Integrating Lean Exploration Loops Into Healthcare Facility Design

Guiding the Lean Design of a Hospital's New Laboratory: A Case Study

PURPOSE

To present the process used by a clinical laboratory to guide the design of their new facility, part of a major campus expansion at a pediatric hospital.

OBJECTIVE

The primary objective was to generate information about arrangement and allocation of laboratory space and functional flows in the early phases of the expansion project.

BACKGROUND

Seattle Children's Hospital has increased the capacity of their primary campus in response to growing demand for specialized services. The clinical laboratory was identified as one of the functional groups that would move their operations to the new building.

METHODS

The clinical laboratory team agreed on a three-stage process to guide the development of their initial design specifications: formulate the concept, develop design alternatives, and evaluate those alternatives.

CASE STUDY

The different tasks were executed successfully. The process defined-based on Plan, Do, Check, Act (PDCA)-provided a context for collaboration among sections of the clinical laboratory, reducing silo thinking, so common in the specialized sections within a large clinical laboratory.

DISCUSSION

The process was developed to guide the lean design efforts, even when initial space and location parameters had not yet been decided and was sufficiently flexible to accommodate changes in the project constraints and emergent information generated by the concurrent design activities of other hospital functional groups to be included in the campus expansion. The three-stage process allowed the team to review each laboratory section's complexity, create multiple conceptual designs for review, and ultimately increase the likelihood of an efficient physical configuration that would satisfy a diverse group of stakeholders.

Towards a Framework for Promoting Communication during Project Definition

Project definition refers to the first three stages of a project life cycle, namely planning, programming, and preliminary design during which client needs are identified and translated into design solutions. An ill-defined hospital project definition may lead to hospital-acquired infections or patient mortality. The traditional management practices have been proved to be inadequate since architects usually do not communicate with users, and thus do not have detailed knowledge about how services are performed in the building. There is the need for more knowledge about the subject to improve and thus promote client value generation. This study first reviews factors that impact the communication between architects and clients during project definition based on the literature. The study then offers a framework based on these factors to help managers assess and improve communication between professionals and clients. The validity of the framework will then be empirically validated and revised based on findings of a longitudinal mega-hospital case study. The main objective of the current investigation is to improve the project definition practices of complex projects, and the assumption is that an effective communication provides more value to end users, as well as better project performance in terms of environmental and social sustainability.

Layout Planning in Healthcare Facilities: A Systematic Review

This study presents a systematic review of the literature on layout planning in healthcare facilities. The review includes 81 articles from journals, conferences, books, and other documents. Articles were classified in two groups according to their main contents including (i) concepts and guidelines and (ii) techniques and tools to assist in layout planning in healthcare facilities. Results indicate that a great variety of concepts and tools have been used to solve layout problems in healthcare. However, healthcare environments such as hospitals can be complex, limiting the ability to obtain optimal layout solutions. Influential factors may include the flows of patients, staff, materials, and information; layout planning and implementation costs; staff and patients safety and well-being; and environmental contamination, among others. The articles reviewed discussed and often proposed solutions covering one or more factors. Results helped us to propose future research directions on the subject.