Improving Healthcare through Built Environment Infrastructure

From the Foreword by Rob Smith, Director of Estates and Facilities (NHS England), Department of Health ‘The built environment for the delivery of Healthcare will continue to change as it responds to new technologies and modalities of care, different expectations and requirements of providers and consumers of care. It is vital that built environment students and practitioners alike avail themselves of the best possible information to guide them in their studies, continuing professional development and the delivery of their tasks. The range is enormous from the assessment of need, planning the service delivery to design, construction, commissioning, maintenance and operation of the healthcare environment. The book that follows addresses these areas from a blend of contributions of experienced practitioners to the descriptions of the output from recent research that moves forward the frontiers of knowledge and practice in the many areas of the healthcare built environment. I happily commend this book to all engaged in the exciting fields of planning, delivering, maintaining and operating healthcare environments. When we get it right, we are able to do immeasurable good.’ This book helps academic researchers as well as practitioners to understand how the healthcare infrastructure sector works by addressing the crucial issue of healthcare delivery from a built environment perspective. It explains the trends in healthcare, models of healthcare delivery; healthcare planning; the NHS building and investment programmes; the procurement process; and facilities management; financial models – including PFI and LIFT; risk allocation and partnering. Past investigations in the area of healthcare delivery have concentrated on either the medical aspects or the design issues of buildings but Improving Healthcare through Built Environment Infrastructure is unique in considering the ‘meeting space’ of built environment technologies and modern methods of procurement with the medical and operational needs of healthcare settings. The authors have brought together key industrialists and academics, all heavily involved in the formulation and delivery of new practices. Case studies illustrate how policies and healthcare models are implemented in practice and help identify the key challenges for the future.

Table of Contents:
Note on Editors Contributors Biographies Forward (Rob Smith) Chapter 1: Introduction: Improving healthcare through built environment infrastructure (Mike Kagioglou and Patricia Tzortzopoulos) Session 1: Practitioner contributions Chapter 2: Planning healthcare environments (Duane Passman, Brighton & Sussex University Hospitals NHS Trust Brighton, UK) 2.1. Introduction 2.2. Background and history 2.2.1. The Hospital Plan of the 1960’s 2.2.2. The Economic Crisis of the 1970’s 2.2.3. Change in the 1980’s 2.2.4. Further change in the 1990’s 2.3. The Planning Landscape 2.4. Policy Developments since 1997 2.4.1. The NHS Plan, 2000 2.4.2. Delivering the NHS Plan, 2002 2.4.3. The NHS Improvement Plan, 2004 2.4.4. Our health, our care, our say: a new direction for community services, 2006 2.4.5. Our health, our care, our community, 2006 2.4.6. Healthcare for London, 2007 2.4.7. High Quality Care for All, 2008 2.5. Capital Procurement Methodologies and NHS Organisations 2.5.1. Overall Capital Investment in the NHS 2.5.2. The Private Finance Initiative (PFI) 2.5.3. NHS LIFT 2.5.4. ProCure 21 2.5.5. NHS Foundation Trusts 2.5.6. NHS Trusts 2.5.7. PCTs 2.6. Settings for Healthcare 2.6.1. The Home 2.6.2. General Practitioner (GP) Surgery 2.6.3. Larger Health Centres 2.6.4. One stop shops/polyclinics 2.6.5. Community Hospitals 2.6.6. District General Hospitals (DGHs) 2.7. Supply-Side Considerations 2.7.1. Beds 2.7.2. A & E 2.7.3. Outpatients 2.7.4. Imaging 2.7.5. Other Factors 2.8. Demand side 2.9. Design and The Physical Environment 2.10. Conclusion 2.11. References Chapter 3: Plan for uncertainty: design for change (Sue Francis, CABE - Commission for Architecture and the Built Environment London, UK) 3.1. Introduction 3.2. Context 3.3. Impact on the built environment 3.4. Optimising design 3.5. Futureproofing design 3.6. Design Matters 3.7. Measuring Design Quality 3.8. Final remarks: Making places 3.9. References Chapter 4: Designed with care? The role of design in creating excellent community healthcare buildings (Kate Trant) CABE - Commission for Architecture and the Built Environment London, UK 4.1. Introduction 4.2. Why does design matter? 4.3. Building healthy neighbourhoods 4.4. Access to health 4.5. Surprise and delight 4.6. Designed with care 4.7. Open all hours 4.8. Better isn’t good enough 4.9. Must try harder 4.10. What makes a good healthcare building? 