Nearly 18 months before the planned start of construction of a $30-plus million Beeghly campus emergency department addition, a major lean initiative kicked off with a goal of shaving 15 percent off the estimated project costs.
At its heart was a full-scale cardboard mock-up of the space in a former Kmart Super Store temporarily rented by the hospital. Think of it as giving ED staff, architects and building trades contractors the opportunity to literally touch, feel and experience the entire layout as if they were walking through a blueprint.
And most importantly, they could identify opportunities to make changes to improve workflow and efficiency before a wall is erected or a single nail is hammered.
“Getting the design right at the beginning of the project is critical. Architects are excellent at crafting floorplans but those plans don’t always translate in two dimensions to the clinical teams who will be using the space,” said Brian Lapolla, vice president of facilities, planning, construction and public safety, Akron Children’s Hospital. “The cardboard mockup provides a real-life experience of the space before the building starts construction – down to the smallest details like medical gas outlets and light switches. It is extremely difficult for an architect or contractor to fully understand Akron Children’s emergency department’s future state workflows, which is why it is so valuable to have the clinical and support teams partner with the designers.”
Akron Children’s has conducted similar “integrated lean project delivery” exercises for the Kay Jeweler’s Pavilion and Considine Professional Building addition in Akron that each led to 20 percent or more of construction savings.
“By going through this integrated process to increase efficiencies and eliminate waste, we’ve been able to provide high-quality spaces, ahead of schedule and 15-20 percent below market value estimates for healthcare spaces. This is tangible savings to the organization in addition to providing a high-quality space designed through the eyes of a child,” Brian said.
The integrated lean project team, he said, is a collaboration of architects, engineers, designers, contractors, patients, families, and all clinical and operational stakeholders at Akron Children’s.
Lean “boot camps” started in July 2020, said Kellie Witkoski, operational excellence leader. In those early stages, the team conducted “future state” surveys to determine what ED staff liked and disliked about their current space, and then they listed wants and needs for the new space. Witkoski said these surveys led to more than 100 desired improvements.
From there, multiple workshops were held once the cardboard walls were put up. There, the teams analyzed patient flow through various scenarios; they looked at the design from an infection control perspective; they considered where each piece of furniture should go; and they even simulated the patient drop-off experience through a full-scale parking lot layout.
“The biggest benefit happens when employees have input,” Kellie said. “It boosts employee retention, improves team morale, and reduces change orders post-renovation. It can end up saving significant money in construction costs.”
The emergency department expansion project is made possible, in part, through the generous support of the community including Lenny Fisher, the Cafaro Foundation and many others.
Construction is scheduled to begin in the fourth quarter of 2021 with a planned completion date of spring 2023.