“The Prentice Story” Prentice Move Phases and Evaluation April 9, 2008.

“The Prentice Story”

Prentice Move Phases and Evaluation

April 9, 2008

“Activation & Readiness Planning”

Prentice Women’s HospitalTransition Planning Model

Op

erat

ion

s R

ead

ine

ssF

acility Read

iness

StabilizationPatient Move

People Commissioning

Program

OperatingAssumptions

OperatingWork Flows

OperatingBudget

Recruitment

Communications&

Events

BuildingReadiness

TechnologyReadiness

BuildingLoad

DepartmentReadiness

Migration

DesignConstruction

FFE

Transition Planning Campus Development

Feinberg/Galter Lessons Learned

• Transition took longer than anticipated

• Operational and department changes were unclear to staff

• Expect and hire for full census

• Pilot all new technology and assure staff have adequate training

• Assure FFE is delivered to the appropriate department and remains in that department

Feinberg/GalterLessons Learned (cont.)

• Time between Facility Completion-Grand Opening Events-Move was too short for staff and vendors– Department Readiness

– Staff Readiness

• Clearly understand the scope of facility transition and the related impact on stabilization post move– Department Readiness

– Technology Readiness

– Staff Readiness

• Assure PAR levels meet new patient demand

• Vacated facilities represent operational and cost challenges

Prentice Women’s Hospital

• OB & NICU patient move plans would require different clinical assessments

• More monitored patients would be moved (L&D and NICU)

• More families would want to move with the patient (L&D, NICU and PP)

• Opportunity existed to communicate the move plan to patients earlier

• Support departments would need to focus on both Feinberg operations as well as Prentice move needs

• Complexity and scope of technology had increased dramatically

Unique challenges existed with the Prentice Transition plan

Transition Plan

• The Transition Plan extended beyond Prentice Women’s Hospital and involved a majority of the Northwestern Memorial Hospital departments.

• Each department/unit established a detailed plan highlighting the move-related activities the year of the move.

A well defined plan assured smooth activation of the new Prentice.

Transition PlanThe move and activation plans were consistent with

Northwestern Memorial Hospital’s mission and strategic plan initiatives.

Best Patient Experience

Best People Exceptional Financial

Performance

Assure patient safety and high standards of quality service are maintained throughout the move.

X

Provide staff and physicians with the time and training needed to acclimate to the new facility.

X

Seize opportunities to enhance operations. X X X

Support patients, family members and visitors throughout the move X

Transition Planning

Op

erat

ion

s R

ead

ine

ssF

acility Read

iness

StabilizationPatient Move

People Commissioning

Program

OperatingAssumptions

OperatingWork Flows

OperatingBudget

Recruitment

Communications&

Events

BuildingReadiness

TechnologyReadiness

BuildingLoad

DepartmentReadiness

Migration

DesignConstruction

FFE

Transition Planning Campus Development

Building Readiness

Technology Readiness

Department Readiness

Staff Readiness

Prentice Women’s Hospital2007: Move Preparation

Prentice Women’s Hospital2007: Move Preparation

• Equipment Procurement and Pilots

• Staff and Physician Training

• Development of Move Plan

• Move Simulation and Mock Move

Transition Planning

Director

Kirk McKie

Transition Planning Manager

Sara Hayes/Heather Daas

Transition Planning Manager

Nick Wojciechowski

Transition Planning Manager

Roberta Clairmont

Transition Planning Manager

Mary Fran Molitor

Organization StructureTransition Planning Team coordinated and facilitated all activities

related to the activation and move.

Chief Operating Officer

Executive Vice President

Dennis Murphy

IT Project Director

Paula Elliott

Consultant

Kerry Shannon

Steve Straka

ProfessionalServices

-D. Woods –S. Hayes

Patient SupportServices

-G. Fennessy –N. Wojciechowski

Move Logistics-J. Przybylek –

N. Wojciechowski

InformationTechnology

-T. Zoph –P. Elliott

FF&EBuilding Load

-G. Fennessy –N. Wojciechowski

Communication &

Events-H. Salls –

R. Clairmont

BuildingReadiness-Jim Bicak –

S. Hayes

Best People-D. Manheimer –

MF Molitor

Transition PlanVP Sponsored Task Forces and Activation Teams addressed the scope of

activities required to execute the overall Transition Plan.

