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Northeast Georgia Medical Center Braselton, Braselton, GA

June 2018
EDAC Advocate Firm Project
Inpatient Unit Staff Collaboration Hub, © 2015 Darris Lee Harris


Firm's Role on the Project: Conduct a rapid post-occupancy evaluation to capture lessons learned from the CtQ implementation.



EBD Goal

The research plan was to conduct a post-occupancy evaluation at the existing hospital focused on three major goals:

1) Study the current inpatient units to inform design modifications for the build-out project.
2) Derive lessons learned from frontline staff of the Braselton Hospital about what was working well, and what could be improved.
3) Evaluate quality outcomes for the CtQs that had been developed for the Braselton Hospital.


When Northeast Georgia Health System decided in 2015 to build a new 100-bed hospital on a greenfield site in Braselton, they invited staff within their existing system to participate on the design team—many of whom would not go on to work in the new building. An initial challenge of the project, then, was how to build a hospital around operations that were being developed for future staff. In response, the design team developed a list of critical to quality (CtQ) needs: a Lean term that identifies critical components of a process that leads to quality outcomes. These CtQs became the cornerstones for operational and design decision-making throughout the project. After using the new facility for over a year and with it now exceeding capacity, the owner decided to move ahead with the build-out of the final floor. Prior to design, however, a team of researchers was asked to conduct a rapid post-occupancy evaluation to capture lessons learned from the CtQ implementation.


To keep up with the project schedule, researchers were challenged to tailor a plan for a two-day onsite visit. Ultimately, a mixed-method approach was used to maximize time onsite and ensure findings could be triangulated.


The research team’s study included focus groups, interviews, and observations. On day one, a two-hour focus group was conducted in the morning with unit managers and supervisors. Using the CtQ list as a template, the researchers reviewed each critical need and asked how it was working. Information gleaned from this focus group was then used to develop questions for one-on-one interviews with frontline staff on day two. While this took place, a process engineer shadowed staff members, gathering time, activity, and motion data using an iPad application.


Overall, the findings supported the design intent of the original CtQ metrics. Comments included:

• Flexibility: “I think that it is pretty well planned out, having med rooms on each end.” “Step-down patient rooms in ICU provide overflow rooms.”
• Collaboration: ” Collaboration areas are in the right location.”
• Efficiency: “It is nice that you can look up and down the hall and see everything, whereas previously, you had to walk to the intersection to see what is going on.” “Nurse servers support our work.” “The sink location in the room supports good [infection control] technique.”
• Aesthetics: “[When] people come in, they are happy and it makes them feel like they have a better experience.” “I think it’s a beautiful facility, nice to be in a new hospital."

After reviewing the results of the post occupancy study, the buildout of the final floor will be done with minimal modifications from the original design.