Specialising in business
strategy management,
training and education
services to meet the
specific needs of our
clients.

...
Presentation
Five Parts: 1.
Healthcare Challenges
2.
Complex Operating Environment
3.
Emerging Technology
4.
Risk Based Ap...
Healthcare Challenges

jakeman.com.au
T + 61 2 6162 1149
Issues Facing Hospitals - 1

Aging Infrastructure
 Short Term Fix
 Silo [absence of integration]
 Emergence of Networki...
Issues Facing Hospitals - 2

Increasing Demand
 Hotel Experience
 Efficient Services
 Flexibility and Choice – Accommod...
Issues Facing Hospitals - 3

Changing Demographic
 Population is healthier and patients are living
longer – with an incre...
Issues Facing Hospitals - 4

Complex Technology
 Evolving at rapid and continuous rates – increased
competition as health...
Issues Facing Hospitals - 5

Budgetary constraints require:  Acceptance [operate within financial capabilities]
 A stage...
Issues Facing Hospitals - 6


Customer Expectations






jakeman.com.au
T + 61 2 6162 1149

Patients want a clean, co...
Meeting the Issues, Challenges & Expectations







jakeman.com.au
T + 61 2 6162 1149

The security and safety of the ...
The Complex Operating Environment

jakeman.com.au
T + 61 2 6162 1149
Complex Operating Environment –
Security/Clinical
Card
Management
Audit

Directory
Services

Monitoring
Response

Complian...
The not so simple Duress Activation

jakeman.com.au
T + 61 2 6162 1149
Process Flow – Where Does Security Fit?

The key is to understand the basic business process’ and identify the common
them...
Emerging Technology

jakeman.com.au
T + 61 2 6162 1149
Identity Management

Preauthorisation
and induction

Doctors &
physicians

Pharmacist

Avoidance of
drug
incompatibility

...
Role Based Access
Role Profile

Zone Schedule

Personnel
Zones or
Areas

Roles
Floors

Department

Access Profile
Door Sch...
Proprietary vs. Non-Proprietary

Summary Management System

Non-Proprietary

Proprietary

Security

Management
Systems

Bu...
Preventative Maintenance
Component State
Analysis
Core
components

High MTBF

High MTTR

Hostile
Environment

High Cost of...
Traditional and Emerging Integration

Base Building Services Include
IT

Patient
Management
•
System

HR and Payroll
Pharm...
System and Process Integration

IT Services
Patient Admin
HR & Payroll
Clinical Systems

Building
Management
Air Systems
W...
Why Public Private Partnering?

jakeman.com.au
T + 61 2 6162 1149
PPP’s the Competing Environment

Stakeholders



State
Consortium






jakeman.com.au
T + 61 2 6162 1149

Special ...
Aligning Expectations



State – Briefs Technical, Functional Services
 Clinical Outcomes
 Functional
 Efficient to ma...
Risk Management

Likelihood
and Exposure

Threat
Assessment
Systematic
assessment of the
threats facing the
Facility inclu...
The Big Picture

jakeman.com.au
T + 61 2 6162 1149
Design Evolution
Best Practice
Experience

Legislation and
Standards

Project Brief
Technical and
Functional

Design

Comp...
Overarching Objectives

– Analyse of the risks facing the hospital, patients and staff to establish an integrated
manageme...
Linkage


Early and continued identification of risks and treatments is
integral to an appropriate, proportionate, effect...
Closing Thoughts

There is an intrinsic link between Safety and Security
Security can become an enabler, improving busines...
Questions

jakeman.com.au
T + 61 2 6162 1149
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David Van Lambaart, Jakeman Business Solution Pty Ltd: Public Private Partnering Projects: A Risk Based Design Approach for Structuring Healthcare Environments

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David Van Lambaart, Senior Consultant, Jakeman Business Solution Pty Ltd delivered this presentation at the 2013 Safe and Secure Hospital Conference. The comprehensive program addressed the following issues:

Early intervention via early reporting of disruptive, aggressive, and bullying behaviour to minimise work place violence
An innovative training model to help clinicians, security and policy makers respond to the problems of challenging behaviours
Therapeutic sedation in the Emergency Department: Best practice in managing the highly agitated patient
A systems approach to the prevention of Occupational Violence and Aggression (OVA)
Contract management security: The change from in-house security to contract security
Role of the Risk Based Approach throughout the design process
Preventing and managing clinical aggression in the paediatric and youth health setting
The roles, functions and training provided by the Mental Health Intervention Team (MHIT), New South Wales Police Force
Interactions between Police, Health staff, Ambulance and Hospital Security and future directions
A Legal Perspective: Prevention and management of violence in hospitals
Code Grey responses - Are they legal?