DepartmentActivation

Teams-Dept VP’s –MF. Molitor

All TP

Prentice AIP

Dennis Murphy

Kirk McKie

Task Forces-assumptions/work flows that cross department

Activation Teams-geographically focused/department specificassumptions/workflows

Transition PlanA three year process from planning through execution and stabilization

2005

Q3

Consultant RFPPlanning Support

Activation Team Activity

2005

Q4

2006

Q1

2006

Q2

2008

Q1

2007

Q4

2007

Q3

2007

Q2

2006

Q3

2006

Q4

2008

Q2

2007

Q1

Plan DevelopmentPlan, Process &

ScheduleBudgetReview/

Approval

Recruit 2Project Managers

Recruit 2Project Managers

Task Force Activity

Confirm Charter/VP Sponsorship

Plan/Assumptions/Work Flows

Validate & ApprovePlans/Assumptions/Work Flows

Implementation

Confirm Charter/VP Sponsorship

Preliminary Operating

Budget Review

Plan/Assumptions/Work Flows

StabilizationTP Transfer

to Operations

Implementation

OpeningPatient Move

Homestretch Coordination

Building Readiness Objective

Security Services

• Validate updated security system and procedures (e.g. Code pink)

• Transition to support pre-operating building access and

opening operations

Security Services

• Validate updated security system and procedures (e.g. Code pink)

• Transition to support pre-operating building access and

opening operations

Safety and Infection Control

• Training of 2200 employees and vendors of pre-move safety

procedures• Environmental testing of facility to ensure air and surface quality

meet defined criteria• Service Disruption Team

Safety and Infection Control

• Training of 2200 employees and vendors of pre-move safety

procedures• Environmental testing of facility to ensure air and surface quality

meet defined criteria• Service Disruption Team

Facilities Management

• Transition to support building operations

(i.e. automation of MEP)• Building commissioning

• City requirements• Statement of conditions

(JCAHO)

Facilities Management

• Transition to support building operations

(i.e. automation of MEP)• Building commissioning

• City requirements• Statement of conditions

(JCAHO)

Environmental Services

• Implement plan for each building clean phase : post-construction, post-load, terminal clean, and

patient ready clean• Transition to support building

operations

Environmental Services

• Implement plan for each building clean phase : post-construction, post-load, terminal clean, and

patient ready clean• Transition to support building

operations

Prepare the physical facility and assure building systems were tested and functioning for the opening of the new Prentice

Technology ReadinessObjective

To assure that all technology works, and works together in advance of opening the new facility to mitigate risks associated with technology failure, information flow and end-user acceptance.

Scope:Infrastructure – 1076 miles of cableWired Devices – 4727 PC’s, printers & phonesWireless Devices – 550 PC’s & phonesBiomedical Equipment – 2650 devicesApplications – 76 applications cross referenced to 50 processesPilots – 6 pilots of new technology

Technology Readiness Process

Application

• Conducted workflow sessions• Mapped processes to

applications• Piloted new technology in

existing facility• Built and tested applications in

production environment

Application

• Conducted workflow sessions• Mapped processes to

applications• Piloted new technology in

existing facility• Built and tested applications in

production environment

Commissioning

• Confirmed commissioning as preferred approach

• Focus Commissioning to confirm process and methods

• Building load sequenced to support commissioning activities• Created “floor captain” role to

facilitate commissioning• Executed

• SWAT approach for remediation

Commissioning

• Confirmed commissioning as preferred approach

• Focus Commissioning to confirm process and methods

• Building load sequenced to support commissioning activities• Created “floor captain” role to

facilitate commissioning• Executed

• SWAT approach for remediation

Infrastructure

• Designed infrastructure with flexibility to accommodate

changes in technology for 25 years

• Full wireless capabilities, house-wide

• Built infrastructure off site, tested, then loaded closets

Infrastructure

• Designed infrastructure with flexibility to accommodate

changes in technology for 25 years

• Full wireless capabilities, house-wide

• Built infrastructure off site, tested, then loaded closets

Activation Teams – Task Forces – Department User GroupsActivation Teams – Task Forces – Department User Groups

Building Load Objective

Develop a process and management structure that leverages the organization’s operational strengths to ensure the placement, functionality and retention of all new Prentice Women’s Hospital items in the right place at the right time, in coordination with all pre-occupancy activities.

Scope:45,000 pieces of medical and general equipment11,000 pieces of furniture7,500 Information technology devices703 hours of loading activity

The complexity of the following pre-occupancy elements prompted the need for a fully integrated planning and

execution structure.

Construction

• Regulatory Inspections• MEP Commissioning

• Design-Deferred Construction• Punchlist Construction

Construction

• Regulatory Inspections• MEP Commissioning

• Design-Deferred Construction• Punchlist Construction

Systems Readiness

• Cleaning• Training and orientation• Environmental Testing

• Technology Commissioning• Equipment installation and testing

Systems Readiness

• Cleaning• Training and orientation• Environmental Testing

• Technology Commissioning• Equipment installation and testing

Loading

• Group 1 Equipment• Group 2 Equipment

• Furniture• Artwork and Signage

• IT Devices• Supplies, medications and food

• Grand Opening Materials• Relocated FF&E and materials

Loading

• Group 1 Equipment• Group 2 Equipment

• Furniture• Artwork and Signage

• IT Devices• Supplies, medications and food

• Grand Opening Materials• Relocated FF&E and materials

Integrated Building LoadProject Elements

Video Endoscopy system (8)

Camera, Video/Surgical (x5)(new)

Cart, Fiberoptic(2 new)

PACS

In-room camera (x2)

OR Video Integration(new x8)

Printer (x8)

Ceiling-mounted Flat Panel Display (x24)

Load Sequence (Sample)

PC (standard charting at documentation station)

Wall-mounted display (x2)

Video teleconferenceCoder/Decoder (x2)

Outsideworld

OR Conference

ConferenceCenter

Gateway

Delivery Installation Biomedical

Certification TechnologyCommissioning

Staff Training

FirstUse

Each system and piece of equipment required analysis to reveal the dependencies, activation duration and sequence.

