TRANSFORMING A CRITICAL ACCESS HOSPITALNORTHSTAR Health System - Hospital Addition and RenovationA Miron Construction Case...
F                      , NORTHSTAR                             “creating a unique environment                          for...
Tyink, Miron’s Vice President of Business         SOLUTION                                               Innovation and on...
TRANSFORMING A CRITICAL ACCESS HOSPITAL                                             NORTHSTAR Health System - Hospital Add...
3formed to facilitate the implementation of            Involve every level of thethe ideal experience. Guided by the Miron...
TRANSFORMING A CRITICAL ACCESS HOSPITAL                                             NORTHSTAR Health System - Hospital Add...
also vital to ensure patients felt comfortable   service for meals; First Impressionist position;   RESULTSand calm. Not o...
"The entire Miron team operated like an orchestra or well-choreographed                                                bal...
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NORTHSTAR Health System - Hospital Addition and Renovation


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Miron Construction's health care services team and experience-based design experts worked collaboratively with NORTHSTAR's design partners and owners to create unique and ideal experiences for patients, staff and the community.

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NORTHSTAR Health System - Hospital Addition and Renovation

  1. 1. TRANSFORMING A CRITICAL ACCESS HOSPITALNORTHSTAR Health System - Hospital Addition and RenovationA Miron Construction Case StudyWHAT WILL IT TAKE? HOW DO PATIENTS DECIDE Health System. Shrinking marketshareEvery healthcare organization aspires WHERE TO GO FOR CARE? and a desire to stay up-to-date withto attract and retain patients. Appealing Conventional thinking has long held that emerging patient needs necessitatedwebsites, public awareness and outreach most patients base their hospital choice change. Rampage went on to state “our goalefforts market key services. Announcements on clinical reputation, its location, or their was to [envision] the hospital of the future.of awards, praise and other c linical physicians’ recommendations. Recently, To think differently than before—that isrecognition let potential patients know of hospital executives have begun recognizing how marketshare will be [gained]. Ouryour success. But does any of this impact that patients also consider non-clinical clinical outcomes are superb, [but] we havedecision-making? factors, such as comfortable rooms, surgical to connect on the non-clinical elements education and convenient registration of the experience.” Rampage was facedResearch says no. New research indicates with this challenge and couldn’t help but procedures, when choosing where to seekthat patients and physicians are increasingly get excited about NORTHSTAR’s new treatment.likely to base their choice of hospital on opportunity. Early in 2008, Rampagenon-clinical aspects of their visit—like NORTHSTAR Health System (formerly launched an effort to “re-imagine” thethe overall patient experience (McKinsey Iron Count y Communit y Hospital) critical access hospital experience. He and& Company Quarterly, 2009). Yet, few understands just how important non-clinical his team hired Miron Construction Co.,hospitals have the marketing skills, key factors have become. “Our opportunity is Inc. to develop and construct an addition,organizational structure or the strategic immense. While this facility has served which encompassed 25,000 square feet ofapproach to deliver a distinctive experience the Iron County [Michigan] community new space, and complete the renovationin ways similar to those of retail and well for 35 years, we had to change,” states of 13,000 square feet of existing space.hospitality companies. Bruce Rampage, CEO of NORTHSTAR
  2. 2. F , NORTHSTAR “creating a unique environment for patients and their families. Building four walls wasn’t enough. Miron was selected because they look at projects di erently.” BRUCE RAMPAGE CEO of NORTHSTAR Health System CHALLENGE “Being a great hospital was not enough SETTING THE STAGE for us,” explained Rampage, who joined From the beginning of the project, itNORTHSTAR Health System (formerly IronCounty Community Hospital) was struggling NORTHSTAR less than three years ago. was important to align the experience toto remain relevant with an outdated facility. From day one, he says he focused on “creating NORTHSTAR’s overall strategic plan. “WeAlthough the hospital had excess capacity, a unique environment for patients and their realized that to simply build was not enough,”they were unable to provide the cutting-edge families. Building four walls wasn’t enough. commented David G. Voss, Jr., CEO ofservices that the surrounding community Miron was selected because they look at Miron. “Twenty-five percent of a patient’sdemanded. NORTHSTAR recognized the projects differently.” experience has to do with the outside walls;need to reposition themselves by re-imagining the rest is influenced by what happens insidethe critical access hospital of the future. Understanding that each patient is unique the facility. Successful projects encompass was at the core of the NORTHSTAR strategy. more than schedule, budget, quality and “Most hospitals apply a ‘one-size-fits-all’ constructability.” mentality to understanding the patient experience. We recognize that patients no In the ever-changing world of healthcare, it is longer want a ‘one-size-fits-all’ approach to as vital to consistently deliver on promises, as healthcare” asserted Rampage. it is to stay on the cutting-edge of technology. 2
