FIRST HILL SURGERY CENTER SEATTLE, WA 1101 MADISON TOWER

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1 FIRST HILL SURGERY CENTER SEATTLE, WA 1101 MADISON TOWER largest independent free standing Independent Ambulatory Surgery Center on West Coast

2 Project Team: PolyClinic Swedish Health Systems Sellen Construction Company TGB Architects And many others Today s Presenters: Randal Brand - PolyClinic,Director of Facilities Shanna Dennis - Sellen Construction Co., Construction Project Manager Kristopher Herrell TGB Architects, Project Lead

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4 What is First Hill Ambulatory Surgery Center? 38,000 SF B Occupancy constructed within existing 1101 Madison MOB 12 Operating Rooms 8 PACU and 4 23:59 Private Recovery rooms 24 Pre-Op / Phases 2 Recovery Bays (4 enclosed private rooms) Full Sterile Central Processing Facility with cart-wash, 4 washers & 4 Sterilizers At full capacity designed for 120 employees 200 Polyclinic Physicians Swedish Surgeons

5 THE FOOTPRINT IN A FULL CITY BLOCK!

6 How did this project come to be? The creation of a Joint Venture between a Not-for-Profit Hospital System and a For- Profit Physicians Group to form an LLC and create an Independent fully Free-Standing Ambulatory Surgery Center Polyclinic Physicians Swedish Health Systems First Hill Ambulatory Surgery Center LLC

7 Mission, Vision, and Market Drivers: How did this Project come to be? Increased market competition to drive down cost & increase efficiency Physician recruitment and consumer choice Improved Patient experience and satisfaction Meeting volume projections and community needs

8 Assembling a collaborative and experienced Project Team A Not-for-Profit Hospital System with depth in large operations & surgical processes A For-Profit Physician Owned Group Practice with highly efficient surgical processes An Experienced healthcare construction General Contractor A Design team certified in Lean Methodology & Social Labs Integration An Joint Operation Council for oversight, direction, & decision-making A team of stakeholders interested in collaboration, learning and change opportunity NOT business as usual, but rather creation of a new Practice Model

9 Super Fast-Track Schedule 14 months from Design to Certificate of Occupancy! April Start Design August 2015 Start Demolition of existing Tenant Improvements September 2015 Building Permit Submittal September 2015 Construct Full scale Mock-Up October - November Mock-Up Simulations & Physician Tours January 2016 Start Construction June Certificate of Occupancy August ASC licensure September First Surgical Patient

10 Unique Design & Construction Attributes to note: Designed using Lean Practice methodologies focused on 7 flows of medicine, key visibility corridors, and elimination of wasted processes Installed new dedicated Building Electrical Service Installed new dedicated Generator Installed new dedicated rooftop Air Handling Unit Each OR took approximately 90 days to construct including steel Boom/Light support

11 The Planning Process: Defining Mission and Vision Identifying Common Values Defining Common Goals Agreeing upon Guiding Principles Defining Patient Protocols, Case types Operational model and oversight

12 The Design Process: Using Lean Methodologies & Practices to define and study flows of medicine patient, family, provider, care team, medication, supplies, information & waste Mapping anticipated flows on Paper to test layout Options Full Scale Mock-Up tours for Key Stakeholder and Physicians Vendor Participation in Mock Up Significant Equipment in the Mock Up Practiced flows, process, and patient/staff movement in the Mock Up

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15 Some Challenges along the way? Sure! Potential challenge to CON application Slow City of Seattle Building Permit Review Process Zero lot line existing building w/covered loading dock required 2 hr rated generator & med gas enclosures, and remote fuel fill connection Late realization that Sterilization equipment would exceed Building Electrical Service and addition of dedicated Electrical Service, negotiation with Seattle City Light Rooftop Air Handling Unit would block views from existing 1101 Madison Clinical Tenants Programming change to add 2 additional Operating rooms and 4 additional Patient Pre- Op/Recovery Bays after building permit submittal mock up simulations complete Sterile Processing equipment arrives not as vendor dimensional drawings represented Late addition of Black Diamond Surgical Integration system requesting a 400 SF server room after construction underway

16 Some Successes along the way? Sure! Completion below Project Budget, even with addition of 2 O.R.s and 4 Patient Bays Completed on Schedule Design/Construction Team conducted daily huddle to discuss immediate issues On site Problem solving with follow up documentation It s working better than anticipated! Currently operating 8 Operating rooms and ahead of projected patient volumes Surgical Case turn-around times exceeding projected times

17 Lessons learned: Mock Ups and simulations are invaluable Include many Stakeholders with many perspectives Include Vendors & equipment Design modifications in the Mock Up by the contractor team New flooring product from Sweden meant potential delays thru in customs Color variation for power outlets to denote normal, critical, isolation, & Seattle Energy Saving Include EMR software programming during design room numbering & signage design Trust your experienced G.C. with early estimating, they now where to hold contingencies Daily huddles w/design team during construction solves issues immediately, document later Include the Sub-contractors in problem solving: Adjusted flooring seams Ceiling track layout & height modulation Equipment surrounds & enclosures of sterile processing equipment

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22 Thank you AHP for the invitation and opportunity to present this exciting and innovative largest Ambulatory Surgery Center on the West Coast Questions & Answers

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