims to serve as a catalyst to the industry and to inspire the members to take the ideas and opinions back into their own professional settings.

The BEN members who spoke at the event include:

•          Don Orndoff, senior vice president of hospital strategy and national facilities, Kaiser Permanente – Evolving Access to Healthcare
•          Walt Vernon, principal, president and CEO, Mazzetti Nash Lipsey Burch – Connecting Operating Cost to Capital
•          Clifford Harvey, senior architect, Ontario Ministry of Health and Long-Term Care – Linking Transformation
•          Albert Park, vice president of facilities planning, ThedaCare – Rolling Capital Approval Process
•          Chip Cogswell, national healthcare director, Turner Construction Co. – Vision Collision

Orndoff discussed Kaiser Permanente’s (KP) continuum of care “from clicks to bricks” and how the model is developing and advancing toward the virtual world to tackle the changing healthcare landscape. The built environment is being looked at from a new angle and KP as a system is challenging itself internally as to whether the capital investment in these large, expensive projects are the way forward. The current model isn’t sustainable. Orndoff states that the buildings of today have to be flexible and adaptable but the constant sticking point is the additional front cost. Opinions are varied as to when the price has to be paid for this flexibility, and this must include a new system of care that incorporates electronic health records, primary care, high-quality standards, and low health management costs.

The Canadian health system operates under a universal care model which has been in existence since 1955. Although it’s a federally run program, each province runs its own health system. It is starting to go through a transformation as it becomes evident that Ontario’s current type of universal care is becoming too expensive. With a population of 13 million people in the province, Harvey, explains that there is a need to link the Transformation Agenda (excellent care for all, healthcare quality, patient centeredness, shift to the community, and funding reform) to intelligent capital investments for new and renovated environments. Looking to other health systems like those in the United Kingdom and the United States like KP, particularly the built environment, the Ontario Health system is seeking to share and gain knowledge in relation to their infrastructure. Harvey points out that the Canadian Ministry of Health does not provide any services, they only pay for the services, and give capital investments to be able to create, design, build, and be able to provide services.

Finding a smoother process for the annual approval process in capital management can humble even some of the more experienced in a health system. Park explains that ThedaCare saw the wasted efforts and time that were being generated from the rejection of some of these requests for funding, so they decided to develop a more effective and streamlined process. By creating a capital acquisition review team and developing a process by which it could follow a list of criteria by which to judge capital purchases, ThedaCare was able to move projects and requests through faster. This rolling quarterly capital approval process is responsive to changing needs over the course of the year; places considerably more scrutiny on capital requests; gives project approvals based more on the criteria rather than salesmanship; and keeps capital spend more level-loaded.