Department Readiness AssessmentObjective

• Shake Down: Leverage of existing issue reporting system (Sentact) to report track and resolve issues

Define and Implement process to identify, report, resolve and track issues to assure the planned environment is ready to receive patients and can continue to support patient care

following the move• Department Readiness Assessment Validation: Leverage of existing building load database and multidisciplinary support services rounding group to assess environment to validate readiness state

Scope:3019 pre-move issues reported

62% resolved pre-move148 move day issues reported236 stabilization issues reported – 3 weeks95% issues resolved to date

Scope:1000 rooms assessed pre-move56,000 FFE items validated16 hours – average assessment time100% rooms approved to open

Shake Down Leverage Sentact To Support Issue Reporting/Prioritization And Issue

Resolution Before, During And Immediately Following The Move To The New Prentice

Training Issue Entry

Call 6-8888

OR

Reports

Number of Reported Issues Per Week

0

2040

6080

100120

140160

180

Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8

# of Open Move Critical Items # of Move Critical Resolved

# of Open Other Items # of Other Items Resolved

Department Readiness AssessmentDepartment assessment of loaded and commissioned equipment by

department managers utilizing Task Management Tool

Deliverables

• Report of % of items:

– Loaded/installed

– Commissioned

– Certified

• List of open items to begin focused issue resolution inserted within the “add comment” field

• Go No-Go Decision

Department Readiness Assessment EOC Review

Multidisciplinary support services rounds accompanied by department manager to validate department’s environment is ready to accept patients

Deliverables

• Sentact Shake Down report of all identified issues

• Report of % of EOC rounds completed

• Go No-Go Decision

Unit Estimated Length of Rounds

Patient Care 90 minutes

Support Services 30 minutes

Public & Office Spaces 15 minutes

Team Members•Safety

•Bio Medical Engineering•EVS

•Materials Management•Facilities

•Pharmacy•Construction/Renovation

•Infection Control

Many project resources and organizational structures were leveraged to streamline the migration process.

Implementation Planning

• Activation Teams Identified Dependencies and Items Needed for

First Day of Operations• Department Assessment Conducted

to Label All Migrating Assets• Bid and awarded commercial mover

contract

Implementation Planning

• Activation Teams Identified Dependencies and Items Needed for

First Day of Operations• Department Assessment Conducted

to Label All Migrating Assets• Bid and awarded commercial mover

contract

Move

• Labels Distributed to Departments for Box Identification and Relocation

• Vendors Engaged to Assist with Complicated Migration Items

• Master Migration Plan Established

Move

• Labels Distributed to Departments for Box Identification and Relocation

• Vendors Engaged to Assist with Complicated Migration Items

• Master Migration Plan Established

Planning

• FF&E Group Established New Asset Master List

• Gap Analysis Completed; Migration List Created

• Migration Guiding Principles Established and Distributed

• Activation Teams Validated Migration List and Established the Migration and Commissioning Plan

Planning

• FF&E Group Established New Asset Master List

• Gap Analysis Completed; Migration List Created

• Migration Guiding Principles Established and Distributed

• Activation Teams Validated Migration List and Established the Migration and Commissioning Plan

MigrationProject Elements

Sept 24 Oct 29 Nov 12Nov 5Oct 22Oct 15Oct 8Oct 1

MOVE

Screening Center in 676 Closes

Galter 13 Operates at Half Capacity

Galter 13 Closes

New Prentice Opens with 3 Diagnostic Pods and a Screening Pod

Operate at Full Capacity

Move remaining Mammo Units from Galter 13 to New Prentice for Installation and Commissioning

Sample Migration PlanBreast Imaging

Move Half of the Mammo Units from Galter 13 to New Prentice for Installation and Commissioning

Screening Center Equipment to New Prentice for Installation and Commissioning

Operating Program - Assumptions - Work Flow

Objectives

Task Forces

To develop operating assumptions and

workflows that cross departments in

Prentice – e.g. Pharmacy.

Activation Teams

To develop geographically

focused/department specific

operating assumptions and

Workflows – e.g. NICU.