  3. 3. Tyink, Miron’s Vice President of Business SOLUTION Innovation and one of our Experience-Based At the core of the NORTHSTAR transformation Design team members. “Reverse outcome were seven non-negotiable ‘Guide Lights’ that modeling actually begins with understanding NORTHSTAR and Miron Construction used to the outcomes that occur at every patient help lead the organization through re-design attach point within the hospital setting.” and construction efforts. “We never wavered from the core guiding lights. At every step Experience-Based Design (EBD) of the transformation process, we asked in healthcare focuses on capturing and ourselves: does it align with the strategy? understanding patient and caregiver needs, Does it align with the [guide] lights?” stated not simply their view of the process—for Tyink. instance, the efficiency and speed at which Seven Guide Lights: they travel through the system. Instead, it deliberately sets targets and establishes 1. Intentionally design the patient experience. benchmarks for subjective outcomes: personal feelings a patient and caregiver experience at 2. Understand the ideal patient ecology. critical points along the care pathway. 3. Involve every level of the organization in the creation. “Our healthcare services team and Experience- 4. Research best and innovative practices Based Design experts work collaboratively (both inside and outside the healthcare with design partners and owners to create industry) and use them. unique and ideal experiences for patients, staff 5. Choose wisely what you measure and the community,” Tyink elaborated. and hold people to it. 6. Listen to patients, but more e EBD process begins with the formation importantly, watch what they do. of Innovation Teams in which current staff 7. Define the standards that will and physicians serve as co-creators of the set us apart. experience. Employees selected from variousBefore you can exceed patient expectations, disciplines were brought together to answeryou must thoroughly understand what questions such as: Why does NORTHSTARthose expectations are. For NORTHSTAR, exist? What makes our hospital unique? Evidence-Based Design Accreditationre-imagining the patient experience began What are we going to be famous for? If we and Certificationwith the organization defining and setting disappeared tomorrow, would we be misseda project vision, creating project drivers, and why? Throughout the design and constructionand determining expectations and desired process, Evidenced-Based Design principles Innovation Team members identified and were followed. This process bases designoutcomes. e ultimate goal was to link the created an experience that is original and decisions about the built environmentnew facility to patients’ unique needs and relevant to the Iron County community. on credible research to achieve the bestalign people and behaviors to deliver new outcomes. Critical to the NORTHSTAR mission “Here is the truth,” added Rampage “wesolutions. was designing a facility that: A) reduced can’t be something we’re not. e hospital patient slips & falls; B) Lowered nosocomial has been here for a long time. Our beliefs,NEXT STEPS infections: C) Eliminated inaccurate prescription truths and cause are different than that of ourTo begin the process, Miron scheduled medication D) decreased nurse attrition rate competitors. e community knows us as a‘Innovation Sessions’ for all 350 employees (through the elimination of steps) E) minimized trusted guide and partner. We had to create patient transfer rates; F) reduced noise andas a way to jumpstart the process of the experience around who WE are.” improve air quality. Most importantly, were-thinking and understanding what was developed single patient rooms and accessimportant to patients, the community Miron explored and challenged what to nature and natural lighting.and the NORTHSTAR staff. “From the employees and patients really wantedbeginning, Bruce challenged the entire team. and what they really needed. The teamWe used the non-traditional approach of watched, listened and understood not just thereverse-outcome modeling,” explained Steve words, but the behaviors. “Too often when A Miron Construction Case Study
