PLANNING

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The COVID-19 pandemic highlighted the need for health systems to prepare for anything, and to design their facilities to be as nimble as possible.

Two members of MaineHealth’s strategic facilities planning team—Angelique Kennison, the director for regional clinical planning, and Alexander Green, the vice president of planning and business development—will share their recent approaches to facility planning efforts during a live symposium at the Society for Health Care Strategy & Market Development (SHSMD) Connections Conference, being held Sept. 11-14, 2022, in National Harbor, Md., as well as in an accompanying podcast.

“Strategic planners play such an important role during this process,” Kennison says in the podcast, available here.

Although Kennison acknowledged that planners are neither architects nor the final decision makers in the process, she says they “inform the decisions that are going to be made.” The informing is takes place mainly in the form of data on the health system’s current financial and physical state as well as in projections that forecast where the health system will be in the years ahead and the services it will be expected—and perhaps need—to provide.

“We’re process people as much as we are big thinkers, so we think about important questions, but then we look at the period of time that we’re planning for and the period of time that we have to plan within, and try to organize those questions in terms of what’s important to know before we answer the next set of questions,” adds Green, in explaining the role of planners in the process. “We’re not the most creative people when it comes to how a building looks and feels and functions, but we’re really good at helping a group of people, a group of stakeholders and subject matter experts, define a need.”

That need could remain the same for the next 50 years or change over time, he says. Indeed, while such long-term planning—and planning for flexibility—has always been important for health systems, the pandemic has served as a stark reminder of why this is so, according to Green. At its peak, in the spring and summer of 2020, many health systems nationally were overwhelmed with patients and experienced shortages in staffing, beds and needed supplies and equipment, ultimately affecting the delivery of care (Ann Intern Med 2021;174[9]:1240-1251).

As a result, many systems were forced to make key facility and resource allocation decisions on the fly, and found they lacked the flexibility to do so. This adaptation included being able to establish dedicated wards for COVID-19 patients and to add new ICU beds, as needed, among other challenges.

However, even with all the “changing variables in the world … process [of planning] is still very important,” Green notes. At MaineHealth, this process involved developing long-term facility plans for a tertiary medical center as well as a rural health center within the system—experiences and perspectives that Green and Kennison will share during the Connections Conference session.

“There is a foundational approach there that is consistent and will help guide you throughout these conversations, but because so much has changed—especially in these past few years—we’re also going to be approaching the session from a lens of getting the audience to think a different way,” Kennison says. “Are we thinking about facilities planning differently, knowing that the pace of change is happening faster than ever? How should that impact facilities planning? Does it impact facilities planning?”

Kennison and Green say they also want the audience to think differently about “resource constraints”—an age-old problem in healthcare delivery.

“We’ve always been confronted with resource constraints,” Kennison explains. “However, over the past few years, we’ve had unbelievable staffing challenges. Health systems have spent so much money to just keep trying to care for their patients and their communities. How do we approach our governing bodies and our boards with our asks for facilities planning?”

According to Kennison and Green, here are some other things for planners to consider as they seek to make changes to facilities:

• Remember that the “foundational approach” to planning remains the same, regardless of the pandemic. There are key foundational elements to facilities planning that never change, including ensuring that the current state of the infrastructure is truly understood and layering in forecasts, trends and intelligence that will help lay the groundwork for planners to “build off of,” Kennison and Green say. This underscores how critically important it is to make sure everyone in the room has the same understanding of the data and realities before moving forward, they add.
• Define your guiding principles, and refer back to them throughout the entire process. Your guiding principles in any planning process become essential when you and your team need to make a tough decision, Kennison says. “You have to ground yourself on what you initially set out to do,” she adds. “For example, if one of your guiding principles was to pursue the highest and best use of space—are you staying true to that? If another was to improve care team workflow, does what you've become focused on align with that?” Your guiding principles help to get the team “unstuck,” which is important because getting stuck is inevitable when you get in the weeds of master facilities planning, according to Green.
• Take a long view. Facilities planning is not just for immediate needs, but also for the future, Green says. “We don’t know how various disruptors and shifts in care delivery will impact our markets, and we likely will all have varying experiences depending on our individual markets and demographics,” he explains. “Not every disruption will impact your hospital or health system—but in today’s fast-paced, ever-changing world, you need to keep a pulse on what’s happening and be prepared if tides change in your market.” Keeping your eyes focused on what’s coming down the road, and not just what is right in front of you, will help you to ask better questions and influence planning with an eye to the future, he adds.

Ultimately, the goal of the session will be to help attendees prepare for planning conversations, whether they’re “at the table” with architects, clinical staff, hospital presidents or C-suite personnel, she adds. This includes the framework needed for the planning process, such as the questions planners need to ask (and answer), the data needed to make informed decisions, and how to identify future challenges and trends that could influence the health system and the healthcare industry as a whole.

“My hope is that people can learn from our experience,” Green says. “I hope that we equip anyone who attends the session with that list of important questions to ask themselves for their environment. I hope to really engage the folks who do attend in a conversation about some of the important questions that we’ve asked ourselves at MaineHealth in the various facility planning exercises that we’ve done, and also hear from folks in situations that they’ve been in as well.”

This article features interviews with:

Angelique Kennison
Director, Regional Clinical Planning
MaineHealth

Alexander Green
Vice President, Strategy and Business Development
MaineHealth

 Learning More

• Register soon for SHSMD Connections 2022 in-person conference this September in DC and attend this breakout session, “Designing for the Post-Pandemic Future: Modernizing Space to Promote Safety, Efficiency, and Agility”
• To hear more from Angelique and Alexander via a preview of their presentation topic at this year’s SHSMD Connections conference, click here to listen to their recent SHSMD Rapid Insights podcast episode.

image credit: Wokandapix from Pixabay