HLS Presentation Hospitals 2013

Healthcare Licensing and Surveys (HLS) ● Wyoming Department of Health (WDH)

Improving the ProcessLife Safety Reviews &

Inspections of HC Facilities

Healthcare Licensing and Surveys (HLS) ● Wyoming Department of Health (WDH)Healthcare Licensing and Surveys (HLS) ● Wyoming Department of Health (WDH)

P r e s e n t a t i o n O u t l i n e

HLS

• Personnel

• Statutes, Rules & Regs

• Policies & Procedures

• LSO HLS Mgmt Report

Facilities & Projects

• Facilities by HC Type

• HLS History

• Projects per Year

• Reviews/Inspections

• Queue Metrics

• 3rd Party & Jurisdictions

Process Changes

• Triage Review

• Deliverables

• Project Database 2.0

Discussion

• Cost-Scope-Schedule

• Timing of Submittals

• Prelim/Final Combined

• Reduce Final Reviews

• Future Improvements




Healthcare Licensing

& Survey


H L S - P e r s o n n e l

• Wyoming Department of Health – Aging Division

• Heather Babbitt – Senior Administrator (Aging Division)

• Healthcare Licensing & Survey (HLS)

• Ron Pearson – Administrator (HLS)

• Life Safety & Construction Branch

• Todd Wyatt – Chief

• Milt Werner – Engineer

• John Bruner – Engineer

• Jason Jensen – Life Safety Surveyor

• Healthcare Surveillance

• Laura Hudspeth – Chief

• (2) Lead Surveyors + (10) Surveyors

• Business Office

• Tammy Schmitt – Chief (Licensing)

• (2) Certification Specialists + (1) Website Administrator



Ron Pearson

Todd Wyatt

Milt Werner

Pat Davis

Jeffrey Shahan

Laura Hudspeth Tammy Schmitt



• Heather Babbitt – Senior Administrator (Aging Division)

• Started on April 8, 2013

• MPA (Master of Public Administration)

• Ron Pearson – Administrator (HLS)

• Started on December 15, 2011

• MHA (Master of Healthcare Administration)

• CFAAMA (American Academy or Medical Administrators)



• Todd Wyatt – Chief of Life Safety & Construction Branch• Started at HLS on 5/2012

• Education : University of Illinois • Architecture : Bachelors 1990 & Masters 1993

• Professional• 1990 - 1996 : Gary Anderson Architects (Rockford IL)

• 1996 - 2004 : H+L Architecture (Denver CO)• Role : Project Architect + Project Manager

• Ivinson Memorial Hospital (Laramie, WY)

• St. Mary’s Hospital (Grand Junction CO)

• Great Plains Regional Medical Center (North Platte NE)

• Children’s Hospital (Denver CO)

• 2004 - 2009 : EUA (Milwaukee WI)• Role : Quality Assurance Manager

• Production/PM/Design/Staff Development/Data Management

• Risk Mgmt : reviewed (25) projects during SD/DD/CD phases

• 2010 - 2011 : H+L Architecture (Denver CO)• Role : Senior Project Architect

• Children’s Hospital (Denver CO)

• Licensed Architect (CO 2003)



• Milt Werner – Engineer : Started at HLS on 11/1991

• Pat Davis – Engineer : Started at HLS on 11/2013

• Engineer #3 : To be hired in 1Q of 2015

• Certifications for Life Safety & Construction Branch Staff• Certified Plan Examiner

• Certified Fire Plan Examiner (CFPE - NFPA)

• Building Plans Examiner (B3 - ICC)

• Mechanical Plans Examiner (M3 - ICC)

• Plumbing Plans Examiner (P3 - ICC)

• Certified Fire Inspector• Fire Inspector I (66 - ICC)

• Commercial Building Inspector (B2 - ICC)

• Commercial Mechanical Inspector (M2 - ICC)

• Commercial Plumbing Inspector (P2 - ICC)

• (8) Plan Examiner & Fire Inspector Tests = +6000 pages of codes

• Centers for Medicare & Medicaid Services (CMS)• Principles of Documentation

• Basic Life Safety Course

• NFPA 99

• FSES/HC


S t a t u t e s, R u l e s, & R e g s

• Statutes

• Formal written enactment of a legislative authority.