  4. 4. TRANSFORMING A CRITICAL ACCESS HOSPITAL NORTHSTAR Health System - Hospital Addition and Renovationunderstanding the voice of the customer, clinical outcomes. Without intentionally procedure to chance. Why on earth does thehealthcare organizations think they ‘know’ designing the experience, you leave the healthcare industry leave the experience towhat is desired. Why then do we still use a entire encounter to chance. How should the chance?” questioned Rampage. To his point,hospital gown that everyone hates, one that experience go? What types of feelings are we following is a snapshot of a patient’s typicalwas invented in the early 20s?” asks Tonya experience at a hospital: trying to elicit? What do patients say aboutDittman, a Miron EBD Leader. “Innovation NORTHSTAR after their first encounter? You hide in the parking lot until yourTeams bring newly created experiences to life, “We would never leave a diagnosis or surgical appointment. Next, you walk inside andand ensure they continue long after they aredeveloped because the solutions belong to provide your name. A receptionist asks forthe NORTHSTAR team, not to Miron. A “The changes that have occurred your insurance card. Your name is called andcomplete cultural transformation occurs, one at the Hospital, in both our you’re brought into a small, cold and sterilethat is organized to deliver the ideal patient room. Someone you have never met asks services and physical facility,experience.” you to remove your clothes and hands you a have been tremendous. From paper gown with an exposed backside. en the beginning, the team set outAt project inception, Miron facilitated you are left to stare at a wildlife photo onvarious workshops with NORTHSTAR team to create a critical access hospital the wall. You wait, and wait, and wait a littlemembers using the Seven Guide Lights, their that was unique and focused on more while paging through a House Beautifulproject vision and drivers, an Innovation reducing stress and anxiety for magazine. After at least a fifteen minute wait,Team summary, and EBD tools to guide the every patient and their families you are finally greeted by your doctor. isexperience process. e following is an outline while improving their clinical type of experience is no longer acceptable.regarding how the ‘Guide Lights’ made an outcomes. I cant say enough aboutimpact on the transformation: the transformation.” Our teams identified 32 experience action items when the project commenced, all of ROBERT W. POSSANZA, SR.1 Intentionally design the patient Former Board President which needed to be incorporated into the experience. Too often the entire NORTHSTAR Health System new facility. To bring these innovations toexperience is overshadowed by more pressing life, 11 Innovation Teams (see right) were 4
  5. 5. 3formed to facilitate the implementation of Involve every level of thethe ideal experience. Guided by the Miron organization in the creationReverse Outcome Modeling Tool, impression of the ideal patient experience.areas and attach points were understood at New healthcare research underscores justeach intersection with the NORTHSTAR how important non-clinical elements havebrand. To begin the innovation experience, become. An online survey by McKinsey &outcomes were understood first and process Company of more than 2,000 US patientsissues second. with commercial insurance or Medicare regarding their attitudes toward the patient2 Understand the ideal patient experience revealed that most of them are ecology. How did we begin to willing to switch healthcare providers forunderstand patients? We listened. We learned better service and amenities (McKinsey &that each patient comes to our facility with Company Quarterly, 2009). In fact, manya different set of expectations, requirements have already asked their physicians to refer them to specific facilities specializing inand needs. We listened to compliments, providing this type of care. In a separatecomplaints and concerns from the patients at survey, doctors revealed that they are oftenkey interaction points during the traditional willing to accommodate a patient’s requesthospital experience. We knew, through our for a referral to a healthcare organization thatresearch, that the expectations of a perpetual offers a positive experience—sometimes evenpatient differ greatly from the expectations if it has a lesser clinical reputation.of an elective patient who has little time fortesting, treatment and healing. We conducted Staying ahead of the competition wasfocus groups to better understand what the critical to the long-term vision and success PROCESSexpectations of occasional, elective, perpetual of NORTHSTAR. Creating innovative Innovation Teams were created aroundand complex critical patients were. Our solutions that did not yet exist in healthcare the following key interaction points withultimate goal was to ensure that the elective was the challenge. NORTHSTAR’ iTeams, patients: compr ised of individuals f rom e ver ypatient, who literally has numerous surgical 1. Patient Education & Registration department in the hospital, were providedoptions available to them and will only endure with the knowledge, research, and tools 2. Patient Welcoming & First Impressionsone poor experience before finding a new to determine where the discrepancies lied 3. Hospice & Home Healthcarehospital, would be satisfied with our facility between the current and ideal state in orderand services. 