IU Health: Joe Arruda, Vice President of Design, Construction, and Supply Chain Operations, and Shayda Bradley, Executive Director of Design and Construction

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Indiana University Health is Indiana’s most comprehensive healthcare system and is comprised of over 20 hospitals. It also has health centers, partners, affiliates, and joint-venture operations. The system has more than 2.2 million admissions and outpatient visits annually. Overseeing supply-chain management and facilities construction of a system this size is a daunting challenge.

Joe Arruda, vice president of design, construction, and supply-chain operations, is responsible for managing costs related to the supply chain as well as standardizing design and construction. His team is focused more on ways to improve the patient experience in order to meet the needs of patients and the requirements of payers instituting value-based purchasing.

Creating a healing environment

While not involved in direct patient care, the design, construction, and supply-chain team can contribute to patient satisfaction in significant ways. For example, a seemingly small change that can have a big impact on patient-satisfaction scores is replacing the wheels of the carts in hospitals.

“We challenge our staff to look at how to better design facilities from a healing perspective,” Arruda said. “As a patient trying to sleep, if you hear a cart in the evening, it can be disturbing. Even replacing the wheels to provide a quieter environment allows for better healing.”

Creating a healing environment is a shifting focus from previous years of hospital design, when facilities tried to incorporate luxury hotel-style features. Now, the trend is to look at what heals the patient and affects all the senses–aroma, paint colors, natural light, and noise.

Furniture for patients and families is another contributor to satisfaction, and IU Health has partnered with Kimball Office Furniture, based in Indiana, to develop furniture solutions that create a better environment. Kimball designers have toured the hospitals with executives, talking to staff and patients about value-added features and needs for family members and patients in order to identify ways to increase comfort.

Standardizing design and construction

In the future, to help manage costs and consistency across the facilities, IU Health is looking at ways to standardize construction and design across all entities and new projects. This includes implementing a building standard with specific features so that patients will feel comfortable and familiar in any IU Health facility.

To develop standards, reduce costs, and increase value, Shayda Bradley, executive director over design and construction, said IU Health is considering a partnership with a limited number of architectural firms and general contractors that embrace this approach. This strategy would allow IU Health to educate firms and contractors about the healthcare environment and have those partners brainstorm ways to achieve further efficiencies on their end.

“Construction is more stringent in healthcare,” Bradley said. “It is a challenge to get architects and general contractors focused on the patient versus focusing on the single project.”

Bradley said her department has also recruited an employee in design and construction to focus specifically on the customer experience. This employee connects with IU Health patients and families, bringing back suggestions that can be incorporated into future designs with the goal of improving healing and patient-satisfaction scores.

“We cannot assume that our historical perceptions are correct without talking to patients and families,” Arruda said. “We need to pause and listen, check and validate, and retool independent of cost. We can find creative ways to design and control costs.”

Furthermore, since it is such a large system, IU Health is beginning to directly negotiate contracts with manufacturers of building materials on items such as flooring, lighting, air handling units, and services for multiple facilities.

As many health systems have found, Lean Six Sigma creates standardized processes, measurable returns on investments, and cost reductions. IU Health is implementing the Lean process management philosophy and Building Information Modeling (BIM) in the design of new construction projects.

Given the economic times, Arruda said that future investments will be more closely examined to evaluate community benefit and improved outcomes for their patients. The health system may proceed a little more cautiously and re-examine investments in its 10-year strategic plan.

Embracing sustainability

IU Health is looking for ways to implement more green initiatives both in new building projects as well as existing facilities. One recent project is the Riley Hospital for Children at IU Health’s Simon Family Tower, a 10-story inpatient building. The $475-million expansion will increase access to children’s care at IU Health and is part of a $500-million 10-year strategic plan for the children’s hospital.

The first phase of the tower opened in January 2012, and the entire project is scheduled for completion in 2013. The tower is working toward attaining Leed silver certification.

“By having our facilities Leed-certified, we are creating a healthier environment for our patients, more productive employee work spaces, and reducing environmental impact to our community,” Bradley said.

However, even without pursuing certification, IU Health achieved approximately 40 credits for sustainable features in the IU Health Saxony hospital that opened in December of 2011.

With the future moving toward value-based purchasing, all design and construction initiatives keep patients and their families in “top of mind.” Arruda’s team works with nurses, physicians, and staff to interview patients and to spend 24 hours with them and understand their experience.

“We try to determine what the patient goes through and design accordingly,” he said.

-by Patricia Chaney

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