• Command or prohibit something, or declare policy.

• Regulations

• A written order containing rules having the force of law.

• Prescribed by authority, especially to regulate conduct.

• Rules

• Details of how a statute or a regulation is put into effect.

• Governs conduct, action, procedure, or arrangement.

• Policy & Procedures

• Identifies the responsibility, authority, and accountability

of individuals within the framework of the department.

Difficult

Easiest

Easier


S t a t u t e s, R u l e s, & R e g s

• Statutes

• TITLE 35 - PUBLIC HEALTH AND SAFETY

• Chapter 2 - Hospitals, Health Care Facilities and Health Services

• Article 9 - Licensing and Operations W.S. 35-2-906.

• Rules & Regulations

• Chapter 3 : Construction Rules and Regulations for HC Facilities

• Chapter 2 : Hospitals, Health Care Facilities and Health Services

• Chapter 12 : Rules and Regulations for Licensure of Hospitals

• Policy & Procedures

• C-007 - Plan Review and Inspection Policy

• C-026 - Protocol for Acceptable Plans


H e a l t h c a r e S t a t u t e s

TITLE 35 - PUBLIC HEALTH AND SAFETY

Chapter 2 - Hospitals, Health Care Facilities and Health Services

• Article 9 - Licensing and Operations

• W.S. 35-2-906.

• Requires proposed HC facility construction projects be reviewed and approved prior to commencing with construction.

Chapter 9 - Fire Protection

• Article 1 - Department of Fire Prevention and Electrical Safety

• W.S. 35-9-121.1.

• Passed in 2003 … gives the Office broad jurisdiction over “all aspects” of construction, except for electrical installations (where jurisdiction resides with the DFPES or delegated local government).

• This statute also requires the Office to adopt certain construction codes and it allows the Office to delegate plan review and inspection responsibilities to local governments.




Chapter 2 - Hospitals, Health Care Facilities and Health Services


• W.S. 35-2-906.

• Construction and expansion of facilities; exemption.

(a) A licensee who contemplates construction of or alteration or

addition to a health care facility shall submit plans and specifications

to the division for preliminary inspection and approval prior to

commencing construction. Significant changes to the original plans

must also be submitted and approved prior to implementation. The

plans and any changes shall indicate any increase in the number of

beds.




Chapter 2 - Hospitals, HC Facilities and Health Services


• 35-2-901. Definitions; applicability of provisions.

• (a) As used in this act:

(x) "Health care facility" means any ambulatory surgical center, assisted living

facility, adult day care facility, adult foster care home, alternative eldercare

home, birthing center, boarding home, freestanding diagnostic testing center,

home health agency, hospice, hospital, intermediate care facility for people with

intellectual disability, medical assistance facility, nursing care facility,

rehabilitation facility and renal dialysis center;






• W.S. 35-9-121.1. • Health care facilities; jurisdiction; delegation; rules.

• (a) The department of health has jurisdiction over all aspects of construction and remodeling, except electrical installation, of any state licensed health care facility as defined in W.S. 35-2-901.

• (b) The fire safety code requirements for the construction and remodeling of any state licensed health care facility shall meet the minimum requirements established in the National Fire Protection Association 101 Life Safety Code or any other code required to meet federal fire and life safety certification. If any code requirements for federal certification conflict with the code of any other state or local governmental entity, the code required for federal certification shall prevail.






• W.S. 35-9-121.1.

• Health care facilities; jurisdiction; delegation; rules.

