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Implementing LEAN strategies and the 8 steps of Evidence Based Design to increase caregiver efficiency at Central Washington Hospital

This session will offer insight into how HDR integrated LEAN strategies and all 8 steps of the Evidence Based Design process to deliver a new patient bed tower at Central Washington Hospital.  We will discuss our methodology and results from the research conducted and how that research impacted the design of the hospital, the occupants within the hospital, and the efficiency of the building itself.
Lean studies performed during programming through construction will be highlighted, including a comprehensive process improvement study of travel patterns for nurses and doctors using handheld PDA devices to track staff travel time. Three units were analyzed including Critical Care, Medical Oncology and Obstetrics in order to track clinical behaviors and to identify opportunities for improvement for the newly designed space. Travel distances were calculated and new workflow processes were identified. The travel study indicated for all units measured that the time spent on value added care, the time spent on direct care, and the aisle effectiveness all increased from current to future state workflow and generally outperformed the national benchmarks for their corresponding unit types.  Additionally, we will review the process and results of the post-occupancy evaluation HDR conducted one year after occupancy. This included building user focus groups conducted to gather feedback from occupants on how well the design of the building supports their work processes and a comprehensive survey distributed to staff to supplement the findings of the focus groups.  A significant finding includes the reduction in natural gas use per square foot by 56.2% and a reduction in electricity use by 39.3%.