April 27, 2012
Activating and opening a renovated or new healthcare space can be a monumental challenge few people have had the pleasure to experience. Planning to relocate existing services and patients presents a unique challenge that many healthcare organizations have not had the opportunity to confront on a daily basis. In addition to planning for relocated items, an organization must also plan for the activation of the renovated or new space which can include receiving thousands of new items during a short period of time on larger projects.
In the current facility activation planning world Furniture, Fixtures, Equipment, and Technology (FFE&T) is managed in one of three ways:
• FFE&T is managed internally in silos with little discussion between planning teams on the best approach to manage information and activate the new facility.
• FFE&T is managed internally in an efficient manner and relevant planning teams communicate through a facility activation steering committee. The healthcare organization manages the receiving, warehousing, placement, and installation process by their in-house facilities team through an onsite storage facility.
• FFE&T is managed by various third party vendors such as medical equipment planners, interiors firms, low-voltage/IT consultants, etc. A third party warehouse is selected to manage the receiving process for all new FFE&T to ensure an orderly delivery and installation process. The healthcare organization may coordinate the overall schedule internally or they may look to an outside consulting firm or Activation Consultant to manage all of the vendors as well as the entire process to ensure an efficient and cost effective transition.
In a perfect world, the activation of renovated or new healthcare space follows a seamless path from construction substantial completion through first move. The client and third party vendors work in harmony to develop a comprehensive facility activation plan, all FFE&T deliveries arrive at their scheduled times, all items fit neatly in their pre-determined locations, a thorough infection prevention program has been implemented and followed, and all FFE&T is accounted for in mint condition.
However, the perfect activation scenario is rarely experienced for a host of reasons. FFE&T may arrive days early and/or late causing confusion at the loading dock. In-house facilities teams must then juggle their day-to-day responsibilities with receiving and placing all Owner Furnished Owner Installed (OFOI) items associated with the project. This can be a significant burden and cause operational disruption to core business functions. Experience has also proven that this added responsibility may inhibit the ability to properly train staff in the new space and on the new systems. The improper allocation of key resources can result in stress on the activation schedule and increase the cost of activation. A balanced FFE&T process is one where the client and the project manager develop a comprehensive planning process well in advance of construction substantial completion. This process includes the procurement manager(s), finance, medical equipment planner, IT/Telecom consultant, interiors firm, facilities manager, security, infection prevention, and the Activation Consultant (if managed externally). A process will be developed to manage all items from the creation of the initial purchase order through final sign-off in the new facility. This process will include the selection of a third party warehouse to receive, verify, warehouse, deliver, install, and sign off on all OFOI purchased to complete the new space.
A thorough process will include the following steps:
• Develop comprehensive facility activation schedule;
• Establish warehouse controls and client access;
• Establish inventory control system;
• Receipt and delivery reporting;
• Determine FFE&T insurance requirements;
• Item and piece count verification;
• Delivery examination;
• Develop reporting of goods damaged in transit and project claims process;
• Develop delivery schedule for all FFE&T;
• Conduct regular procurement planning meetings;
• Develop an Owner’s manuals;
• Remove debris;
• Develop a vendor and facility access and security plan;
• Coordinate BioMed and Infection Prevention;
• Room-by-room sign off sheets;
• Owner acceptance of all OFOI; and
• Project closeout.
Additional Procurement Planning Factors
Warehousing options should also be considered well in advance of the move. Which is best for your organization – Just It Time (JIT) or third party warehousing? In the world of Six Sigma, LEAN, and ongoing process improvement, many organizations have moved the management of supplies and equipment to a JIT process. The JIT process saves organizations valuable resources through more effective use of space by limiting storage needs, reducing staff, and creating a more efficient process to move materials throughout the organization.
However, JIT is not as effective during the activation of a new or major hospital addition. This process includes the receipt, verification, placement, and installation of thousands of pieces of new FFE&T. Much of the new equipment requires assembly, BioMed testing, IT set-up, etc. Receiving space for the thousands of items is often limited which requires receiving staff to quickly move items into a temporary holding area or deliver direct to the final location.
Utilizing a third party warehouse allows for all items to be received and inspected in an orderly process. The warehouse company assumes the risk and liability for inspecting all items for damage and contents. Furthermore, the warehouse company will assemble most items ahead of delivery and will remove all packaging and debris, saving the hospital time and money. The hospital or its planning consultant will coordinate all deliveries from the warehouse to the new facility to ensure all items have been received and installed to meet the overall facility activation schedule.
As hospitals plan for a new facility, FFE&T is often overlooked and delegated to a small in-house facilities team to manage without appropriate consideration of backfilling their day-to-day responsibilities. The success of activating renovated or new healthcare space will always be judged based upon how it finished. Was the building activated according to plan? Was everything in its proper place? Did all the new equipment work? Did the patient move go smoothly? Was the stress level on the organization acceptable? What additional dollars were spent to make up for the inefficiencies in execution? These final activities are the things that all personnel, patients and the public will remember as they begin experiencing the new space. Properly planning the management of the FFE&T will impact the success of staff training, final licensing, start date of the move schedule as well as the patient experience. Therefore, it is imperative for any healthcare organization involved in a capital facility project to begin development of a comprehensive FFE&T plan at inception of the project to maximize success.
For more information on Managing FFE&T and other Capital Facility topics, visit KLMK’s Educational Insights.