Continued …

• (c) The department of health shall promulgate rules and regulations for all aspects of construction and remodeling of health care facilities except electrical installation. For aspects of construction and remodeling included in codes adopted by the council pursuant to W.S. 35-9-106, the rules and regulations shall be based on and not exceed the standards of these codes except where federal certification requirements dictate otherwise.





Article 1 - Department of Fire Prevention and Electrical Safety

• 35-9-106. Powers and duties of council.

• (a) The council shall adopt rules and regulations to:

• (i) Establish minimum fire standards not exceeding the standards prescribed by

the International Fire Code, the International Building Code, the International

Mechanical Code, the International Existing Building Code and the

International Fuel Gas Code for:

• (A) All new building construction or remodeling under W.S. 35-9-108(a);

• (B) The prevention of fire and the protection of life and property from fire and panic in

all existing buildings;

• (C) The safeguarding of life and property from hazards of fire and explosion arising

from storage, handling and use of hazardous substances, materials and devices.





Article 1 - Department of Fire Prevention and Electrical Safety

• W.S. 35-9-121.1.

• Health care facilities; jurisdiction; delegation; rules. Continued …

• (d) Upon written request from any county or municipality, the department of health shall delegate plan review and inspection responsibilities to the county or municipality that has personnel who are certified pursuant to the applicable code. The department of health shall transfer jurisdiction and authority by letter. The department of health shall notify the governing body of the municipality or county of the minimum standards and requirements under this section and W.S. 16-6-501 and 16-6-502. The following shall apply:• (i) Any municipality or county may issue a certificate of occupancy for a health care facility.

The certificate shall reference any code applied to the construction or remodeling of the facility;

• (ii) A municipality or county which has enforcement authority under this subsection shall create its own appeals board to determine the suitability of alternate materials and types of construction.

• (e) After construction or remodeling of any health care facility, the department of health shall have jurisdiction over the fire and life safety inspections required for federal certification.


C H 3 : R u l e s & R e g s

• Section 1 : Authority

• Section 2 : Applicability

• Section 3 : Definitions

• Section 4 : Department of Health Jurisdiction

• Section 5 : Construction Design Requirements for HC Facilities

• Section 6 : Approvals, Inspections, Tech Assistance, Interpretations and Plan Review

• Section 7 : Exist Bldg Licensure

• Section 8 : Electrical Safety

• Section 9 : Variances

• Section 10 : Severability


G u i d e l i n e s t o C H 3

• Intro

• Facility Types Requiring

Construction Approval

• Project Programming Phase

• Plan Reviews

• Inspections

• Technical Assistance


H L S W e b s i t e


P o l i c i e s & P r o c e d u r e s

• C-007 Plan Review and Inspection Policy

• C-008 Plan Review Follow-Ups

• C-014 Construction Project Organizational System

• C-015 Construction Plan Review Protocol

• C-016 Waiver Criteria for Construction Plan Reviews

• C-017 Electrical Plans Review Protocol

• C-018 Construction Queue

• C-021 Transfer from Construction to Licensure

• C-022 Construction Variance Tracking

• C-025 Protocol for Determining Rqmt for Design Prof. Seals

• C-026 Protocol for Acceptable Plans

• C-027 Design Professional Seals

• C-028 Minor Project Final Plan Review



Purpose:

The purpose of having a queue system is to manage the workload and assignments and to ensure that preliminary and final plans are reviewed in the order of receipt or that projects pursuant to federal Life Safety Code requirements are prioritizedto protect the healthcare entity’s certification status.

Policy:

All preliminary plans and final plans received by HLS for review are entered into the queue and assigned to an engineer for review. The status of each project will be monitored on a weekly basis.

