Improving Healthcare through Built Environment Infrastructure

"The built environment for the delivery of Healthcare will continue to change as it responds to new technologies and modalities of care, different expectations and requirements of providers and consumers of care. It is vital that built environment students and practitioners alike avail themselves of the best possible information to guide them in their studies, continuing professional development and the delivery of their tasks. The range is enormous from the assessment of need, planning the service delivery to design, construction, commissioning, maintenance and operation of the healthcare environment. The book that follows addresses these areas from a blend of contributions of experienced practitioners to the descriptions of the output from recent research that moves forward the frontiers of knowledge and practice in the many areas of the healthcare built environment. I happily commend this book to all engaged in the exciting fields of planning, delivering, maintaining and operating healthcare environments. When we get it right, we are able to do immeasurable good." —From the Foreword by Rob Smith, Director of Estates and Facilities (NHS England), Department of Health This book helps academic researchers as well as practitioners to understand how the healthcare infrastructure sector works by addressing the crucial issue of healthcare delivery from a built environment perspective. It explains the trends in healthcare, models of healthcare delivery; healthcare planning; the NHS building and investment programmes; the procurement process; and facilities management; financial models – including PFI and LIFT; risk allocation and partnering. Past investigations in the area of healthcare delivery have concentrated on either the medical aspects or the design issues of buildings but Improving Healthcare through Built Environment Infrastructure is unique in considering the 'meeting space' of built environment technologies and modern methods of procurement with the medical and operational needs of healthcare settings. The authors have brought together key industrialists and academics, all heavily involved in the formulation and delivery of new practices. Case studies illustrate how policies and healthcare models are implemented in practice and help identify the key challenges for the future.

About the Editors x About the Contributors xi Foreword by Rob Smith, Director of Estates and Facilities (NHS England), Department of Health xxi Acknowledgements xxiii 1 Introduction: Improving Healthcare through Built Environment Infrastructure 1 Mike Kagioglou and Patricia Tzortzopoulos 1.1. Part 1: Practitioner contributions 2 1.2. Part 2: Academic contributions 3 Part 1 Practitioner Contributions 7 2 Planning Healthcare Environments 9 Duane Passman 2.1. Introduction 9 2.2. Background and history 9 2.3. The planning landscape 13 2.4. Policy developments since 1997 14 2.5. Capital procurement methodologies and NHS organisations 20 2.6. Settings for healthcare 26 2.7. Supply-side considerations 30 2.8. Demand side 35 2.9. Design and the physical environment 37 2.10. Conclusion 38 3 Plan for Uncertainty: Design for Change 40 Susan Francis 3.1. Introduction 40 3.2. Context 40 3.3. Impact on the built environment 41 3.4. Optimising design 45 3.5. Future proofing design 47 3.6. Design matters 49 3.7. Measuring design quality 50 3.8. Final remarks: making places 51 4 Designed with Care? The Role of Design in Creating Excellent Community Healthcare Buildings 53 Kate Trant 4.1. Introduction 53 4.2. Why does design matter? 54 4.3. What makes a good healthcare building? 