The Veterinary Teaching Hospitals of the Future – Innovators or Dinosaurs?

John Haven

Director

UF College of Veterinary Medicine

New Construction

• Few of us get to build a major new building more than a few times in a career – hard to be “good at it” – what was good 10 years ago is dated today…

• Funding issues • Constituencies pulling the project in

different directions• Internal challenges

Funding Issues

• Project Plan to funds acquisition to project completion often result in a let down…

• Construction costs grow at 10% or more

• Equipment costs continue to grow

• Battle with Referral Practices to have state of the art equipment

Pull of Forces

• Need quality teaching space– Interaction with clients– Rounds areas – OR’s and other areas configured for viewing

• Clinic Efficiency for client experience – generate revenue– Streamline workflows– Demands for technology

Pull of Forces (cont.)• Need competitive technology to attract and retain

faculty – the new arms race– (MRI, CT, Linac, cathlab, etc.) and to perform research

– Faculty want a $1.4 million Linac when others in the state have $250k units…

• Need high end equipment to maintain tertiary care role or lose to referral practices

• All these “tools” have maintenance contracts after year 1… usually 8-12% of the purchase price!

Space – the Final Frontier

• Many schools do not allow construction of “shell space” for future growth – even though this it for next 20 years…

• Need to build with an eye for future caseload growth and new services

• Collectively services will ask for more space than available

• Less total space means more money for equipment• Campus may lay claim to part of new building

Key Players

• Faculty• Staff• Students• Residents and Interns• Campus – HVAC, utilities, IT, etc…• Permits and requirements – parking, wildlife,

mitigation, etc.• Clients?

Project Management • Coordination of information and stakeholders is

CRITICAL– Information flow can be fast and furious – easy to fall

through the cracks

– Leadership team is compromised if they appear to be doing everything at the last minute

• Delays in the project plan can really add up…• But change orders later can be very expensive…• It is an iterative process…

Managing Expectations

• Ask faculty for what they want in the new building– Space– Equipment

• Analysis will then mean managing their wants, to what they need – and figuring out how to afford

Don’t Forget the Little Things

• Phones and faxes?• HIS…

– Computers– Printers

• Chairs• Home Base?

– Lockers– Lunch bags

Coordinating the Big Picture• Ensuring if there are 12 OR’s – is there

adequate anesthesia support…• Ensuring all the services goals of seeing

clients can be handled by client services…• Ensuring equipment isn’t being duplicated• What may seem reasonable in the micro

level is ridiculous at the macro level…• What fell through the cracks?

UF Plans

• 3 Pods to streamline reception and create a smaller feeling

• Build as much new space as possible – retrofit is cheaper – do later

• Home base/rounds rooms for services

• Strong engagement of staff to ensure they can function

UF Plans (cont.)

• Zone construction– Surgery and interventional work on second

floor– Separate clients from inner spaces– Offices on third floor

• Interns and residents in collaborative spaces• Image of the building to make a statement

about what is in side

UF Plans (cont.)

• Small caseload of 16k to grow to 30k in next 20 years

• 22 new exam rooms

• 12 new OR’s

• Plan for student growth from 88 to at least 120

• Continued growth of residents/interns

UF Plans (cont.)

• Emergency Room

• OP Medicine to operate as “a real practice”– Own radiology area (share with ER)– Own lab (for basic tests)– Own reception/waiting (share with ER)