Procedure:

… all other projects will be moved up in the queue by order of date received …



Prioritization

We prioritize submissions based on the following criteria:

1. CMS or State Related Deficiencies (from Surveys)

2. Minor Projects (recent revision)

3. Plan of Corrections (Licensure Survey)

4. 3rd Party/Delegated AHJ Approved Final Plans

5. Phased Construction Review (Foundation)

6. Modifications to approved projects1. Construction Phase

2. Final Plans

3. Preliminary Plans

7. Deferred plan submittals (fire alarm, fire sprinkler, etc)

8. Disposition responses to reviewed projects1. Final Plans

2. Preliminary Plans

9. All projects (routine maintenance, minor and major projects) placed in the Review Queue per the date of submission.


L S O H L S M g m t A u d i t

WHAT?

• Program evaluation report

• Compares what a program

is accomplishing to what

the Legislature intended

the program to accomplish

• LSO requests info from

HLS including:

• Documents

• Data : staffing/budgets

• Case Files : projects

• Questions : process


L S O H L S M g m t A u d i t

WHY?

• Statutes passed in 2003 required HLS plan reviews & inspections

• Increased HC project submissions during 2005-2008 caused a backlog

• 80% of construction projects come from hospitals and nursing homes

• Main issues & concerns

• Timeliness

• Consistency

• Transparency

4855

47

5664

6065

106

123

9488

68 7175

97

118

0

20

40

60

80

100

120

140

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

Projects by Year


P r i n c i p a l F i n d i n g s

1. Timeliness of the Office’s work has significantly decreased in recent years.

2. Preliminary plan reviews do not assist in quicker or easier final plan reviews.

3. Combining code requirements with process criteria in rules with frequent promulgations causes confusion for Office staff and other stakeholders.

4. Office’s application of project process waivers is inconsistent and does not help manage project workload.

5. There is no clear or consistent appeals process for facilities to check the Office’s code application or interpretation decisions prior to final licensure.

6. The Office’s paper and electronic project tracking systems are cumbersome and ineffective for review and oversight.

7. The Office lacks formal internal policies to provide guidance and assist staff in consistently implementing its work processes.

8. The Office has not proactively carried out its statutory responsibility to delegate authority to local governments, contributing to additional workload and timeliness problems for the Office.

9. Coordination on electrical plan reviews conducted by the DFPES or delegated local author cities is lacking and does not ensure facilities are constructed according to appropriate codes.


R e c o m m e n d a t i o n s

1. Re-establish reasonable timelines for review and inspections

2. Re-evaluate need for Preliminary Plan reviews

3. Codes/standards are consistently applied

4. Manage waivers effectively

5. Establish an appeals process

6. Re-evaluate its paper & electronic record management

7. Develop clear and sufficient policies to ensure consistency

8. Encourage more local governments to perform plan reviews

and inspections

9. Work with DFPES to mirror certifications of local delegation

of authority

10. Coordinate with DFPES to ensure plan reviews are performed


T i m e l i n e s s

1. The Office should re-establish in rules or formal policy

reasonable time lines for conducting plan reviews and

inspections; engineer staff should be monitored on their

timeliness per these time lines.

2009 HLS Response : Agreed

• An engineering manager position was created in 2010 in

order to better manage the engineering section, manage

existing policies, and to develop new policies to comply

with all the Management Audit Committee’s

recommendations.


T i m e l i n e s s

• Facility Survey : Prelim/Final Reviews should take :

• (45) days or less (70% thought) … (30) days or less (30%)


C o n s i s t e n c y

2. The Office should re-evaluate the overall need for the review of preliminary plans; if upon further review the Office chooses to eliminate the requirement, it should seek statutory change if necessary.

2009 HLS Response :

• Office of Attorney General concluded that the legislature mandated a preliminary review of plans and specifications prior to the commencement of construction.

2013 HLS Response :

• Statute states “submit plans and specifications … for preliminary inspection and approval prior to commencing construction …”• Option 1

• Reduce scope of Preliminary Plan submittal

• Focus HLS energies on review of Final Plans

• Option 2

• Expand scope of Preliminary Plan submittal

• Require submittal (but not review) of Final Plans only


C o n s i s t e n c y

3. The Office should promulgate codes/standards and process elements into separate rules to ensure that codes/standards and processes are consistently applied throughout the duration of each project.

