PRR Design Proposal1
Proposal for Design of Non-laboratory Space at NCRC:
Designing For a Future That Is Not Yet Known
Background
The pathology relocation and renovation (PRR) project now underwayprovides a unique opportunity to design innovative solutions for utilization of space in a digital age for which no predicates, exemplars or templates exist.
Anatomic Pathology (AP) has invested in a number of site visits intended to generate deeper understanding of opportunities for innovative design. The desire is to enable Lean Facility Design that takes advantage of digital solutions while driving collaboration in an increasingly subspecialized practice for which teamwork remains a core value.
A team comprising our Directors of Clinical Informatics (Ul Balis), Surgical Pathology (Dave Lucas) and AP (Jeffrey Myers) visited the University of Toronto in November 2011 to gain insights regarding all-digital workflow using whole slide imaging as a core technology. Although much progress had been made at this site much remained to be done and little had changed with respect to either laboratory or work space design.
A team comprising Christine Rigney (Assistant Administrator for Operations), John Perrin (Quality Assurance Coordinator), Dave Lucas (Director of Surgical Pathology), Jeffrey Myers (Director of Anatomic Pathology), Julia Dahl (Pathologist, CEO, and Medical Director, The Mosaic Companies; MLabs client and colleague), and Ulysses Sean (“Sean”) Vance (Assistant Professor, A. Alfred Taubman College of Architecture and Urban Planning)visited the laboratories and offices of Hospital Pathology Associates (HPA) at Abbott-Northwestern Hospital (Allina Health) in July 2012 to observe a unique approach to surgical pathology workflow and space utilization as part of a large facilities project in Minneapolis, MN. Observations included a unique approach to assigning shared office space to services rather than individuals linked to a model that synthesizes patient characertistics, subspecialty practice, and workload leveling for “smart” case triage. Other key components included shared “huddle” space designed to encourage collaborative and educational interactions between staff and faculty.
A large team comprising staff and faculty from AP and Clinical Pathology (CP), departmental leadership, and our PRR Project Manager Christine Baker, visited the pathology department at Indiana University in May 2014 to gain knowledge of challenges and potential countermeasures for providing pathology services from a central location situated at a distance from the sites of health care delivery. Observations were captured in an onsite brainstorming session that informed issues pertaining to specimen couriers, employee services, connections between faculty and their non-pathology peers, conferencing space, trainee space, on-going operational costs, waste and logistics flow, and use of natural light.
This project is an academic exercise centered on a real world problem with the potential to significantly influence the future of our discipline. With thisproposalwe seek permission to put in place a process to ensure an innovative approach to designing effective and efficient non-laboratory space for staff, trainees and faculty that encourages collaboration and Lean workflow in a digital age while also mitigating ergonomic and activity issues unique to our specialty. Our goal is efficient design that drives collaboration across subspecialty subcultures with sufficient flexibility to meet the needs of our patients, providers, staff, trainees and faculty now and in the future. We are confident that departmental staff and faculty, partnered with Christine Baker, Corrie Pennington-Block (PRR Lean Coach),and our consultant Karen Mortland, are sufficiently expert in Lean principles and laboratory design to develop and execute effective space solutions for our laboratories in collaboration with Project Directors in Architecture, Engineering and Construction (AEC) and contracted architects at Tsoi-Kobus and Associates (TKA). The scope of this project is instead focused on an opportunity to develop and articulate unique design solutions for how pathologists, students, trainees and staff will work together in an uncertain future. Partnering with U. Sean Vance allows us the opportunity to take advantage of his academic interests in health care design and creating spaces that mitigate the physical consequences of working in an increasingly sedentary world.
Scope
The focus of this project is to clearly articulate design principles and concepts that will inform schematic and detailed design of non-laboratory work space by Tsoi-Kobis. The key deliverable is a document (“report”) intended not to supplant but rather to inform the architectural design done by Tsoi-Kobis.
Proposal
We propose a multistep approach with the goal of delivering a report to AEC and (TKA) Project Directors by November 1, 2014, or earlier should the project timelines require it. Preliminary work should also inform the two day Lean event for future state planning scheduled for October 9 and 10, 2014.
1. Clearly articulate the problem – The scope of this project is to clearly articulate opportunities and potential solutions for offices assigned to both AP and CP staff and faculty, signout rooms, and shared spaces including those intended for conferencing, at NCRC. Areas of focus include a) the impact of digital workflow, b) collaboration across subspecialty based and geographically hardened subcultures, c) teamwork across traditional authority gradients in more horizontally constructed, multidisciplinary, fully integrated, diagnostic teams, and d) physical movement efficiently aligned with a)-c) that addresses ergonomic consequences of microscopy and other sedentary work-related tasks.
2. Engage faculty, staff and trainees – We will make one or several presentations to faculty, staff, and trainees to share some of the observations made in the previously referenced site visits as opportunities to expand the dialogue regarding innovative use of non-laboratory space in a digital age. One goal of this engagement is to identify champions willing to serve as members of a newly created AP Design Work Group.
3. Contract for services of U. Sean Vance – U. Sean Vance, Assistant Professor of Architecture, specializes in design for healthcare and more recently has focused on creating spaces that create opportunities for collaboration and mitigate the physical consequences of sedentary tasks. He has been engaged in preliminary dialogue with AP leadership and Christine Baker to understand challenges and opportunities in designing space for a workflow likely to be significantly different from our current state. He will be primarily responsible for preparing the key deliverable of this project, a report that translates the solution concepts developed by our Design Work Group into the language of architectural design. He will make himself available to AEC and TKA Project Managers to serve in a consultative or advisory role as they may deem appropriate. Additionally, U. Sean Vance will assist the Design Work Group in reviewing design deliverables from TKA in Program Validation, Schematic Design and Design Development to ensure that the concepts are integrated into the overall project narrative and design.
4. Appoint Design Work Group – This work group will be led by Jeffrey Myers andbe comprised of AP and CP staff, trainees and faculty, Christine Baker, Corrie Pennington-Block, and if deemed appropriate, outside practitioners. Team members must have the capacity to invest their time in working closely with U. Sean Vanceto, a) deeply understand the relationships between design, Lean workflow, and collaboration in a subspecialized environment, b) benchmark against other sites as appropriate, and c) develop solution concepts for schematic design of non-laboratory pathology space in the new pathology building.
5. Budget – All expenses related to this project will be born by the Division of Anatomic Pathology (A. James French fund).