61 4.4. Final remarks 70 5 The Stages of LIFT – Local Improvement Finance Trust and Delivery of Primary Healthcare Facilities 71 Richard L. Groome 5.1. Introduction 71 5.2. The LIFT process 72 5.3. Cultural differences 82 5.4. Conclusions 83 6 The Integrated Agreement for Lean Project Delivery 85 William A. Lichtig 6.1. Introduction to Sutter Health 85 6.2. Integrated form of agreement 86 6.3. Traditional responses to owner dissatisfaction with the status quo 86 6.4. What is lean? 87 6.5. The application of TPS principles to design and construction 88 6.6. Sutter Health's formulation of a lean project delivery strategy 90Contents vii 6.7. Development of the integrated agreement for lean project delivery 92 6.8. Conclusion 100 7 The Sutter Health Prototype Hospital Initiative 102 Dave Chambers 7.1. Getting started 103 7.2. Goals and metrics 106 7.3. Design 107 7.4. Results and conclusion 108 8 The Strategic Service Development Plan: An Integrated Tool for Planning Built Environment Solutions for Primary HealthCare Services 109 Ged Devereux 8.1. Introduction 109 8.2. Background 109 8.3. The development of primary care 111 8.4. The role of the built environment in delivering primary healthcare 114 8.5. The origins of the strategic service development plan 117 8.6. A comparative case study of the MaST LIFT SSDP 119 8.7. Conclusion 126 8.8. Recommendations 126 Part 2 Academic Contributions 129 9 From Care Closer to Home to Care in the Home: The Potential Impact of Telecare on the Healthcare Built Environment 131 James Barlow, Steffen Bayer, Richard Curry, Jane Hendy and Laurie McMahon 9.1. Introduction 131 9.2. Key trends 132 9.3. What is telecare? 133 9.4. The impact of telecare on care services 134 9.5. Implications for the healthcare built infrastructure 135 9.6. Conclusion 137 9.7. Acknowledgements 138 10 Risk Management and Procurement 139 Nigel Smith, Denise Bower and Bernard Aritua 10.1. Introduction 139 10.2. General principles of risk management in infrastructure procurement 140 10.3. Risk and procurement routes 144 10.4. Risk in NHS procurement 146 10.5. Multi-project procurement 147 10.6. Sustainable NHS procurement options 148 11 Supporting Evidence-Based Design 151 Ricardo Codinhoto, Bronwyn Platten, Patricia Tzortzopoulos and Mike Kagioglou 11.1. Definitions 152 11.2. The built environment and health outcomes: considerations about evidence-based design 153 11.3. Searching for evidence 154 11.4. Healthcare environments and impacts on health 157 11.5. Organising information 159 11.6. Conclusion 163 11.7. Acknowledgements 164 12 Benefits Realisation: Planning and Evaluating Healthcare Infrastructures and Services 166 Stelios Sapountzis, Kathryn Yates, Jose Barreiro Lima and Mike Kagioglou 12.1. Introduction 166 12.2. Benefits realisation 167 12.3. Research methodology 169 12.4. BeReal model overview 172 12.5. Case studies 178 12.6. Conclusions 192 12.7. Acknowledgements 193 13 Achieving Continuous Improvement in the UK Local Improvement Finance Trust (LIFT) Initiative 196 A.D. Ibrahim, A.D.F. Price and A.R.J. Dainty 13.1. Introduction 196 13.2. Continuous improvement concept 199Contents ix 13.3. Research method 202 13.4. Results and discussions 203 13.5. The development of a generic continuous improvement framework for LIFT 206 13.6. Application of CIF within LIFT procurement 207 13.7. Conclusions 211 14 Performance Management in the Context of Healthcare Infrastructure 216 Therese Lawlor-Wright and Mike Kagioglou 14.1. Introduction 217 14.2. Organisational performance measurement systems 217 14.3. Building performance assessment 218 14.4. Contribution of infrastructure to performance of healthcare organisation 222 14.5. Conclusions 225 14.6. Acknowledgements 226 15 Hard Facilities and Performance Management in Hospitals 229 Igal M. Shohet and Sarel Lavy 15.1. Components of healthcare facilities management 229 15.2. Key performance indicators in hospital facilities 232 15.3. Research methods 236 15.4. Analysis of a hospital using the indicators developed – a case study 238 15.5. Discussion 246 15.6. Towards a maintenance performance toolkit 246 16 Community Clinics: Hard Facilities Management and Performance Management 249 Igal M. Shohet 16.1. Introduction 250 16.2. Clinic facilities 253 16.3. Profile of clinic facilities 260 16.4. Hospital facilities versus clinic facilities – comparative perspective 263 16.5. Concluding remarks 264 References 265 Index 267