2009 HLS Response :

• Chapter 3 Rules & Regs were simplified in 2008.

2013 HLS Response :

• Additional simplifications will be made in Q3 of 2013.

• Separate process requirements from codes, standards & other requirements.




Facilities and Projects


F a c i l i t i e s b y H C T y p e

• (8) Adult Day Cares (ADC)

• (26) Assisted Living Facilities (ALF)

• (20) Ambulatory Surgical Centers (ASC)

• (9) Boarding Homes (BH)

• (16) Critical Access Hospitals (CAH)

• (3) Community Mental Health Centers (CMHC)

• (1) Comprehensive Outpatient Rehabilitation Facilities (CORF)

• (9) End Stage Renal Dialysis Centers (ESRD)

• (13) Federally Qualified Health Centers (FQHC)

• (1) Freestanding Diagnostic Testing Center (FSDTC)

• (43) Home Health Agencies (HHA)

• (19) Hospice Center (HSPC)

• (11) Hospitals (HOSP)

• (1) Intermediate Care Facilities for the Mentally Retarded (ICF/MR)

• (38) Nursing Care Facilities (NH)

• (1) Outpatient Physical Therapy (OPT)

• (3) Psychiatric Residential Treatment Centers (PRTC)

• (2) Psychiatric Hospitals (PSYCH)

• (2) Rehabilitation Facility (REHAB)

• (1) Rehabilitation Hospital (RHOSP)

• (18) Rural Health Clinics (RHC)

• (1) Rural Hospital (RH)

• (246) Total WY HC Providers


H L S H i s t o r y

1991 to 2003

• HC Codes enforced• NFPA 101• Federal certification purposes

• AIA Guidelines • Focused on engineering,

infection control, and safety of facilities.

• Review & Inspections• Preliminary Plans

• Final Const Inspections

• Staff : (1)• Pro’s : Consistency &

Timeliness

• Con’s : Deficiencies found late in process (Post-Const) = $$$


H L S H i s t o r y

2003 to 2008• HC Codes enforced

• NFPA 101 (2000 & 2006)

