Geisinger Health System: William Gladish, AIA, Director of Construction

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As clinical care is shifting toward a focus of decentralized decision making, so facilities construction is following a similar track toward teamwork throughout the entire process.  Many facilities recognize the importance of bringing in members of a design and construction team early to establish expectations and priorities.

Geisinger Health System in rural Pennsylvania has perhaps mastered this team approach better than other health systems.

“We think the best way to have great results is to have a great team,” said William Gladish, AIA, director of construction. “We need to bring in participants early and make sure they are compatible with our designers and have a philosophy that fits ours.”

Geisinger’s facilities group is broken into planning, design, and construction. Gladish and others in the group have experience acting as general contractors on smaller projects for the health system. This gives them detailed insight on what to look for in partners.

Geisinger employees about 13,000 people across two major hospitals and a number of clinics and other facilities spread over about 40 sites in northeastern Pennsylvania. The facilities group has about 30 people and receives numerous requests for upgrades, new equipment, expansion, and other construction projects.

The smaller projects can be handled by the in-house architects and engineers. Gladish and his staff act as general contractor utilizing internal superintendents, project coordinators, project managers, and laborers. For larger projects that would consume all of the internal resources, Geisinger goes outside.

Award-winning teamwork

Geisinger received the 2010 Vista Award for New Construction for its Critical Care Building at the Geisinger Wyoming Valley Medical Center site. The Vista Award is presented by the American Society for Healthcare Engineering of the American Hospital Association and the American Institute of Architects Academy of Architecture for Health and recognizes teamwork in healthcare design and construction.

This new building increased the campus size by about 50 percent. The building attained LEED silver certification and houses a level 2 trauma center. The project began in 2005 and ended in 2008 and came in $2 million under budget. Even President Obama praised Geisinger for its ability to provide quality, cost-effective care.

Gladish attributes the organization’s success to teamwork and communication.

“People at the top and the bottom must understand each other,” he said. “In facilities, we’re in the middle. We need to understand what the executives are doing, and they need to understand our concerns. With a new building, it’s the same. You establish a team and communicate. The people at Geisinger do a good job of communicating what they are trying to accomplish.”

A commitment to sustainability

Gladish said the health system has a commitment to teamwork and sustainable elements. All new buildings must be LEED certified, and nearly 10 existing buildings have some LEED certification.  In addition to new construction, Geisinger has retrofitted existing facilities to be more energy efficient.

“We think that LEED certification serves our purposes well,” Gladish said. “We are a cost-driven organization, and most things you do to attain certification end up saving money in the long run. We have been doing this in the organization for years and have seen energy reduction, which saves money. We have done cost studies that demonstrate a return on investment.

“Although meeting the requirements for LEED certification can increase the budget up front, once your investment is recouped, the organization can reap the savings for years to come.”

Being flexible for the future

As with all healthcare organizations, Geisinger is looking toward the future for flexibility, expansion needs, new technology, and what it all means for the organization.

“We have consistently seen a demand for more beds, a trend toward more high-tech equipment,” he said. “We have to ensure we have enough electricity and the chilled-water capacity to provide cooling. We have to be positioned to be quick and nimble to deal with the changing technology.”

Gladish said it’s difficult to predict future space requirements because buildings must last for decades and hospital priorities can change in that time. Cardiology and oncology have grown in the past 20 years, while other specialties have become less prominent.

Gladish said facilities design needs to plan for the proper space and be ahead of the curve, but at best they can plan for adequate utility capabilities and flexible space. Again, he stresses, communication of intent and openness is the key.

-by Patricia Chaney

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