Healthcare infrastructure planning

Healthcare infrastructure plannin

Strategy formulation capabilities of construction professionals

Strategic formulation involves synthesising complex, uncertain and often ambiguous information that necessitates a continuous need for senior managers to develop appropriate cognitive attributes. Professionals involved in strategy formulation should be able to exhibit flexibility along with creativity to ensure that the organisation they lead is steered in the right direction in response to a changing and demanding business environment. This paper is set out to explore the strategy formulation capabilities of construction professionals. A range of senior managers from multidisciplinary construction organisations were interviewed in order to explore the various factors that contribute to the strategy formulation capabilities of the professionals. The key factors identified were knowledge and skills. It is suggested that such an evaluation can have a significant role in increasing and improving strategic thinking, thereby enhancing the process of strategy formulation

Strategic asset management and master planning within the healthcare sector: exploring the theoretical need for evidence based change management in strategic planning

The delivery of health and social care in the UK is undergoing profound change and being redesigned to provide high quality, person-centred services and improved capacity and performance. This is taking place in a context of: change in asset ownership; moves towards increased local autonomy in the provision of services; and the introduction of national, evidence-based standards and inspection. There has been considerable activity surrounding the planning, design and operation of healthcare services and facilities, however, Strategic Asset Management as a field of literature has not sufficiently developed in line with this change in emphasis. The recent move towards PFI, LIFT and World Class Commissioning within the NHS (National Health Service), has meant that roles and responsibilities for estates are shifting alongside commissioning competencies; however, the impact of this shift on the built healing environment is not well understood. Strategic Asset Management on a regional scale requires: reliable predictive data; effective tools and processes for developing and modelling future scenarios; and people with the appropriate skills and expertise, although these are not always available. As such, these factors need to be better understood and the stakeholders responsible for them defined

EuHPN Workshop: One Problem, Many Solutions: how to make healthcare infrastructure deliver for society

EuHPN Workshop: One Problem, Many Solutions: how to make healthcare infrastructure deliver for societ

An open value-based perspective to healthcare building

AIM. This paper aims to build a conceptual relationship between value and open building and scenario planning to aid the assesment of healthcare infrastructures over the short, medium and long term and against dynamically changing contexts. BACKGROUND. Faced with the current financial climate, organisations often find themselves debating the impact of short-term economic pressures, at the expense of planning the strategic long-term sustainability and value of their physical assets. Existing decision making and stakeholder consultation approaches are inadequate and as such an open and dynamic value-based approach to scenario planning is required that will capitalise on the benefits of standardisation, customisation and learning. METHODOLOGY. This paper is supported by a critical and comparative review of health infrastructure, value management and open building literature to understand similarities and differences. It also reports on a workshop with academics and industry professionals and coins open planning and open building. IMPLICATIONS. Value is an important concept in open scenario planning and building. Furthermore, a new method of categorising open value as benefits, sacrifices and resources is trialled

Strategic asset management: relating to open building concepts

Healthcare services are provided in increasingly complex environments which are driven by multifaceted internal activities and the management of the physical assets is vital for efficient delivery of these services. Healthcare estates planning are supported by Trusts’: Strategic Service Development Plan (SSDP); Strategic Outline Case (SOC); Commissioners Investment & Asset Management Strategy (CIAMS); Estates Code; service specifications along with programme management; and investment appraisal and planning. This paper aims to explore current approaches and develop an approach to Strategic Asset Management using open building concepts that can be applied to healthcare projects to enable a flexible estates response to service redesign, technology innovation and changing business demands. This is achieved through collation and comparison of these approaches to identify existing gaps and inform how open thinking can transform business case procedures for estates planning and assist in the strategic evaluation of healthcare assets

Open building for a kaleidoscope of care: a new conceptual approach to open scenario planning

Open scenario planning, in a market such as healthcare infrastructure where change at every scale is inevitable, provides a significant opportunity. Healthcare, which comprises a complex mix of people, technology, buildings and other forms of infrastructure, is facing huge pressures. As such healthcare trusts are looking to make better use of resources; decrease carbon emissions; and re-think how they can act in a more sustainable and integrated way. Within the UK National Health Service, “taking care closer to home” and “saving carbon, improving health” are two of a number of Department of Health (DH) initiatives to improve healthcare and respond to the need for sustainable, accessible, efficient and effective services. Furthermore these are also the drivers for integration between health, social care, local authority, independent and third sector providers which is creating blurring between spatial scales and roles. Against this backdrop it is not surprising that the effective life span of buildings is continuing to shorten, which is significant in a sector that has infrastructure that is one of the most expensive to operate, maintain and replace. As such the notion of “change ready” is key. This paper through a state-of-the-art literature review introduces and explores the potential and conceptual linkage between infrastructure, capacity and scalability within open building and planning extending (Astley, 2009; Kendall, 2009). The authors’ collaborative and action research has contributed to the development of a new approach and this research has identified the need for a flexible, dynamic and scenario based approach to planning that goes beyond estates strategy and beyond master planning and which precedes open building. The diversity of care pathways across a changing healthcare planning environments is demonstrated using a case study review, which raises the importance of a hierarchy of decision making, principles and process within an open planning approach. This paper further provides a review of existing business case development processes and capacity planning tools that are prevalent in healthcare strategic planning and operations management, but not so in adaptability research. Scalability as a concept that can bridge the healthcare and estates infrastructure domains is also introduced