4. Patient Discharge to create a new and ideal experience for 5. Follow-Up/Home HealthFinally, our team listened and integrated patients. Who better to create the ideal patient experience than those who live, eat 6. NORTHSTAR Tour & Wayfinding Storythe thoughts, belief s and feelings of and breathe hospital life? These are the 7.NORTHSTAR staff members. rough the Food Service individuals who best understand patientutilization of 12 Experience-Based Design 8. Oncology needs and desires because they’ve spent theirtools including Innovation Teams (iTeams), 9. Imaging careers interacting with them. Empoweringthe team was able to understand the current team members to share thoughts, ideas 10. Brandingstate and, more importantly, the ideal state. and solutions is the best way to encourage 11. Housekeeping e behavioral, informational, and physical ownership of altered processes and systems.components through which any experience 4is delivered must be modified to support and Research best and innovativedeliver the newly constructed experience. We practices (both inside andneeded to determine how to model, create and outside the healthcare industry) andultimately replicate these experiences through use them. Some very special companies,process changes in order to repeatedly bring such as Southwest Airlines, Apple andthe NORTHSTAR experience to life. Panera Bread, focus their efforts on creating A Miron Construction Case Study
  6. 6. TRANSFORMING A CRITICAL ACCESS HOSPITAL NORTHSTAR Health System - Hospital Addition and Renovationattachment with their customers as a natural a complete cultural transformation occurs Everyone can identify with positive andorder of business. With NORTHSTAR, we within your organization. negative service experiences. For example,knew we had to look from the ‘outside in’ you’ve walked into a health club where you To ensure that the measurement process isto create a new model for the experience. feel energized and excited to start, or continue on-going, NORTHSTAR leadership createdWe looked at things from an entirely new on, your journey toward achieving a healthy e PACE team (Promoting a Culture ofperspective, for our inspiration. We wanted to lifestyle. And you’ve no doubt walked into Excellence) staff initiative. The initiativelearn how the best-of-the-best command space one where the receptionist is on the phone, is led by the PACE UP group comprisedwithin their market. What is it that created you can’t find a towel, or the locker room is of department managers. The initiative istheir uncontested space? Was it pricing, a disaster area. Most likely you leave with a charged with keeping the culture alive andadvertising, marketing, facilities, innovation, horrible impression of the facility and, in turn, holding team members accountable for notor service? We toured numerous organizations the organization. only continuous improvement activities, butin order to gain an understanding of what they the metrics associated with system deployment Why is it that some places connect with us andwere doing to differentiate themselves from activities as well. some don’t? e answer: If you understandthe competition (in some cases gaining five to that the front steps to your facility are asseven times the market share of their rivals). Employee recognition is key for important as the person greeting patients at transformational success at NORTHSTAR.Here is what we found. Each organization the front door, you get it. If you think your ad To recognize staff members for their greatunderstood the outcome of their customers’ budget is more important than your parking patient care and process improvementexperiences before they ever occurred. lot, you don’t. Your parking lot is where activities, the Shining Star program was rough the assistance of Experience-Based people first connect with your facility. Make created. Each month patient care stories areDesign tools, they intentionally recreated it memorable. Rethink the signage. Consider recognized and highlighted for other staffthose ideal experiences to elicit those same ease of navigation. Plant flowers for visual members to learn from.emotional outcomes, time after time. interest. Tell a story and be unique. It’s all about customer attachment.5 Choose wisely what you measure 6 Listen to patients, but more importantly, watch what they do. and hold people to it. In order tobe successful, you can’t merely copy whatother successful organizations are doing to Few healthcare organizations systematically seek to understand what patients value in 7 us apart. Integrating new hospital standards into our overall plan was critical to the non-clinical aspects of their hospitalensure quality care. Measuring outcomes the success of the project. Documenting and visits. We needed to understand the process,involves understanding what best-in-class standardizing processes ensured nothing was systems and impression areas that create theorganizations’ goals are and how they have left to chance. “Department leaders worked ‘Ideal Patient Experience’ before we designedachieved those goals through process and hard throughout the design and construction and constructed the new facility. Perceptionsoperational improvement. Once you have that