Crystal Ball? Ouija Board? Tarot Cards? CASSANDRA Speaks! Meet the New Oracle of Predictive Facilities Master Planning

Crystal Ball? Ouija Board? Tarot Cards? CASSANDRA Speaks! Meet the New Oracle of Predictive Facilities Master Planning

Session Description Master planning for healthcare facilities is filled with complexity and contradiction. Every consideration has a ripple effect, making predictive modeling notoriously difficult. After undertaking major facilities planning and development over the past decade, The Children s Hospital of Philadelphia has developed an exciting new tool to quickly analyze and simulate master planning scenarios for a regional care network that comprises over 5 million square feet. This session will help institutions recognize current planning challenges, identify key parameters that drive institutional growth, and augment traditional master planning methods.

Session Objectives 1. Introduction 2. Recognize Current Institutional Planning Challenges 3. Identify Key Parameters that Drive Institutional Growth 4. Compare and Optimize Planning Scenarios 5. CHOP s CASS 2.0 Solution

1 Introduction: CHOP Regional Pediatric Network FACTS Main Campus 4,500,000 SF 535 TOTAL BEDS 273 Med/Surg Beds 18 Rehab Beds 185 ICU Level Beds 24 Telemetry Cardiac Beds * * 24 Progressive Care Unit Beds 11 LDRP/OB Beds 159,045 Patient Days Network 1,200,000 SF 1,191,174 Outpatient Visits 30 Primary Care Centers 3 Urgent Care Centers 12 Specialty Care Centers 5 Ambulatory Surgical Facilities 15 Community Hospital Affiliations 5 Specialty Care & Ambulatory Surgery Centers * CHOP FY2014

1 Introduction: What we have done Over 20 years, Does this look familiar? 9 Master Plans by 7 different A/E Firms. Over $1.8 Million spent! Master Facility Plan Master Plan Update South Campus Master Plan 1995 2002 2005 Facilities Master Plan Master Plan Update Inpatient Growth Site Feasibility 2007 2010 2010 Schuylkill CHOP Avenue CASS 1.0 Master Plan 2011 2012 Inpatient Growth Master Planning 2013

1 Introduction: What are we doing? $350 $300 $250 $200 400% increase in capital spending over years! 4 $207M $283M 8 Capital Projects 587 Planning Requests $321M 10 Capital Projects 458 Planning Requests $150 $135M 8 Capital Projects 505 Planning Requests $100 $81M 7 Capital Projects 474 Planning Requests $50 6 Capital Projects 354 Planning Requests $0 FY' 2011 FY' 2012 FY' 2013 FY' 2014 FY' 2015 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015

1 Introduction: CASS 1.0

2 Recognize Current Institutional Planning Challenges: Traditional Output

2 Recognize Current Institutional Planning Challenges: Inpatient Bed Growth Scenarios

3 Identify Key Parameters that Drive Institutional Growth Current Institutional Planning Challenges Confirm projected campus development area is less than projected in the CASS 1.0 hypothesis Prioritize single occupancy rooms Increase ratio of Main Campus ICU beds compared to Medical / Surgical beds Accommodate proportional growth for hospital support space Accommodate growth for anticipated research programs and modalities Evaluate needs to develop existing building capacity and pursue additional real estate expansion if appropriate Refine campus wide transportation, parking, and open space coordinated strategy Align the Master Plan with economic and qualitative objectives defined by CHOP DRIVERS Patient Safety Patient Experience Scale Coordination of Care Philosophy of: right care at the right place at the right time ACTIONS Where the beds are @ Main % ICU capacity Beds Grow the Model Semi-private verse Private Risk-based contracts Growth (in excess of plan) Partnerships / Scale Regional Markets National contracts International Medicine CARE MODEL Growth of network Create more community associations More ambulatory at Main and Network Increased inpatient acuity at Main Higher Acuity Ambulatory Care at Main Campus Increased Ambulatory Care in the Network Create more community associations Economics CHOP Capital Outlay Annual Operating Expenses Attributable Gross Revenue by Bed Type Project Cost Facilities Public Realm Parking Strategic Factors Reinforcing the Brand Philanthropic Opportunities Support of Strategic Goal to create scale Location & Access Patient Safety Patient Experience Growth Potential Parking Quality / Availability Workplace Environment Employee Retention/Attraction Campus Environment Parking Quality / Availability

3 Identify Key Parameters that Drive Institutional Growth PICU FY15 Capacity Breakdown - CHOP Case Study Green ROUTINE <88% <461 filled, >63 open Yellow FLEX 89-94% Orange SURGE 95-99% licensed or 90-94% of licensed + surge* Red CRISIS > 100% licensed or >95% licensed+surge* 462-493 filled, 31-62 open 489-519 licensed beds occupied 506-526 licensed + surge beds occupied 524 licensed beds occupied >95% of licensed + surge beds occupied (532-560)

4 Compare and Optimize Planning Scenarios Inception Why do it?

4 Compare and Optimize Planning Scenarios Variable Parameters Contribution Margin BGSF Factor Construction Lead-in Demand Assumptions Capital Cost Space Use Type Construction Timeframe Space Use Dependencies Space Use Suitability Scenario Start/End Dates Building Use Type Vertical Expansion Cost Renovation Cost Operating Cost Fit-out Cost Teardown Cost Core & Shell Cost Space Use Ratios Bed Type Parking Allocations

5 CHOP s CASS 2.0 Solution Meet the New Oracle of Predictive Facilities Master Planning ANSWER #1: CASS 2.0 QUESTION #1: How do we determine the feasibility of constructing a new bed tower vs renovating an existing building for tomorrow s board meeting? ANSWER #2: CASS 2.0 QUESTION #2: How do we optimize space utilization across our campus with the press of a button? ANSWER #3: CASS 2.0 QUESTION #3: How do we accurately display cost and time that everyone can easily understand without another 500 page report?

5 CHOP s CASS 2.0 Solution Meet the New Oracle of Predictive Facilities Master Planning

5 CHOP s CASS 2.0 Solution Scenario Comparisons

Can you confidently say that every square foot of your institutional space meets the highest and best use at the lowest cost to create? At CHOP, we have created a solution that bridges the gap between the strategic thinking of master planning and execution of strategy.

Contact Information Doug Carney, AIA LEED AP Senior Vice President The Children s Hospital of Philadelphia Facilities Services, Real Estate, Construction Management carneyd@email.chop.edu Christine Kerner, EIT Project Manager The Children s Hospital of Philadelphia Facilities Services, Real Estate, Construction Management kernerc@email.chop.edu Special Thanks to Holistic City for their involvement with this venture Chris Sharpe Director Chris.Sharpe@holisticcity.co.uk Svet Pelipenko Technical Director Svet.Pelipenko@holisticcity.co.uk

Thank You