Scope:8 Task Forces160 Staff & Physicians

Scope:16 Activation Teams300 Staff & Physicians

Operating Program - Assumptions - Work FlowStructure

Task Forces• Building Readiness

• Technology Readiness

• Patient Support Services

• Professional Services

Activation Teams• Inpatient

– Labor & Delivery– Ante/Post Partum– NICU– Women’s Care Unit– Hematology Oncology

• Diagnostic & Therapeutics− Radiology− Breast Imaging− Ultrasound− Surgery

• Support Services• Professional Services

VP SponsorDirector Oversight

Selection Of Membership

Kick – OffMonthly MeetingsFormal Minutes

Review Department

Specific Program

Validate Staffing Models

Develop Operating

Assumptions & Workflows

Participate in the

Development of the Move

Plan

Provide Input to Training

Plans

Operating Program - Assumptions - Work FlowProcess

• Projected Volume

• Facility Design & Size

• New Programs

• Service Enhancements

• Regulatory Requirements

Provide Input to

Technology Device &

Application Plans

Key Factors

Work Flow SampleOB Triage

• Swipe Employee Badge at Kronos Station on floor which staff is assigned.

• Keycard Reader Access to the Staff Lounge. Place personal belongings/purse in purse locker within the Staff Lounge

• Staff will then participate in Assignments/Report on a one to one basis in the conference area adjacent to the private patient care workstation

• Wireless devices will be stored in the private patient care workstation area and will be picked up there at the beginning of the shift.

• Paper charts will be stored at the patient care workstation

• The Clinical Coordinator will use their shared office on “office days” and be at the patient care station other times.

• The unit secretary will work in the Patient Care station at the PC closest to the Nurse Call master station.

• Purse lockers will have keys – Staff will use locker only during shift returning key and emptying purse locker at the end of shift

• After report the receiving nurse will sign in the the Rauland Nurse Call System

KeycardReader

Kronos ReportConference

LoungePatient

CareStation

ReceptionDesk

People Commissioning Objective

Working with organizational resources to ensure that all staff and

Physicians have novice competency to work effectively and safely with the

New Prentice building, equipment, systems and workflows and to verify

same to senior management.

Practically this means the ability to locate, access, retrieve and use spaces,

systems, equipment and supplies with no delays, no adverse events and

with minimal assistance in urgent situations.

Note: Clinical competence is outside the scope of this charter.

Scope:16 Staff and contractors7124 Total participants (2514 unique individuals)474 Physicians18,537 Training Hours Delivered102.5 Training Hours Developed

New Prentice Women’s Hospital

• 100% of employees completed mandatory training

• 600 training sessions held in September and October

• Training scheduled 6 days/week, 15 hours/day

• 138 trainers participated (primarily patient care staff)

• Over 1300 employees completed 4-18 hours of training

• Electronic Learning Management System used to track enrollment and completion in real time

Training: Our Staff

• Over 300 providers from multiple specialties completed building orientation

• Building tours tailored to individual provider’s specialty and focused on navigating new environment

• L&D and NICU: Multidisciplinary simulation exercises conducted to practice emergency responses in new environment

New Prentice Women’s Hospital

Training: Our Attending and Resident Physicians

People Commissioning Process

Plan Development

Administration

Development Process

Plan Development

Administration

Development Process

Implementation

On-Line Training

General Orientation

Department Training

Implementation

On-Line Training

General Orientation

Department Training

ScopeValidation

Needs Assessment

Strategy

Budget

ScopeValidation

Needs Assessment

Strategy

Budget

Evaluation

Follow-Up

Remediation

Evaluation

Follow-Up

Remediation

Process for DevelopingUnit Specific Transition Training

Conduct Needs

AnalysisUnit & General

Identify & Prioritize Training Needs

Evaluation & Follow-Up

NPWH:Process for

Training Development

Develop Training

ApproachDevelop

Scenarios

Develop Evaluation

Plan

Develop Training Materials

Identify Subject Matter

Experts (SMEs)

Finalize & Communicate

ScheduleIdentify & Prepare Trainers

Conduct Training

Quality Checks

Certification Process

“Patient Move”

Move Logistics Objective

Develop and implement a move plan that takes occupancy of the new Prentice in the most efficient, safe and cost effective manner for the patients, visitors, staff and physicians.

Scope:208 total patients8 laboring mothers49 critical care neonatesDuration: 5 hours

Prentice Women’s HospitalPrentice Women’s HospitalThe Move: October 20, 2007The Move: October 20, 2007

Move Statistics

• Move start –7:43 am

• Average trip –12 minutes

• Patient moved every 2 minutes

• 208 adults and infants moved, including 49 NICU Infants

• Move duration: 5 hours, 1 minute All patients moved safely with no untoward

incidents

Patient Move – ResourcesOver 500 staff and volunteers supported the move

• Patient Movement

• Materials Movement

• Move Route Security & Facilities

• Care Stations

• Diagnostics & Therapeutics

• Communications & Media Relations

• Visitor Management

• Concierge (Orientation to Patient Room & Technology)

• Patient Move Gift Distribution

• Ongoing Operational Support

• Data Management

The Move Plan: Move Sequence Simulated Duration – 5 Hours, 44 minutes

Antepartum (15)est. 9-10 pts.

