Mission Health System: True Morse, Director of Facility Planning

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With technological advances, increased patient loads and healthcare facilities merging or consolidating, building expansion is a major focus of most American healthcare systems.  Mission Health System, in Asheville, North Carolina, has building expansion and transition down to an art.

The health system has a total of 873 beds, more than 600 physicians and about 6,000 employees at its location in Asheville.  Mission Hospital is the primary facility with two adjoining campuses and other off-site facilities along with  involvement in three community hospitals.   Mission serves as the tertiary medical center for the 20 counties of western North Carolina.

The hospital’s largest current project is building a 117,000 square-foot outpatient cancer center. This $59 million project is expected to be open by 2012. As a companion project, the hospital is also widening and extending a public road to create better connectivity between the hospital campus and the cancer center.

The health system also added a new wing for surgical services and critical care to its Memorial Campus. This new space replaced outdated facilities and allowed more room for advanced technology. Mission also has other smaller expansion, renovation and ambulatory projects.

Building with a vision

All building projects start with Mission’s strategic plan.

“All projects are considered within our overall capital capacity,” said True Morse, Director of Facility Planning. “From that point, we work closely with business leaders in the operations side of the house to match the program and scope with our business needs.”

Project leaders stay aware of budget throughout the building process, including budget requirements for the transition process.

“For projects over $250,000, we obtain initial planning funds to arrive at a preliminary scope so that the budget obtained in the previous fiscal year is a firm budget, not conceptually based,” he said.

Once the new facility is ready to be occupied, Mission has a detailed process for transitioning from one facility to the next. The first step is identifying all departments impacted by the move and speaking with them on how they will be affected.

“We have routine accountability meetings with leaders up to the occupancy date to assure that the public and internal staff are aware of what is going on and why,” Morse said. “In clinical and nonclinical areas, we identify actions that need to take place, whether staffing or scheduling, to assure they support  the occupancy itself and post-occupancy startup. We begin planning in the budget year prior so that any budget impacts are reflected in those departments’ requests.”

Building with growth and flexibility in mind

Technology is growing rapidly, creating challenges for existing building space and for planning growth in new facilities. New facilities can easily be in place for years, and planning construction projects with the ability to grow as technology changes is key.

Morse said the primary impact of technology on construction is in floor dimension and space above the ceiling to house advanced technology that requires greater airflow, as well as room for data distribution.

“Our drivers for flexibility are column spacing, floor to ceiling height, and the basic footprint of plumbing and HVAC to allow upgrades to technology in patient rooms,” Morse said. “From a design standpoint, we assure to the best of our ability that we increase the space provided so that the day we open, we have not consumed all the space.”

One area Morse anticipates technology growing and impacting design is in pathways for data and power.

“We want to make sure we have capacity to add things later in those concealed areas,” he said. “We put in a percent factor for growth to accommodate unknown future needs.”

He said after Facility Services, Information Systems is the next department with which his team works closely.

“We have routine meetings with them to review all facility initiatives because of the impact they have on our data center’s capacity to move data,” he said. “As we work on distribution cabling, we work closely with them on matching projected size and needs of the facility with their ability to move data.”

This is especially important as the system moves toward a more and more integrated electronic medical record. Where caregivers once had individual pieces of paper that were dispersed among them and then added to the combined patient record, now they need access to a computer terminal to interface with the medical record.  This means many more computers for access, either at desk locations or mobile locations.

Throughout the planning and construction process, Morse said there is always a direct tie to Mission’s strategic goals. This helps ensure that strategic initiatives are supported with the new facility design. For example, Mission has embarked on a safety initiative to achieve zero preventable harm within three years.

“Achieving this initiative has a ripple effect in analysis and clinical approaches and how we design the facilities,” Morse said. “We look at space and workflow to ensure the facilities themselves do not impact, but more importantly support the goal of zero preventable harm.”

Mission has developed a successful, detailed process to manage construction projects from initial planning all the way through occupancy. He stresses that the keys to success are maintaining a direct tie to the organization’s strategic goals and tracking projects through  all phases on performance dashboards to ensure Mission is adhering to budget and schedule.

-by Patricia Chaney

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