2 texas childrens hospital. tch conversion $6.6m initial construction budget (10% contingency...
DESCRIPTION
Computer SimulationTRANSCRIPT
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2TEXAS CHILDREN’S HOSPITAL
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TCH Conversion
$6.6M – Initial Construction Budget (10% Contingency Included)$6.6M – Actual Construction Budget
$13 M – Overall Approved Project Budget$12.6M – Actual Total Commitment To Project
Building Relationships with Community – Metro, Local Council
Managing non-TCH tenants (Dental) – infrastructure heavy & delayed opening timing
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Computer Simulation
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Overview Of Simulation Modeling
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ARRIVAL AT MEDICAL HOME
PT TO SUB WAITING FOR NAVIGATOR
GATHERS ANY SIGNITURES AND
REVIEWS NECESSARY DOCUMENTS
CHECK-IN KIOSKS FOR ESTABLISHED
PATIENTS? 3-5 MINS
SICK CHILDWELL VISITNEW VISIT
%$ WELL VS. SICK
SICK VISIT
WELL VISIT
NEW VISIT
PT TAKEN TO EXAM ROOM
VITALS TAKEN ON WAY LAB
DRAW AR VITALS IF REQ
3-5 MINS
PT TAKEN TO EXAM ROOM
VITALS TAKEN ON WAY 3-5 MINS
PT TAKEN TO EXAM ROOM
VITALS TAKEN ON WAY 3-5 MINS
EXAM VISIT HISTORY & PHYSICAL
TIME BASED ON ESTABLISHED PT
HISTORICAL DISTRIBUTION
5-40 MINS
EXAM VISIT HISTORY & PHYSICAL
TIME BASED ON ESTABLISHED PT
HISTORICAL DISTRIBUTION
5-40 MINS
EXAM VISIT HISTORY & PHYSICAL
TIME BASED ON ESTABLISHED PT
HISTORICAL DISTRIBUTION
10-60 MINS
DISCOVERY OF ISSUE
DISCOVERY OF ISSUE
DISCHARGE IN EXAM ROOM
UNLESS COMPLEX DISCHARD NEEDED 3-10 MINS
TO COMPLEX DISCHARGE AREA FOR
SCHEDULING DIAG OR
TREATMENT10-20 MINS
DISCHARGE IN EXAM ROOM
UNLESS COMPLEX DISCHARD NEEDED 3-10 MINS
TO COMPLEX DISCHARGE AREA FOR
SCHEDULING DIAG OR
TREATMENT10-20 MINS
TO TREATMENT ROOM
20-90 MINS
PATIENT LEAVE MEDICAL HOME
PATIENT LEAVE MEDICAL HOME
THIS SIMPLIFIED FLOW DIAGRAM IS USEFUL TO LOOK AT THE NUMBER OF EXAM ROOMS IN A STANDARD CARE TRACK. HOW WITH THIS FLOW DIFFER FOR PED PATIENTS IN A CENTERING
CONCEPT? WHAT % OF PATIENTS COULD THIS BE?
DID WE WANT TO MODEL PATIENTS HAVING THEIR PERSCRIPTIONS BROUGHT TO THEM IN THE EXAM ROOM, OR
WAITING IN A SUB-WAITING AREA?
TCH MEDICAL HOME PEDI PATIENT PROCESSMODEL - 01/30/2012
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Medical Home – Space Program SummaryTotal Area
50,458 sf Quantity of Rooms
Public Area 3,528 sfPediatric Service Module 8,338 sf 25 Exam Rooms, 2 Consult RoomsOB Service Module 4,726 sf 11 Exam Rooms, 4 Consult RoomsCentering Module 2,030 sf 2 Centering RoomsService Module Support 1,972 sfDiagnostics 5,340 sf 1 Gen Rad, 2 UltrasoundPharmacy 3,074 sfEye Clinic 5,733 sf 4 Exam RoomsDental Clinic 3,560 sf 9 OperatoriesSpecialty Clinic 2,160 sf 4 Observation RoomsMember Education 2,849 sfAdministration 4,874 sfSupport 2,273 sf
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Site Selection
Reflects Pilot Program Preferred Area
-Membership Density-Proximity To Potential Partner Hospitals-Near Major Freeways
site
TMC
CBD
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Vehicular Access- Site Along Beltway Feeder Road- Can Be Approached From Multiple Directions
N
I 45
B 8
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Existing BuildingTCH Medical Home
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Site OrganizationParking1.1=Patient & Public Parking
2.Staff Parking3.Patient Flow from Bus Stop
4.Main Entry5.Public Retail Entry
6.Staff Entry
4
3
65
6
N
1
2
1 2
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Public Areas
1.Main Entry/Drop-Off
2.Public Retail Entry- North/East Natural Light
3.Waiting/Circulation
4.Retail Corridor
3
1a
a
42
3
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Program Plan
3 1a
a
2
Public/Retail/EDU/Admin1.Main Entry/Drop-Off2.Public Retail Entry3.Waiting/Circulation4.Retail Corridor5.Pharmacy6.Dental7.Optometry8.Education9.AdministrationStaff10.Staff Work AreaOB Program Space11.OB Clinic12.CenteringPeds Program Space13.Primary Care Clinic14.Specialty Clinic15.Diagnostics
13
14
15
10
12
1111
89106
57
4
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ReceptionTCH Medical Home
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WaitingTCH Medical Home
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Team WorkstationsTCH Medical Home
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ReceptionTCH Medical Home
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3Lessons Learned
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POE Methodology
(to be provided at learning session)
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POE Results
(to be provided at learning session)
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Common Takeaways – Conversion “Pros”
- Large, open footplate- Opportunity for various ceiling heights / high ceilings- Potential for second floor / mezzanine- Opportunity for skylights- Potential for separate front-of-house and back-of-house - Good visibility from major thoroughfares- Ample parking- Economical investment- Places care directly in the target community - Create a feeder system to or away from hospital campus
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Common Takeaways - Conversion “Cons”
- Inappropriate column spacing - Undersized / shared utilities with adjoining tenants- Usually no emergency generators- Inappropriate / unusable mechanical systems- Low-budget original construction- Poorly documented building alterations over time- Undocumented / undiscoverable existing conditions- Potential limitations to exterior façade changes- Significant saw-cutting for under-floor plumbing- High roof: ceiling-mounted equipment challenging- Security
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Dianna Prachyl [email protected]
Allison Muth [email protected]
Diane Osan [email protected]
Lance Winn [email protected]