Hear lessons learned from two recent hospital fires and how the Total Concept of the Life Safety Code® (design, construction, and compartmentation; provision for detection, alarm, and extinguishment; and fire prevention including training and drills) kept patients safe. The session will take the Total Concept one step further to where the building design process not only addresses the minimum codes (e.g., the Life Safety Code) but is expanded to take into account effective fire procedures, surge planning, and building evacuation.

Learning Objectives:

• Identify the building design and operational features that support an effective health care fire and evacuation procedure.
• Describe the lessons learned from one or more recent hospital fire scenarios.
• Recognize the interrelationship between fire procedures, staff training, and fire drills.
• Identify how the requirements of the Life Safety Code® directly correlate to effective fire and evacuation procedures.

Efforts to achieve high patient satisfaction scores at UF Health North began before the first patient walked through its doors. From design to building occupancy and beyond, the comprehensive approach maximized the patient experience through the built environment, team culture, and clinical processes. An expert panel and the project's lead planner and interior designer will present strategies that have resulted in a 98th percentile satisfaction rating in the ED. Specific metrics, customer comments, academic studies, and organizational practices will be provided.

Learning Objectives:

• Cite evidence-based factors influencing high patient satisfaction.
• Explore staff-building strategies that contribute to high patient satisfaction.
• Create an organizational culture to support patient satisfaction.
• Track performance metrics and use the data to manage satisfaction outcomes.

At UW Health's new satellite campus, lean planning inspired a new approach to health care delivery. In 2015, UW Health opened a flexible facility that could respond to changes in medicine and meet patients' needs through collaborative teamwork and cross-training. One example is the Universal Care Center (UCC), a unique building element containing six pods of eight identical rooms. Each pod is shared by ED, pre/post-surgery, and imaging departments. The area provides on-stage/off-stage circulation and creates work zones to allow for patient privacy and optimal communication.

Learning Objectives:

• Use new operational methods and create building plans to leverage change and reduce program size and square footage.
• Apply lean planning/metrics to improve efficiency, focus on the patient, and encourage space sharing.
• Describe the successes and challenges of cutting 20 percent of program space.
• Foster a vision and commitment to change among diverse stakeholders, including patient and family advisors.

A panel of design professionals, facility executives, and real estate professionals will explore the current urgent care guidelines, experiences with the Department of Public Health's plan review processes, and how these experiences have shaped planning and approach to future urgent care clinics. The panel members will discuss opportunities to share services at urgent care locations, develop operational efficiencies to reduce care costs, and provide better access to care for patients.

Learning Objectives:

• Identify the needs of urgent care clinics, typical urgent care programs, and the relationship of urgent care clinics to the current health care environment.
• Review challenges associated with development of new urgent care clinics and understand strategies for meeting those challenges.
• Evaluate the regulatory environment around development and implementation of urgent care clinics in new and existing facilities.
• Provide insight into the current real estate market and the impact of outpatient programs in commercial buildings.

The Legacy Project Award celebrates outstanding health care design that has stood the test of time and contributes to future advancements. This award recognizes health care architecture that demonstrates superior planning and excellence. This session will describe how the original planning and architecture has evolved to contribute to a changing health care environment. Discussion will focus on the leadership qualities, project drivers, team experiences, and the story of this year's award-winning place of healing.

Learning Objectives:

• Describe how initial design and planning decisions addressed the issues of the time and provided flexibility for future change.
• Articulate key drivers and planning and design concepts that have endured for more than 15 years.
• Connect great planning and design to evidence-based practices.
• Identify principles of iconic work that contribute to the knowledge base of health care facility planning and design to become worthy of a Legacy project.

This session provides an overview of the newly created ASHRAE/ASHE Standard 189.3: Design, Construction and Operation of Sustainable High Performance Health Care Facilities, which prescribes the procedures, methods, and documentation requirements for the design, construction, and operation of high performance sustainable health care facilities. The session covers how this standard relates to ANSI/ASHRAE/USGBC/IES Standard 189.1 and the upcoming revisions to the International Green Construction Code (IgCC). With the recent implementation of the new LEED V.4, numerous jurisdictions are evaluating the adoption of the IgCC to provide an alternative to LEED.

Learning Objectives:

• Discuss the components and structure of ASHRAE Standard 189.3
• Describe the impact of ASHE's co-sponsorship on the requirements of ASHRAE Standard 189.3
• List the differences between Standard 189.1 and Standard 189.3
• Explain how the IgCC code will impact LEED, and how Standard 189.3 may alleviate the design challenges of green code applications for health care facilities.

Natural ventilation has many proven benefits, including energy savings, improved indoor air quality, and occupant connection to the outdoors. European patient wards are typically conditioned using natural ventilation, but passive cooling strategy is rarely used in the United States. This session identifies relevant design and patient care issues and outlines safe and effective approaches for incorporating natural ventilation into the health care setting. Additionally, the results of a survey to U.S. health leaders will quantify the most critical challenges to natural ventilation.

Learning Objectives:

• Identify the key challenges to implementing natural ventilation strategies, as perceived by the health care community.
• Quantify the effect of aspects of current local and international code parameters on the feasibility of using natural ventilation in patient rooms and wards.
• Describe the effect of window geometry on the potential to achieve minimum required airflow rate for a typical patient room.
• Recognize the key geometrical parameters that can allow for natural ventilation of ward corridors.

Prefabrication offers dramatic opportunities for construction process improvement and quality control. This interactive session walks through prefabrication techniques and unwraps the benefits and challenges of standardization and offsite construction techniques. This session will also describe historical precedent projects highlighting barriers to prefabrication and how those have been overcome. Live, web-based polling during the presentation will gauge audience priorities and preconceptions before and after the presentation.

Learning Objectives:

• Identify design concepts of the current state of prefabrication.
• Compare future opportunities of prefabricated pods versus prefabricated structural modules.
• Discuss the time and cost savings from different design interventions and their effect on the construction schedule.
• Consider how offsite strategies can be investigated and evaluated for health care construction.

The new Cleveland Clinic Avon Hospital developed a model patient room through a design and research process that employed full-sized mockups, patient and caregiver interviews, and prefabricated room elements. The process engaged decision makers to address all aspects of design, from unit layout to room configuration to room lighting. The integration of research, design, and construction facilitated consensus among the stakeholders and provided data to inform innovative design solutions for a room that is a new model for the health system.

Learning Objectives:

• Demonstrate how objective research can be a valuable part of the health care design process.
• Explore the refinement of the patient room through the construction of multiple mockups.
• Discover how the three-phase research approach informed innovative patient- and caregiver-oriented solutions.
• Improved the overall project delivery with prefabrication of patient room components.

Total project alignment strategy ensures improvement in all three areas of the Triple Aim at the University of Arkansas for Medical Sciences. The university focuses on the total cost of ownership which includes all parties in a collaborative delivery model. These processes ensure high quality, effective, and efficient product delivery and constant improvement, which will be demonstrated in a case study of a replacement clinic project using total project alignment strategies.

Learning Objectives:

• Discuss the value of designing for the total cost of ownership instead of the first cost of construction.
• Identify how the alignment model's roles and responsibilities were developed during the OPR (owner's project requirements) charrette.
• Explore the developmental process within the collaborative to achieve the OPR and the Triple Aim.
• Review a case study using the alignment technology.