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HOSPITAL DESIGN & BUILD
Master Planning: “Festina lente” Simon Thomas Director of Healthcare Planning for AECOM, Asia
Master Planning services are as diverse as the hospitals and medical campuses they can be commissioned to study. Ranging in duration from several weeks to several months the scope of services and depth of study varies considerably. The most important factor of any Master Plan is the need for one to exist and for it to be maintained as the campus grows. Without a guiding map the development will likely be fraught with inefficient capital investment, as well as a facility that will struggle functionally to support the people using the spaces.
Healthcare facility owners understand that it is a virtually impossible task to stay ahead of the curve in preparing for change. Healthcare delivery and clinical technology are changing ever more rapidly and they are increasingly impacting the physical considerations of buildings. However, a rapidly changing landscape is the prime reason to maintain a Master Plan, not to shy away. The Latin expression “festina lente” or “(the) more haste (in preparation), (the) less speed (in implementation)” conveys the pitfall of rushing to build. Taking time to carefully prepare and map will always result in a smarter approach.
In the United States, where I have my professional experience, among the challenges of developing a strong Master Plan is the fact that facilities are often older, have grown over several decades and may not have maintained a relevant Plan. Untangling decades of development presents many professional challenges. In Asia, and India where I am now based, healthcare architects are being pressed to design facilities or entire health cities very quickly, often from the ground up. Speed to market becomes a big driver for many. Visionary owners will see that taking time ahead of the rush to build will enhance the continued development of the business. A complete Master Plan will include several key ingredients. The following elements should be tailored based on the level of detail contracted for the Master Plan but should always be part of the Plan.
Owner Vision: Every great project requires an owner who has a clear vision. The Master Plan must capture the owners’ vision in order to ground the entire process in the essence of why the owner is in business. Although most owners will have documented their vision and mission statements before talking with an architect, it is important for the whole team to understand and share this commitment.
Strategic Goals: Beyond the vision, specific goals should be documented that impact the focus of the Master Plan such as establishing Centers of Excellence or other targeted areas of development, expansion or even contraction.
Schedule: Master Plans should always be fixed to a time line of implementation. The time line for development should predict the growth of the facility and tie to the financial resources that can be applied for capital investment. Agreed planning horizons should be identified and typically would include short term (0-5 year), mid-term (5-10 year) and longer term (10+ year) goals.
Budget and Cost: Estimates of cost can be made at a level appropriate to the information gathered in the Master Plan. Matching these numbers to budget requires close collaboration with the owner and should be linked to a comprehensive operational assessment, including prioritization of projects, funding capability (scale, timing, link to revenue projections) and stakeholder interests.
Functional Space Program: The program analysis should document the current operations, tied with the current usage data, and filter these statistics through the vision, goals and schedule out to the planning horizons. The use of internationally benchmarked metrics can allow a seasoned consultant accuracy in predicting department program size. Additional depth of inquiry may overlay discussions of Lean principals and other methods of analysis that will affect operation, function and the space program. This information will help size the building and give the planner and designers the tools needed to shape and test fit options to the site.
Medical Planning: Through creative, evidenced based medical planning concepts, the Master Plan will identify locations for all departments at each planning horizon. Clear planning strategies will allow for departments to right-size, grow or contract over time with minimal cost or function expenditure toward whole-sale relocation of departments or moving sensitive departments such as surgery or central sterile supply.
Design: Some Master Plans will take the opportunity to develop a design language for the campus. Most often for Plans preempting new construction or major expansions, the development of the design can be added to the Master Plan to marry the aesthetic image with the owners’ goals. Rendered images of the campus or key building may also be important for continued marketing and providing a picture of the vision for all stakeholders.
Sustainability: Managing the earth’s resources should go hand-in-hand with healthcare design. Without good stewardship of the environment human health will suffer. This is true at the level of the hospital, the community and beyond. Entwining sustainable design principals with the Master Plan will ensure a vision for health and wellness that extends across the built environment, site resource use and the quest for a net-zero energy use campus.
A rigorous facility Master Plan is as critical a document for an owner as the business plan. Both should be linked in describing the way forward for the visionary owner. Healthcare planning and design is a complex form of the art. Providing a road map, as described and maintained by the Master Plan, will guide on-going successful development. Change is inevitable and can be unpredictable but being prepared with a Master Plan in place will support efficiency cost savings and creating a physical environment that upholds every owners’ vision; a place where people receive care, visit and work, are treated with dignity, caring and compassion, and experience a built environment the enhances and sustains body and soul.
Simon Thomas is Director of Healthcare Planning for AECOM in Asia. Currently working on hospital projects in India and Vietnam, AECOM is committed to supporting owners in the development of exceptional environments for healing and wellness.