4.10.1. Good integrated design 4.10.2. Public open space 4.10.3. A clear accessible plan with one main reception 4.10.4. An environmentally sensitive approach to building design, materials, construction and management 4.10.5. Circulation and waiting areas 4.10.6. Materials, finishes and furnishings 4.10.7. Natural light and ventilation 4.10.8. Storage 4.10.9. Adapting to future changes 4.10.10. Out of hours community use 4.11. Final remarks 4.12 References Chapter 5: The stages of LIFT - Local Finance Improvement Trust - for the development and delivery of primary healthcare facilities (Richard Groome) John Laing plc Manchester, UK 5.1. Introduction 5.2. The LIFT Process 2.1. Project Inception 2.2. Project Set up 2.3. Feasibility 2.4. Stage 1 Approval 2.5. Outline Design 2.6. Final Scheme Design 2.7. Financial Close 2.8. Construction Management Set Up 2.9. Facilities Maintenance (FM) 5.3. Cultural Differences 5.4. Conclusions 5.5. References Chapter 6: The Integrated Agreement for Lean Project Delivery (William A. Lichtig,  McDonough, Holland & Allen California, USA) 6.1. Introduction to Sutter Health 6.2. Integrated form of agreement 6.3. Traditional Responses to Owner Dissatisfaction with the Status Quo 6.4. What is Lean? 6.5. The Application of TPS Principles to Design and Construction 6.6. Sutter Health’s Formulation of a Lean Project Delivery Strategy 6.7. Development of the Integrated Agreement for Lean Project Delivery 6.7.1. Relationship of the Parties 1.7.1. Creating a Collaborative Design and Construction Environment 1.7.2. Articulating and Activating the Network of Commitments 1.7.3. Optimizing the Project, not the Pieces 1.7.4. Tightly Couple Learning With Action 6.8. Conclusion 6.9. References Chapter 7: The Sutter Health Prototype Hospital Initiative (Dave Chambers, Sutter Health California, USA) 7.1. Getting Started 7.2. Goals and Metrics 7.3. Design 7.4. Results and conclusion 7.5. References Session 2: Academic contributions Chapter 8: The Strategic Service Development Plan: An Integrated Tool for Planning Built Environment Solutions for Primary Health Care Services (Ged Deveraux Manchester Joint Health Unit Manchester City Council, UK) 8. Introduction 9. Background 10. The Development of Primary Care 11. The Role of the built environment in delivering primary health care 12. The Origins of the Strategic Service Development Plan 13. A Comparative Case Study of the MAST LIFT SSDP 13.1. Partnership Working 13.2. Planning Process 13.3. Benefits Realisation 13.4. What was learnt? 13.5. Common Themes of the Document Analysis 13.5.1. Partnership Working 13.5.2. Planning Process 13.5.3. Benefits Realisation 13.6. Common Themes from the Interviews 13.6.1. Partnership Working 13.6.2. Planning Process 13.6.3. Benefits Realisation 13.7. Discussion 13.7.1. Partnership Working 13.7.2. Planning Process 13.7.3. Benefits Realisation 14. Conclusion 15. Recommendations 16. References Chapter 9: From care closer to home to care in the home. The potential impact of telecare (James Barlow, Steffen Bayer, Richard Curry, Jane Hendy and Laurie McMahon Imperial College London and Loop2 London, UK) 9.1. Introduction 9.2. Key trends 9.3. What is telecare? 9.4. The impact of telecare on care services 9.5. Implications for the healthcare built infrastructure 9.6. Conclusion 9.7. Acknowledgments 9.8. References Chapter 10: Risk Management and Procurement (Nigel Smith, Denise Bower, Bernard Aritua School of Civil Engineering, University of Leeds Leeds, UK) 10.1. Introduction 10.2. General Principles of Risk Management in Infrastructure Procurement 10.2.1. Risk Planning 10.2.2. Risk Identification 10.2.3. Risk Assessment 10.2.4. Risk Response 10.3. Risk and Procurement routes 10.4. Risk in NHS Procurement 10.5. Multi-project procurement 10.6. Sustainable NHS procurement options 10.7. References Chapter 11: Supporting evidence-based design (Ricardo Codinhoto, Bronwyn Platten, Patricia Tzortzopoulos, Mike Kagioglou University of Salford Salford, UK) 11.1. Definitions 11.2. the built environment and health Outcomes: considerations about evidence-based Design 11.3. Searching for Evidence 11.4. healthcare environments and impacts on health 11.5. Organising information 11.5.1. Framework 1: Patient groups framework 11.5.2. Framework 2: Route cause and effects 11.5.3. Framework 3: Specific built environment characteristic framework – Colour 11.5.4. Framework 4: Built Environment and Health Outcomes – Overview 11.5. Organising Inforamtion 11.6. Conclusions 11.7. References Chapter 12: Benefits Realisation: Planning and evaluating healthcare infrastructures and services (Stylianos Sapountzis, Kathryn Yates, Jose Barreiro Lima, Mike Kagioglou Uiversity of Salford Salford, UK) 12.1. Introduction 12.2. Benefits realisation 12.2.1. Benefits taxonomies 12.3. Research methodology 12.4. BeReal model overview 12.4.1. BeReal Usability and Controlling Structure 12.4.2. Investment Appraisal Approaches: General, Healthcare Specific and BeReal Mode 12.5. Case Studies 12.5.1. Brighton & Sussex University Hospitals (BSUH) Tertiary, Trauma and Teaching (3Ts), Case Study 12.5.2. Manchester, Salford and Trafford (MaST) Local