• AIA Guidelines

• ICC Codes

• National Electrical Code

• Review & Inspection Scope• Added Final Plan Reviews

• Added Interim Inspections

• Delegated Jurisdictions

• 3rd Party Plan Reviewers & Inspectors

• Staff : (2-3)• Pro’s : Deficiencies identified earlier

• Con’s : Consistency & Timeliness

2010 to Present• Added Chief of LS & Const Branch

• Staff : (3)• Pro’s : Engineers focus on review/inspection

• Con’s : Consistency & Timeliness


P r o j e c t s b y Y e a r

8

4

7

4

18

9

15

1

87

8 8 87

67 7

1110

2

8

5

13

65

45

87 7

2

9

7

3

0

2

4

6

8

10

12

14

16

18

20

Oct

-11

Nov

-11

Dec

-11

Jan-1

2F

eb-1

2M

ar-1

2A

pr-

12

May

-12

Jun

-12

Jul-

12

Aug

-12

Sep

-12

Oct

-12

Nov

-12

Dec

-12

Jan-1

3F

eb-1

3M

ar-1

3A

pr-

13

May

-13

Jun

-13

Jul-

13

Aug

-13

Sep

-13

Oct

-13

Nov

-13

Dec

-13

Jan-1

4F

eb-1

4M

ar-1

4A

pr-

14

May

-14

Jun

-14

Jul-

14

Projects by Month

4855

47

56

6460

65

106

123

9488

68 7175

97

89

76

0

20

40

60

80

100

120

140

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Projects by Year


R e v i e w s & I n s p e c t i o n s

1410

13 12

18

129

4

2117

20

13 13 1310 12

2124

1815

26

19

13

24 25 2521

17

9

19

13

28

6

6

11

7

8

58

14

10

11

13

13

6

15

3

9

64

8

8

5

3

8

2

74 10

5

7

12

17

5

16

9 11

19

0

10

20

30

40

50

60D

ec-1

1

Jan

-12

Feb

-12

Mar

-12

Ap

r-1

2

May

-12

Jun

-12

Jul-

12

Au

g-1

2

Sep

-12

Oct

-12

No

v-1

2

Dec

-12

Jan

-13

Feb

-13

Mar

-13

Ap

r-1

3

May

-13

Jun

-13

Jul-

13

Au

g-1

3

Sep

-13

Oct

-13

No

v-1

3

Dec

-13

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

LS Surveys Inspections Plan Reviews


Q u e u e M e t r i c s

• How is it determined?

• Average of ALL projects in

Review Queue

78 78

63

72

84

91

97

104

100

6769

64

7574

54

4243

4647

50

39

52

4647

43

47

50

46

53

6058 57

43

4847 47

51

54

60

5453 53

4644

46

51

43

49

5352

57

52

41

34

39 3938

46

4142

54

47

43

31

37 38 37 38

35

42

38

4142

43

47

51

6058

59 59

62

57

44

49

43

38

35

32

3634

40

37

40

43

46

53

61

69

60

51

55

58

61

70 71

79

74

81

88

100

94

107

39

20

0

15

30

45

60

75

90

105

120

06

/01

/12

06

/15

/12

07

/09

/12

07

/23

/12

08

/13

/12

08

/27

/12

09

/11

/12

09

/24

/12

10

/08

/12

10

/22

/12

11

/05

/12

11

/19

/12

12

/03

/12

12

/17

/12

12

/31

/12

01

/14

/13

01

/28

/13

02

/11

/13

02

/25

/13

03

/11

/13

03

/25

/13

04

/08

/13

04

/22

/13

05

/06

/13

05

/20

/13

06

/03

/13

06

/17

/13

07

/01

/13

07

/15

/13

07

/29

/13

08

/12

/13

08

/26

/13

09

/09

/13

09

/23

/13

10

/07

/13

10

/21

/13

11

/04

/13

11

/18

/13

12

/02

/13

12

/16

/13

12

/30

/13

01

/13

/14

01

/27

/14

02

/10

/14

02

/24

/14

03

/10

/14

03

/24

/14

04

/07

/14

04

/21

/14

05

/05

/14

05

/19

/14

06

/02

/14

06

/16

/14

06

/30

/14

07

/14

/14

07

/28

/14

08

/11

/14

Days in Queue by Week

• Today (Monday’s) - Day

submitted = Days in Queue

• Goal = 30 - 45 days



39 3938

46

4142

54

47

43

31

37 38 37 38

35

42

38

4142

43

47

51

6058

59 59

62

57

44

49

43

38

35

32

3634

40

37

40

43

46

53

61

69

60

51

55

58

61

70 71

79

74

81

88

100

94

107

39

20

0

15

30

45

60

75

90

105

120

Days in Queue by Week

PD’s First

Day

(11/04/13)

JJ’s Last

Day

(02/21/14)

JS’s First

Day

(05/05/14)

JB’s Last

Day

(09/26/13)



75

49

20

15 15

30

2521

59

64

0

10

20

30

40

50

60

70

80

1-1

3

14-2

7

28-4

1

42-5

5

56-6

9

70-8

3

84-9

7

98-1

11

112

-12

5

126

-13

9

140

-15

3

154

+

Number of Projects by DIQ

48

54

40

79

58

50

6971

67

32

4549 48

43

5356

19

43

5957

32

72

0

10

20

30

40

50

60

70

80

90

Oct

-12

Nov-1

2D

ec-1

2Ja

n-1

3F

eb-1

3M

ar-1

3A

pr-

13

May

-13

Jun-1

3Ju

l-13

Aug-1

3S

ep-1

3O

ct-1

3N

ov-1

3D

ec-1

3Ja

n-1

4F

eb-1

4M

ar-1

4A

pr-

14

May

-14

Jun-1

4Ju

l-14

Average DIQ by Month



• Disadvantages of Metrics from “Spreadsheet”