Post Partum Admissions – 9 New Prentice(Admitting Unit for deliveries occurring in current/new L&D during the move)

Open New L&D and OB Triage(Point of entry all

OB pts. during the move)

Hematology/Oncology Units (15E, 15W then 16E)

Neonatal Intensive Care Unit

NICU PPMothers

Women’s Care Unit

Post Partum Units (12, 11 then 9)

Close CurrentL&D

Close Current LDOU

12:00AM(All patients to L&D)

7:30A

Transfer early labor patients from current L&D to new

PWH L&D

8:00A 9:00A 9:30A 10:00P 11:00A 12:00P8:30A

Deliver and recover remaining patients at current PWH

11:30A10:30A 12:30P 13:00P 13:30P

MoveFinal

Olson Pavilion

New PWH

PWH

Feinberg/GalterPavilions

Chicago Avenue

Superior Street

Huron Street

- Bridges and 2/3 floor corridors

- Tunnels & Lower Concourse Corridors

- Elevators

- Major Care Stations

- Patient Move Route

N

(Note: Incline of Lurie Bridge)

New PWH – Patient Move Route

L&D

NICU

- Doorways (requiring support)

- Privacy Curtains

- Minor Care Stations

- Return Route

Feinberg return Route

PWH Return Route

Lurie Research

Elevator to

basement level

Elevator to ground

level

Across drive

under tent

New Prentice Women’s HospitalMock Move: August 2007

Coordination of resources to validate the department move plans, move sequence - timing and move route

Mock Move Roles– Patients– Family Members– Patient Care Staff - RN’s/PCT’s– Physicians– Unit Secretaries– Patient Escort– Volunteers - Movement of Personal Belongings – EVS - Equipment Cleaning– Elevator Operators– ADT/Navicare Data Input– Move Leads– Command Center Members

New Prentice Women’s HospitalMock Move

Successfully completed the move of

34 patients ahead of schedule!!!

• Allow unit managers control and flexibility

for patient move sequence

• Provide route signage and move staff

identifiers

New Prentice Women’s HospitalMock Move: Lessons Learned

• Scripting of messages to patients/families

• Keep infants in view of Mother

• Separate return route for resources &

equipment

New Prentice Women’s HospitalMock Move: Lessons Learned

New Prentice Women’s HospitalMock Move: Lessons Learned

• Transporter fatigue – maintain

consistent pace and provide

breaks

• Coordination of transportation

equipment

• Care Station strategy &

locations

– Major versus Minor

– Distance between stations

– Emergency Response within Tunnel

Patient Move SimulationThe Simul8 application allowed for the definition of resource

requirements and the implications of assumption adjustments

The Last Baby Born at Old Prentice

Born: 11:43 AM

It’s a boy! 

The First Baby Born in New Prentice

Born: 11:48 AM

It’s a girl!

“Stabilization”

Stabilization Objective

Support Prentice Women’s Hospital departments through the initial stabilization of the facility and operations.

Operations - Optimization -

January 1 - Ongoing

Operations - Optimization -

January 1 - Ongoing

Post Occupancy Assessment

Spring 2008

Post Occupancy Assessment

Spring 2008

Stabilization

October 20 – December 31

Stabilization

October 20 – December 31

StabilizationInitial Dashboard

FACILITY Room Temp

Elevators

Doors

Locks

1. Engineering Solution successfully testing in one NICU pod and successfully implemented throughout.

2. CSS elevator is staying on floor-automatic override currently not available. FM has ordered part.

3. Doors on 15, 16, employee entrance at Chicago Ave.

4. Push-button door hardware on 14-16 clean utility rooms

D.

Stout

SYSTEMS Infant Security (HUGS)

Paging

Phones

1. Alarm data from former Prentice facility establish baseline for normal false alarming

2. NICU code pages were not received by staff in areas on L&D

3. Telephone rollover between 16N and 16S is not reflecting the separate operation of the units

D. Dahmen

C. Colande

r

FFE Equipment 1. Training regarding the location on bed storage room in the lower concourse

D. Stout

SUPPLIES/LINEN 1. Missing linen cart on 15 to support Patient Escort B. Stepien

PHARMACY

FOOD SERVICE

EVS

PATIENT CARE

MD TRANSITION L&D 1. Identify status of L&D multidisciplinary roomsBF

Post Move Operations Stone Stabilization

Overall Detail Follow-Up BIC

Physical Facility• Scope of issues decreasing each week• Open items may require funding to address

Technology• Scope limited to the following systems:

• HUGS• Wireless Devices - Dead Zones• Nurse Call - Emergent & Urgent Notification

Security• Scope limited to the following:

