The thought of going through the process to establish a new facility sends chills down many doctors and administrators’ spines. Either they have never gone through it and only heard horror stories, or they themselves have vivid memories of how difficult it was. Establishing a new facility is like any other project, with the right process the tasks can be less daunting and success of the project likely. The following article will walk you through a process that will allow you to successfully create your new facility. In a very simplistic way establishing a new facility follows a process similar to a patient that is a surgical candidate in your practice. You first assess the need, discuss financial arrangements, schedule the surgery and go over requirements, pick a location, perform the surgery, provide follow up care.
In establishing a new facility the process is as follows:
- Develop a schedule - Everyone needs to understand the time constraints.
- Determine the practice’s needs for space, parking and land.
- Develop a budget for the project.
- Select a location.
- Design a new facility.
- Select a contractor. Either through bidding or negotiations.
- Build new facility.
- Move in and begin seeing patients.
Now doesn’t that sound easy, eight simple steps to a new facility! Let’s get into the details of some of the steps.
Develop a Schedule
- Pre-Design needs assessment and location evaluation/selection
- Design
- Contractor Bidding/Negotiations
- Permitting Time
- Construction Time
- Move in
Make sure to have adequate time for your review of the design as it progresses through each stage. It is much more costly making changes after construction has begun than during the design.
Determining the Practice's Needs
To successfully achieve an intended end result, you must identify what that result should be. The end result in creating a new facility is one that properly houses the practice, has proper flow patterns for patients, staff and doctors, and allows for future growth. To accomplish this you need to first get an understanding of the future growth of the practice, assess and correct the current practice flow and project the space needs of the practice.
The process your practice needs to go through to identify these items is:
- Identify growth plans of the practice
- How many doctors does the practice plan to grow to in the short and long term?
- Are there any additional services the practice wants to incorporate?
- Will there be any new equipment?
- Does the practice plan to add or eliminate satellite locations?
- Will there be any changes to doctor schedules?
- Does the practice want to add an Ambulatory Surgery Center to the practice?
- Does the practice want to add or expand the Optical Shop?
- Assess current practice flow – Are there logjams in the current flow of doctors, staff, and patients through your facility? If the answer is yes, assess the following items to uncover the issue.
- Is the rate at which the appointment schedule brings patients in-sync with the true rate the doctor is seeing them? If not, this can cause doctors to run behind, waiting rooms to overflow, and patients to not be seen on time.
- How many lanes does each doctor need to efficiently see patients? This is dependent on the rate the doctors see patients and the staffing model that supports them.
- What is the maximum number of doctors seeing patients at once in your practice now? Does the overall weekly clinical demand for access require that many?
- Are doctors in your practice performing tasks that do not require a doctor to do? Such as data entry in the chart, escorting patients, working up and refracting patients, standing around waiting on a ready patient. If so, the staffing model and job descriptions assigned to those supporting the doctor need to be reviewed.
- When observing your practice, do you see staff and doctors walking to communicate, or leaving their area to deliver information? This is a sign of the communications system in your practice wasting time and limiting the volume of patients they can handle.
Once the future growth of the practice is determined, flow issues are identified and solutions determined then the practice has the information to begin developing a list of rooms and spaces needed. This list should included every room and space (do not forget the hallways) the practice needs and the size of each room (do not forget the space beneath the walls) to determine the total amount of space the practice needs. A complete space needs assessment combined with a realistic parking count and your project budget will allow your realtor to find an appropriate site.
Designing and Building the New Facility
Once the space needs are determined, the current practice flow is assessed and you know how you want the new facility to flow it is time to begin designing.
Approached properly the design of your new facility will be based on the functional flow requirements and the practice planner will share flow diagrams with you as the planning concept for your new facility is developed. This keeps you informed of the direction of the design so you can voice any concerns. Once the practice planning concept is developed the remaining stages of the design process layers on more and more detail until the Construction Documents are complete and ready to be bid or negotiated with contractors.
Once a contractor is selected they will submit/receive a construction permit and the construction of your new facility can begin. The process of designing and constructing a facility is complex and because of this there has never been a perfect set of Construction Documents. There will be issues that will need to be resolved. If the pre-design assessment and space needs determination are done properly they will limit the need for changes during construction and make the process less stressful and costly.
In conclusion, just as your new building needs a solid foundation, your project does as well. Assessing your practice as it flows now and identifying how you want the new facility to flow when complete creates a solid project foundation. Following a sound process and working with experienced professions will make establishing your new facility a success.
Published in EyeWorld