• Difficult to differentiate project types & reviews/inspections

• Projects :

• Major vs. Minor,

• New Facility, Addition, Renovation

• Reviews :

• Inquiries

• Triage, Routine Maintenance, Prelim, Final

• Dispositions

• Revisions

• Inspections :

• Interim, Final, Follow-Up, Plan of Corrections


3 r d P a r t y & J u r i s d i c t i o n s




Process Changes


H L S T a s k s

• Pre-Construction

• Preliminary Plan and Final Plan reviews

• Permission to proceed with construction

• Construction

• Interim inspections of the project as it is being built

• Post-Construction

• Final Construction Inspection and provisional licensure for

facilities to begin using the construction space for rendering

healthcare services.

• Upon gaining state licensure, some facilities choose to

become certified for federal Medicare and Medicaid service

reimbursement.


T r i a g e R e v i e w


D e l i v e r a b l e s


P r o j e c t D a t a b a s e 2 . 0


P r o j e c t D a t a b a s e 2 . 0

• Old Database

• HLS Engineers & Chief can all input information

• Emails : add summaries in notes, print to TXT file

• No reports (spreadsheet on steroids)

• New Database

• Gmail : Cc each other, searchable by project # (YYYY-###)

• Reports : mine for project data• Projects List : A summary report of several (or all) projects grouped by

filtering categories.

• Project Info - Summary : A summary report of a single project.

• Project Timeline : A detailed report of a single project's timeline.

• Notes - Single Project : A list of all notes for a single project

• Contacts - Single Project : A detailed report of all the contact info

• Contacts - Multiple Projects : A list of third parties and/or jurisdictions sorted by project and/or project type.




Discussion


Cost – Scope - Schedule

• One side of the triangle cannot be changed without affecting the others.

• A trilemma is a difficult choice from three options, each of which is (or appears) unacceptable or unfavorable.


Cost – Scope - Schedule

• Option 1

• Design something quickly

• and to a high standard,

• but then it will NOT be cheap.

• Option 2

• Design something quickly

• and cheap,

• but it will NOT be of high quality.

• Option 3

• Design something with high quality

• and cheap,

• but it will NOT occur quickly.


S u b m i t t a l s - T y p i c a l


S u b m i t t a l s - I d e a l


P r e l i m / F i n a l C o m b i n e d

Schematic

Design

Design

Development

Contract

DocumentsConstruction Occupancy

Preliminary

Review

Final Plan

Review

Final

InspectionCurrent

Preliminary

Review

Final Plan

Review

Final

InspectionOption

A

Preliminary

Review

Final Plan

Review

Final

InspectionOption

B


F i n a l P l a n R e v i e w s

• Final Plan Reviews (FPR)• Required for …• New Facilities & Additions & Renovations > 4500 sf

• Optional for …• All other project types

• Facility may OPT out

• Eliminate FPR’s?• Make preliminary plan reviews (PPR) the “final” review

• Require level of completion per FPR’s for PPR’s

• Advantage• (1) submittal = Improved timeliness

• Disadvantage• 3rd Party Review would be reduced • HLS has to review “prelims” per statute

• Risk Mgmt : Design Teams could design down the wrong path


F u t u r e I m p r o v e m e n t s

• 2012 ICC Adoption

• Adopted by DFPES

• Enforced by some WY jurisdictions

• Designers are familiar with this edition

• HLS Newsletter

• Educate facilities & designers on code issues

• Improve transparency

• Plan Review Queue

• Weekly version saved to WDH website, accessible to public (?)

• Documentation Mgmt

• Online, project portal• Newforma

• Email Mgmt

• Eventual replacement for database




T H A N K Y O U

HLS Presentation Hospitals 2013

Documents

Transcript of HLS Presentation Hospitals 2013