Improvement Finance Trust (LIFT) Case study characterisation and discussion 12.6. Conclusions 12.7. References Chapter 13: Towards the achievement of Continuous Improvement in the UK Local Improvement Finance Trust (LIFT) initiative (A.D. Ibrahim, A.D.F. Price and A.R.J. Dainty Dpartment of Quantity Surveying, Ahmadu Bello University, Zaria, Nigeria Department of Civil and Building Engineering, University of Loughborough, UK) 13.1. INTRODUCTION 13.2. CONTINUOUS IMPROVEMENT CONCEPT 13.3. RESEARCH METHOD 13.4. RESULTS AND DISCUSSIONS 13.4.1 CI concept 13.4.2 Essential Requirements of Continuous Improvement in LIFT 13.4.2.1 Preconditions and success factors for CI 13.4.2.2 CI driving values 13.4.2.3 CI enabling values 13.4.2.4 CI infusing values 13.4.2.5 Barriers to achieving CI in LIFT projects 13.5. THE DEVELOPMENT OF A GENERIC CONTINUOUS IMPROVEMENT FRAMEWORK (CIF) FOR LIFT 13.5. APPLICATION OF CIF WITHIN LIFT PROCUREMENT 13.5.1 Contextual analysis 13.5.2 CI strategy formation 13.5.3 CI implementation 13.6. CONCLUSIONS 13.7. REFERENCES Chapter 14:Performance Management in the Context of Healthcare Infrastructure (Therese Lawlor-Wright and Mike Kagioglou www.mace.manchester.ac.uk School of Mechanical, Aerospace and Civil Engineering, The University of Manchester, UK School of the Built Environment, University of Salford, UK) Abstract 14.1. Introduction 14. Organisational Performance Measurement Systems 14.3. Building Performance Assessment 14.3.1. Performance of Healthcare Facilities 14.3.2. Assessing Performance at the Design Stage 14.3.3. Assessing Performance at Operational Stage 14.4. Contribution of Infrastructure to Performance of Healthcare Organisation 14.5. Conclusions 14.6. References Chapter 15: Hard FM and performance management in hospitals (Igal Sohet and Sarel Lavy Ben-Gurion University of the Negev, Israel College of Architecture, Texas A&M University, USA) 15.1. Components of Healthcare Facilities Management 15.1.1. Maintenance Management 15.1.2. Performance Management 15.1.3. Risk Management 15.1.4. Supply Services Management 15.1.5. Development 15.1.6. Information and Communications Technology (ICT) 15.1.7 Summary 15.2. Key Performance Indicators in Hospital Facilities 15.2.1. Asset Development 15.2.2. Performance management 15.2.3. Maintenance 15.2.4. Organization and Management 15.3. Research Methods 15.3.1. Structured Field Survey 15.3.2. Statistical Analysis 15.3.3. Model Development and Computing 15.3.4. Validation 15.4. Analysis of a Hospital Using the Indicators Developed – A Case Study 15.4.1. Profile of the Hospital 15.4.2. Data Analysis 15.4.3. Conclusions 15.5. Discussion 15.6. Toward a Maintenance Performance Toolkit 15.7. References Chapter 16: Community Clinics -  Hard Facilities management and performance management (Igal Sohet Ben-Gurion University of the Negev, Israel) Synopsis 16.1. Introduction 16.1.1. Healthcare Facilities Management 16.1.2. Alternative Architectures of Healthcare Service Provision 16.2. Clinic Facilities 16.2.1. Key Performance Indicators in Clinic Facilities 16.3. PROFiLE OF CLINIC FACILITIES 16.3.1. Case Study 16.4. Hospital Facilities vs. Clinic Facilities – Comparative Perspective 16.5. Concluding Remarks 16.6. References Index

About the Author :
Dr. Rachel Cooperis Professor of Design Management and Associate Head of Research in the School of Art and Design at the University of Salford. She is Chair of the European Design Academy and edits the international journal, The Design Journal. She has published several books and papers in design management, new product development and conducted major research programes in this field. Ghassan Aouad, is Dean of the Faculty of Business, Law and the Built Environment and Professor of Construction IT & Management within the School of the Built Environment. Mike Kagioglou is a Professor of Process Management and Head of the School of the Built Environment, University of Salford. He comes from an engineering manufacturing background and for the past 12 years he has been undertaking research and teaching in the area of the built and human environment. Mike is currently the Director for Salford Centre for Research & Innovation and the Academic Director for Salford University of Collaborative Health and Care Infrastructure Research and Innovation Centre. Mike has published over 100 academic and industrial papers and reports.

Review :
"This book has a wide attraction across a range of interests in the delivery of better supporting infrastructure to the health sector. From a property management perspective it addresses the entire lifecycle of asset provision and draws the important link between good design, operation and the health outcomes that the facility underpins. The book has a good balance between industry and academic contributions and I recommend it to anyone with an interest in this specialised area of infrastructure provision and management." (Emerald Journal: Property Management, 2011)