• Floor Access• Infant Security

Supplies & Linen• Scope of issues decreasing each week

• PAR Levels• Size of Clean Utility Rooms

StabilizationOperating issues that exist as a result of the move to Prentice

Women’s Hospital

Environmental Services• Scope primarily focused on operations:

• Room turn• Cleanliness

Food Service• Minimal issues

• Tray Pick-Up

Pharmacy• No Issues

Work Flow• Reception Desk - Information Flow• Decentralized Patient Care Center - Work Flow & Information Flow• Patient Escort - Information Flow & Scope of Support• Labor & Delivery - Multidisciplinary Work Flow & Information Flow

Stone• Security

“Lessons Learned”

Transition PlanningOver 60 Vice Presidents, Directors and Managers provided feedback

on the Transition Planning Model/Process

Role:Not

Successful       Successful

Critical Success Factors

"What was done well and should be replicated/?”

Lessons Learned"What should we do

differently?"  

Date: 1 2 3 4 5

Department Readiness              

Technology Readiness              

Operations Readiness              

Staff Readiness              

Patient Move              

Stabilization              

Prentice Women’s HospitalMajority of users ranked the Transition Planning process favorably.

Successes

• Executive sponsorship of Task Forces and Activation

Teams highlighted TP as an organizational priority

• TP activities aligned with existing organization structures

• TP structure included individuals involved in earlier planning

efforts (strategy/program/design)

• Overall, consistent management structure from design

through TP

• Strong attention to detail and coordination

0.0

20.0

40.0

60.0

80.0

100.0

120.0

140.0

160.0

1 1.5 2 2.5 3 3.5 4 4.5 5

1% 0% 1%

11%

2%5%

46%

8%

27%

81% Rated 4 or Above

Not Successful Successful

Opportunities

• Appreciate implications of new design and recognize

impact of “change” on users

• Department infrastructures need to be solid to support daily

operations so Directors/Managers can focus on TP activities

• Appreciate the scope of user involvement during the six

months prior to opening (estimate 20 hours/week)

• Operating Pilots/Training/Migration – Patient Move Planning

• Department buy-in to TP process optimizes outcomes

0.0

5.0

10.0

15.0

20.0

25.0

30.0

1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful

Department ReadinessPreparing the environment for patient care/operations

2% 0%

14%

3%

48%

7%

24%

0%2%

79% Rated 4 or Above

Successes

• Early access to the facility to support department transition

& readiness

• Adequate time to prepare the facility for operations (3

months)

• Scope of equipment/furniture migration was minimal

• Strong attention to detail and coordination

Opportunities

• Department Readiness Assessment Tools were too

cumbersome for users

• Accurate data-base of open issues to focus resources and

follow-up (e.g. delayed Sentact issue close out)

• Clearly define purpose of Environmental Testing and what the

strategy will be to respond to results

• Focus on PAR level planning – understand staff behavior

related to supply management

• Audiovisual coordination and installation

Department ReadinessBuilding Readiness

Successes

• Campus Development oversight and leadership of building

commissioning in developing plan for operation of facility and

related systems.

• Earlier department transition provided heightened state of

control, ownership and awareness of facility

• Environmental Services oversight/implementation of building

clean phases (post construction to patient ready cleans)

• Dedicated NMH Security to oversee access control and

respond to staff/vendors/contractors

Opportunities

• Clarification and consistent use of definition of “patient

ready’ state following IDPH

• Trigger operations to support patient environment –

e.g. implement OR restrictions, ICRA standards, etc…

• Leverage planned security systems to enhance control pre-

move (e.g. activate key card readers and individual employee

key card privileges)

• Maintain access control throughout evolving phases of

readiness

• Clearly define access criteria and assure

organizational support of this criteria during each

phase (e.g. building readiness, department readiness,

staff readiness and patient readiness)

• Coordinated key strategy consistent through design,

construction and activation phases

• Building standard key strategy to support design

• Simplified key structure (keys/tokens/punch lock…)

• Appreciate resource intensity of key

production/distribution

Department ReadinessFFE

Successes

• Continuity of staff and knowledge

• Planning to Procurement to Installation

• Consultants, FFE team, TP team

• Importance of teamwork

• Focus on common goal (patients first & schedule)

• Clearly defined schedule, budget & related requirements

• Executive sponsorship

• Monthly progress updates on issues/budget/schedule

• Alignment with organization structures – strengths

• Materials Management – Group Purchasing

Organization

• Maintenance Staff – Biomedical Engineering &

Facilities Management

• NMH relationship with vendors

Opportunities

• Assign dedicated staff to invoice payment

• Assignment to other tasks may impact the

prioritization of invoice payment

• Appreciate the disposable supplies required for the selected

equipment

• Supply changes are needed to support updated

models of same equipment (e.g. fetal monitor probes)