Open infrastructure planning for emergency and urgent care

This paper stems from the development of research currently undertaken at the Bartlett, University College London and Loughborough University School of Civil and Building Engineering, Open Scenario Planning for Healthcare Infrastructure (OPHI). The study has investigated the concepts, tools and techniques that enable innovation and support the financial planning of built infrastructure. The aim is to improve decisionmaking for healthcare pathways across locations and settings through development of a framework for the rationalisation of existing property and buildings. Evidence and analysis is drawn from case studies of Accident & Emergency/Trauma, Urgent Care and service re-organisation within six English Foundation Trust Hospitals, examining their strategic estates planning approach. The study sets out a process to determine scenarios of a shifting pattern of patientcentered requirements and clinical priorities by testing strategic options for clinical effectiveness rather than functional arrangements. The ideas and direction of the research were also supported by case studies from elsewhere in Europe. Most notably, at the Inselspital (Island Hospital) in Switzerland, the Canton of Bern has set out a 2025 to 2060 strategy for an 'Open Development Framework'. Organised through principles of Open Building this directs the future development of the hospital as a set of high-level objectives driven by clinical priorities incorporating planning and design innovation through the mapping of two divergent operational scenarios. The paper sets out the findings of the study with the Trusts in England that respond to these emerging radical solutions and the appropriateness of their introduction within the context of UK service reorganisation for patient-centred, integrated care overcoming organisational commissioning boundaries. Findings suggest the emergence of new, clinically-led business units, supported by mobile multi-disciplinary teams on and off-site, for the planning of admission avoidance, referral patterns and long term care of chronic conditions. This work is informing an outcome for a Strategic Scenario Planning Framework to enable decisions based on explicit values of stakeholders, together with the specific competencie

Stakeholder consultation practices within healthcare infrastructure planning: developing a strategic asset management approach

Purpose – With the advent of the Darzi review in 2008, and more recently the White Paper “Equity and Excellence: Liberating the NHS” (2010), the NHS in England is being redesigned to provide high quality, person-centred services with improved capacity and performance. In this change oriented scenario, stakeholder consultation has a critical role to play given the widespread advocacy in government policy and healthcare literature. In order to support informed decision making, the purpose of this paper is to: explore healthcare infrastructure planning through various approaches to stakeholder consultation within English Primary Care Trusts (PCTs); and develop a conceptual approach to strategic asset management (SAM) based on the findings of stakeholder consultation and engagement exercises. Design/methodology/approach – A multi-method triangulation approach including action research has been adopted to evaluate current stakeholder consultation practices with a local PCT and to explore their approach to healthcare infrastructure planning through: a literature review of stakeholder engagement and theory; evaluation of a local consultation exercise; and a web based document review of consultation practices within 149 English PCTs. Findings – PCT estate managers and healthcare planners have to operate within constantly changing dynamic healthcare environments and need to reduce uncertainty and indecision that often surrounds the debate of reconfiguration of healthcare facilities and services. Consultations by the PCTs vary in: the level of detail provided to the public; sample sizes; detail and transparency of the consultation; distribution and analyses of the consultation; and techniques and approaches. Practical implications – The findings of this study can be used by healthcare policy makers to: inform how clinical commissioning groups (CCGs) could be better involved during patient and public engagement; and determine practical ways of putting patients at the heart of General Practitioners (GP) commissioning. Originality/value – The research identifies gaps within current stakeholder consultation practices in English PCTs and develops a conceptual approach to SAM that accounts for stakeholder consultation; decision making levels within healthcare infrastructure planning within a wider competency based organisational view, which currently does not exist

Master planning and integrated service provision within the healthcare sector: literature review

Healthcare services within the UK are being reconfigured to provide high quality, person centered services to renew the NHS for the 21st century with improved capacity and performance and simultaneously meeting the rising aspirations of the public and the demand set by the demographics...