Often personal experience drives perceptions. Early in my career, I worked in-house at a senior living development and operations company. I was hired to complete contract administration, coming in after design was completed, during construction.
This process resulted in observing the manifestation of a continuous gap
between the built environment’s needs and the design’s solution.
Based on this realization, I started to attend operational meetings to better
understand how everything functions—resulting in a design process that
would support the desired outcomes for both residents and staff. This was
the basis for my consulting practice—improving outcomes through the built
environment based on resident, staff, and operational needs.
The process is now defined as the functional programming process in
the Facility Guidelines Institute’s (FGI) guidelines for hospitals, outpatient, and
residential long-term care settings (for more info, visit www.fgiguidelines.org).
The following sections define the steps and the importance of completing a
functional program that results in a successful project.
The functional program process begins by gathering all of the disciplines
together, including management and administration, to discuss the goals of
the project. For a large scale re-positioning or new project, the first workshop
usually includes discussion on organizational options for care models and the
desired outcomes of a project.
It is important as design professionals to understand an organization’s
mission and core values, as the framework is utilized to evaluate options in
existing as well as new potential care models. The workshop covers impacts
on current staff ratios, opportunities for positive change based on industry
trends and reimbursements, educational and training needs, and financial
and marketing influences. For our clients, this is the time in the planning and
programming process where we discuss resident-centered care and whether
alternate care models should be reviewed. This step is very important, so
that the functional program can reflect the project needs, informing the physical
space program and concept design.
Identifying the sustainable goals for the project are not only about greening
the building, but also evaluating the entire sustainable business model. The
continuous improvement of the desired resident/patient outcomes, and the
operational functions, relies on periodic evaluation as well as ongoing com-
missioning of the physical environment. All three of these dimensions are
evaluated through the filter, and reflective of an organization’s mission and
core values. It’s a quality improvement process, which includes the ROI
evaluation and ongoing review.
Part of establishing the goals often includes the selection of a building rating
system such as LEED, Green Globes, and the all-inclusive Senior Living
Sustainability Guide, which includes information for evaluating resident/patient
desires and needs, organizational mission, and operational goals supported
by the designed environment. However, it is important to note that reviewing
the building is only a piece of the ongoing continual improvement process
necessary for maintaining person-centered care. Utilizing a tool such as Green
Globes for Existing Buildings for Healthcare strives to engage not only the
building performance, but also the patient/resident and staff outcomes, and
operational functions for continual improvement. The process uses an electronic
survey tool, and if desired by a client, it can include third-party certification. A
trained assessor comes onsite to review the documentation and physical plant,
and meet with different departments, staff, and patients/residents. The process
results in individualized recommendations for continual improvement, and a
checklist is available on the Green Building Initiative website.
With the occurrence of both natural and manmade disasters, resilience has
been a very popular topic among not only design professionals, but also
regulators, government agencies, and liability insurance carriers. Healthcare
settings already include emergency preparedness planning and procedure
development. However, when renovating or building new, understanding
potential climate change impacts on a site is important to consider from the
beginning, in conjunction with anticipated building service life considerations.
GSA recently held a workshop titled, “Strategically Incorporating
Sustainability, Resilience, and Footprint Consolidation in Portfolio Planning”
that includes discussion on space utilization, which is well reflected in
the functional programming process outlined in the Facility Guidelines
Institute’s hospital, outpatient, and residential care guidelines. The Veterans
Administration presented during the conference to highlight the need for
incorporation of resilience in healthcare facilities and reaffirm the need for
regular periodic assessments for successful continual improvement to occur.
Once the workshop takes place, I recommend holding focus groups with the
94 INTERIORS & SOURCES OCTOBER 2015 interiorsandsources.com
By Jane Rohde, AIA, FIIDA, ACHA, AAHID, LEED AP, Green Globes CIEB Assessor
Setting, reaching, and documenting goals enables continuous improvement
is Your Key
LEFT Author Jane
on the Facility
process as it