• Build inventory to support availability of supplies for

operational opening

• Understand potential increases in supply cost

• Pursue earlier training for new equipment

Department ReadinessBuilding Load

Successes

• Team Integration (FFE/Tech/Biomed/Security/

Consultants/Campus Development…)

• Bridge between procurement team and load

team

Procurement Data Installment Support/Management

• Early integration of IT into the load planning process

• Daily debrief and planning sessions during

implementation

• Clear turnover of building from CM at the time of substantial

completion

• Regulatory preparedness

• Leverage of procurement data and readiness/load work

plans to populate Department Readiness Assessment tool

• Off-site warehousing and dedicated labor to support material

movement

• Disciplined approach to decision milestones related to

procurement (e.g. May 31 decision deadline)

• Centralize management of training

• In-house Environmental Services team

Opportunities

• Earlier user engagement with the data and tools to better

mitigate changes and improve readiness assessment

• Sustained AE engagement through equipment procurement

to respond to infrastructure and architectural layout

implications of equipment selection

• Clearer and earlier understanding of FF&E regulatory

readiness expectations (e.g. FF&E needed to support IDPH

“patient ready” terminology)

• Ensure equal buy-in of integrated process by all

stakeholders

• Earlier Academy involvement for better new equipment

training coordination

• Management of early install (existing facilities) scope creep

should be more disciplined

Department ReadinessMigration

Successes

• Clear understanding of the scope of migrating items

and the commissioning/certification needs

• Processes and schedule responded to this scope

• Alignment of migration plans with the overall patient move

plans – e.g. NICU physiology monitors

• Leveraged equipment database and asset database to

maximize quality

Opportunities

• Inpatient move and migration was complex: more time

should be spent on migration

• Incorporate migration planning into user group

process

• Appreciate staff’s personal attachment to office contents

Department ReadinessReadiness Assessment

Successes

• Leverage of existing processes to report and respond

to identified issues (e.g. Sentact)

• Proactive issue identification/resolution in support of

critical project milestones (e.g. regulatory review,

environmental testing, patient move…)

• Prioritization of issues resulted in development of

focused resolution plans

• Reinforced staff comprehension to department

environment

Opportunities

• Leverage opportunity to create a consistent database

throughout project design, activation and post move (e.g.

room data sheets)

• Simplify assessment tool and process for users

• Provide sample of standard room layout for users to refer to

• Clearly define individuals and coordinate process to assure

issues are resolved in the most timely manner

• Pursue consistent database for reporting and monitoring IT

and support service related issues

• Reinforcement of a consistently clear definition for “move

critical” issues

• Enforcement of existing operating procedures to close out

issue tickets as they are resolved

• Define “true” scope of issues

• Target resources where needed

• Provide users with a “source of truth” of issue status

Technology ReadinessAssuring technology was ready to support patient care/operations

0.0

5.0

10.0

15.0

20.0

25.0

30.0

1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful

2% 0% 3%

15%

3%

44%

8%

24%

0%

76% Rated 4 or Above

Successes

• No unproven technology – use of pilot project approach

• Technology team support and their attention to detail

• Early decision making with user involvement

• Cross team communication

• Integration with Task Forces and Activation Teams

• Technology testing and pre-move sweep of devices

Opportunities

• Manage scope of new technology

• Evaluate opportunity to phase implementation

pre-move/move/post-move

• Technology integration earlier in design process (e.g. systems,

devices…)

• Integration of building and technology systems and the operating

impacts (e.g. HUGS, ASCOM)

• Evaluate scope of operating dependencies on the scope of wireless

technology

• Increase scenario testing pre-move

Technology Readiness (cont.) Assuring technology was ready to support patient care/operations

Successes

• Technology engagement early and often

• IT TP Director involved early and throughout

• Infrastructure design

• End user workflow and activation team participation

• Building commissioning

• Building load (IS devices, FFE and biomedical

equipment)

• Move coordination

• Stabilization availability and support

• On site staging location for devices

• Test in production environment

• Technology leadership commitment during homestretch

• Single point of contact to support coordination and

integration of activities

• Technology Move War Room support model

• Flexibility and fluidity

Opportunities

• Technology presence from programming – design –

construction – activation (e.g. consistent floor captain

involvement)

• Pilot new technologies in lab environment (e.g. mock-ups) to

respond to limited infrastructure in existing facilities

• Build flexibility into load/commissioning schedule to respond

to coordination elements

• Cross connects

• More time for device load/install/biomed certification

• Less time for testing in new facility

• Clear network specifications to support FFE procurement

• Monitor vendor compliance

• Coordination of furniture delivery with device placement

process

• User review of device placement earlier in process

• Consistent documentation from design to

implementation

• Validate placement in situ prior to completing

installation

• Cable management

Operations ReadinessConfirming/validating operations and work flows

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful

0%7%

12%7%

62%

5% 8%0% 0%

75% Rated 4 or Above

Successes

• Executive sponsorship

• Activation Team and Task Force structure

• Multidisciplinary involvement

• Early involvement of staff

• Early access to facility to build/validate workflows

• Transition Planning team support

• Attention to detail

• Benefit of detailed planning realized post-move

• Current service assessment facilitated development of future

service assumptions

Opportunities

• Workflows and operating models should be clear prior to design

• Stakeholder buy-in early with early focus on implementation

• Identify areas of risk and provide focused readiness attention

(e.g. emergency response, infant security…)