phase of the project to standardize many areas of service providers, including hospitals, areinformation, you have to determine how to of the new hospital,” commented imaging formed the moment the experience begins.achieve comparable results given the unique team leader, Eric Beauchamp. erefore, from the beginning, we studiedinternal and external conditions of your desired outcomes to determine their influence One example of an impression area where aorganization. And once changes are made, it on the overall patient experience, and we new standardized process had a great impactis vital to the success of the organization to diagrammed the progression and flow of the on the staff and patients was the registrationcontinue to measure outcomes to ensure every experience exchanges within the facility. In process. e registration team measured thepatient is receiving quality service every time doing so, the vision for each area could be amount of time it took to travel through thethey step foot in your facility. understood and then be designed to meet registration process. e team’s initial plan toInstituting quantitative and qualitative that goal. Understanding the impression areas ‘speed up’ the process did not provide themmeasurements encourages accountability. If you allowed us to analyze movement sequence, with the outcome they had originally expected.measure it, they will respect it. NORTHSTAR spatial integration, patient interchange and They found that making the registrationestablished checks, balances and processes emotional connectivity. We were then able to process as short as p o s s i b l e i n c r e a s e dto ensure continuity in the delivery of their identify service gaps and reinforce consistency anxiety in patients. Therefore, althoughservices. is is critical to guaranteeing that within the organizational brand experience. speed and efficiency were important, it was 6
  7. 7. also vital to ensure patients felt comfortable service for meals; First Impressionist position; RESULTSand calm. Not only was the registration elimination of overhead paging; new forms NORTHSTAR has already experienced amazingprocess changed, but it was standardized so of communication including staff pagers and results due to the organizational changes thethat each and every patient who enters the phones; patient pagers; electronic scheduling team made. Highlights include:doors has the same positive experience. and waiting patient identification practices; and free discharge follow-up for all elderly 2010 Michigan Rural Health QualityOther areas that were standardized at patients by Home Health. Improvement Achievement AwardNORTHSTAR include: inpatient room tours, for overall customer service in inpatient,radiology services, housekeeping, surgical IN CONCLUSION outpatient and ED, discharge planning, food service, In the sea of healthcare sameness, transforming INCREASE IN MARKET SHAREICU preparation, hospice, and the list goes a critical access hospital begins at the top,on. Every interaction point and area of the bottom and everywhere in between. 11% OUTPATIENTservice was evaluated to increase efficiency Creating the ideal patient experience forand heighten the patient experience. Now NORTHSTAR Health System was truly a 48% ORTHOPEDICSthat these standards have been established, team effort, and it will take the commitment 30% CARDIOLOGYit is up to the team to continually confirm of everyone on the team to continue to bringthat they are consistently delivered in order these ideal experiences to life. 82% VASCULARfor NORTHSTAR to bring the ideal patientexperience to life on a continual basis. 97% HEMATOLOGYTo help create the ideal patient experience,many innovations were added toNORTHSTAR including: pre-warmed,discrete mammography robes; iPods andDVD players for inpatient and outpatientrooms; customized “Catering to You” room A Miron Construction Case Study
  8. 8. "The entire Miron team operated like an orchestra or well-choreographed ballet. They touched every inch of our facility without one disruption to our patient or staff. They left a piece of art, they were amazing." MARK TOUSIGNANT Chairman of the Board NORTHSTAR Health System Miron is committed to building more than just design partners to create unique, differentiating buildings. We believe wholeheartedly in partnering experiences that exceed client expectations. We with our clients to develop solutions that deliver know it is no longer enough to simply satisfy. business results. For many, that means increasing At the end of the day, it’s all about helping their bottom line, or enhancing their ability to our clients be successful. Experience-BasedCONTACT: Steve Tyink recruit and retain the best and brightest. For Design is just one way we’re helping clients 920.969.7047 others, it’s giving them a competitive edge. Our deliver on their promises. steve.tyink@miron- Experience-Based Design services offer our clients the ability to distinguish themselves in an Simply stated: our commitment increasingly competitive marketplace. That is why reaches beyond construction; we are committed to collaborating with owners and our passion brings dreams to life!