• Appreciate design impact on staff – “scope of change”

• Understand operating budget implications related to operating

assumptions/design earlier

• Define gap and work through prior to entering budget cycle to

facilitate recruitment initiatives

Operations Readiness (cont.)Confirming/validating operations and work flows

Successes

• Budget tool to project FTE’s based on new program,

expansion of existing programs, building design…

• Budget process fostered a sense of operating reality

with the planned/assumed work flows

Opportunities

• Appreciate flows will evolve post move and provide

supports to facilitate this process

• Monitor volumes annually and identify space/design

implications

• Appreciate Transition Planning structure cannot replace/

supplement operations structure

• Overall engagement of physicians

• Engage Campus Development representation on Activation

Teams to support validation of design to recommended work

flows

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful

People CommissioningPreparing staff to work in their new environment

0% 0% 3% 3%

59%

8%

24%

0% 2%

91% Rated 4 or Above

Successes

• Early Academy support and involvement

• Organizational support and resourcing of training effort

• Training expertise and systems infrastructure

• Model enable departments to drive unit specific training

• Technology/equipment incorporated into unit training

• Early access to facility

• Ability to use facility as a classroom

• Coordination: building load and technology readiness

• Appeal on cognitive and affective level

• Flexibility

Opportunities

• Appreciate design impact on staff – “scope of change”

• Physician involvement and engagement

• Success or failure dependent on infrastructure (inconsistent wireless device

function)

• Inconsistent vendor equipment training

• Pilot new systems in existing facility – or – test environment

• Increase communication throughout project with targeted communication 9-

12 months prior to move

Patient MovePlanning and executing the patient move to the new facility

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

1 1.5 2 2.5 3 3.5 4 4.5 5Not Successful Successful

0% 2% 0%

14% 11%

73%

0% 0%0%

98% Rated 4 or Above

Successes

• Attention to detail

• Broad, inclusive planning process resulted in many experts

• Technology engagement

• Department and physician ownership of individual move

plans

• Mock moves and simulation

• Consistent principles guided the entire move planning process

and implementation

• Leveraged existing processes and policies to the fullest extent

• Family/Visitor awareness and support

Opportunities

• Reliable communication tools/systems used on move day –

inconsistent function (e.g. wireless devices, radios…)

• Artificiality of mock-move renders the execution extremely

challenging

• Appreciate the need for flexibility to support clinical decision making

• Deploy resources earlier on move day

• “Machine is large and slow to start”

Patient MoveCommand Center

Successes

• Integration of Facility Readiness/Operations

Readiness/Move Readiness into one oversight model

• Leveraged existing HEICS model

• Provided process to assure consistent issue reporting –

prioritization – resolution resourcing

• Design of communication focused users on their scope

of responsibility – targeted distribution of information to

individuals who had the authority to address/resolve

• Limited problem solving in silos

• Availability of on-line move dashboard displaying real-time

data throughout move

Opportunities

• Maintain attention to detail and heightened focus until last

patient moves

• Natural instinct of staff to report issues directly into

Command Center - consider locating Department Readiness

issue reporting in Command Center versus decentralized

location

0.0

5.0

10.0

15.0

20.0

1 1.5 2 2.5 3 3.5 4 4.5 5

Not Successful Successful

StabilizationSupporting facilities/operations through issue reporting/resolution

15%

13%

38%

8%

21%

4% 2%0%0%

67% Rated 4 or Above

Successes

• Hospital operations structures and processes were aligned

with Transition Planning effort and therefore, were positioned

well for the early transfer of oversight

• Stabilization meetings provided users with sense of focused

issue resolution

• Senior Management engagement and support

Opportunities

• Structure should respond to facility/system issues as well

as operating/process issues

• Align Activation Team structure with stabilization activities

• Assess areas of high-risk and implement stabilization

processes prior to opening

• Communicate stabilization structure/process pre-move to

support VP/Director/Manager schedules post-move

• Anticipate capacity issues

Transition PlanningSummary

• A detailed/comprehensive/integrated planning effort positions an organization for a successful opening

• Leverage existing organization structures/processes/procedures – but…– Identify that there is a need to pursue consistency to assure success

– Procurement– Training– Move Plans

• Integrate “Activation” Readiness into Design and Facility Readiness effort to assure conceptual plans and assumptions are fully realized– Operating Assumptions/Work Flows– Operating Budget– Building Readiness– Technology Readiness– Department Readiness– Staff Readiness/Training