For more information about the annual event, please visit the conference website: http://www.healthcareconferences.com.au/safehospitals

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David Van Lambaart, Jakeman Business Solution Pty Ltd: Public Private Partnering Projects: A Risk Based Design Approach for Structuring Healthcare Environments

  1. 1. Specialising in business strategy management, training and education services to meet the specific needs of our clients. We work as your trusted adviser to deliver exceptional value through effective results. Public Private Partnering - PPP Risk Based Security in a Complex Healthcare Setting 24th October -2013 jakeman.com.au T + 61 2 6162 1149
  2. 2. Presentation Five Parts: 1. Healthcare Challenges 2. Complex Operating Environment 3. Emerging Technology 4. Risk Based Approach 5. Public Private Partnering jakeman.com.au T + 61 2 6162 1149
  3. 3. Healthcare Challenges jakeman.com.au T + 61 2 6162 1149
  4. 4. Issues Facing Hospitals - 1 Aging Infrastructure  Short Term Fix  Silo [absence of integration]  Emergence of Networking Capability - Sec / IT    jakeman.com.au T + 61 2 6162 1149 Electronic Systems, Information Management, process management. Improvements to Building Management and Security Management Dilemma remains – How do we attain and maintain an integrated infrastructure when the procurement cycle will only allow for isolated improvements?
  5. 5. Issues Facing Hospitals - 2 Increasing Demand  Hotel Experience  Efficient Services  Flexibility and Choice – Accommodation Type, Meals, Entertainment  Reporting – Patient Turnaround,  Service Delivery Levels - Tighter Controls on how services are delivered – Clinical & Operational jakeman.com.au T + 61 2 6162 1149
  6. 6. Issues Facing Hospitals - 3 Changing Demographic  Population is healthier and patients are living longer – with an increased demand in aged care services.  Increase in associated age related illness and disease  Necessitates – longer term care   jakeman.com.au T + 61 2 6162 1149 Monitoring and tracking [location and status] Homely environment - ease of access for family and friends while providing a secure / safe environment
  7. 7. Issues Facing Hospitals - 4 Complex Technology  Evolving at rapid and continuous rates – increased competition as healthcare is viewed as an emerging opportunity – drives change  Resulting distraction for organisations to implement a ‘solution’ that meets an apparent immediate need without considering longer term compatibility and future integration requirements. jakeman.com.au T + 61 2 6162 1149
  8. 8. Issues Facing Hospitals - 5 Budgetary constraints require:  Acceptance [operate within financial capabilities]  A staged approach within an overarching and effective strategy and consistency of defined approach  Procurement decisions to be based upon agreed expectations and defined outcomes jakeman.com.au T + 61 2 6162 1149
  9. 9. Issues Facing Hospitals - 6  Customer Expectations    jakeman.com.au T + 61 2 6162 1149 Patients want a clean, comfortable and secure environment Clinicians and Support Personnel require an efficient and safe environment Visitors would like to have access to immediate and extended family and friends
  10. 10. Meeting the Issues, Challenges & Expectations    jakeman.com.au T + 61 2 6162 1149 The security and safety of the hospital its patients, staff and visitors relies upon a sound understanding of the operating environment and the identification of an appropriate and proportionate security solution. Adopting a clearly defined approach both in terms of security services manpower and technology will ensure a balanced solution that is flexible, responsive and sustainable. It is essential that Security and Hospital staff adopt a collaborative approach to attain and maintain our overarching objective of a safe and secure environment for all.
  11. 11. The Complex Operating Environment jakeman.com.au T + 61 2 6162 1149
  12. 12. Complex Operating Environment – Security/Clinical Card Management Audit Directory Services Monitoring Response Compliance Management Business Objectives Policies, Procedures and Standards Quality Assurance Accreditation Testing Crisis Management jakeman.com.au T + 61 2 6162 1149 Alarms Intrusion Detection Building Access Control System Access Security Management Control System Management Business Continuity Management Disaster Recovery Contingency Planning Biometrics Identity Management Key Performance Indicators Roles and Responsibilities Smartcards Identity Validation CCTV Training and Awareness Continuity Planning Training and Awareness Building Environment Management
  13. 13. The not so simple Duress Activation jakeman.com.au T + 61 2 6162 1149
  14. 14. Process Flow – Where Does Security Fit? The key is to understand the basic business process’ and identify the common themes. Pharmacy System Patient Record MRI Scanner Surgery Booking Patient Administration Car Park/Security System In Patient Episode Arrival at Hospital Admit Initial Tests Scans Surgery Cleaning Services Kitchen/Diet Services Environmental Services jakeman.com.au T + 61 2 6162 1149 There is a great deal of system interaction and common data e.g. Patient Identifier, history, allergies, preferences, status… Post-op Discharge
  15. 15. Emerging Technology jakeman.com.au T + 61 2 6162 1149
  16. 16. Identity Management Preauthorisation and induction Doctors & physicians Pharmacist Avoidance of drug incompatibility Avoidance of double examinations Reduction of medical errors Contractor and Short Term Visitor One Person – One Identity Hospitals - Optimised security and energy management Patient Improved Governance Quick and secure patient identification Building services Knowledge of patient history jakeman.com.au T + 61 2 6162 1149 16
  17. 17. Role Based Access Role Profile Zone Schedule Personnel Zones or Areas Roles Floors Department Access Profile Door Schedule Time Schedule Floors Doors Time Keyed Role Electronic jakeman.com.au T + 61 2 6162 1149 Facility
  18. 18. Proprietary vs. Non-Proprietary Summary Management System Non-Proprietary Proprietary Security Management Systems Building Management Open HLI Management Systems IT Systems Open HLI Management Systems Business Applications Open HLI Management Systems Control Systems Control Systems Control Systems Control Systems End Point Devices End Point Devices End Point Devices End Point Devices jakeman.com.au T + 61 2 6162 1149 LLI
  19. 19. Preventative Maintenance Component State Analysis Core components High MTBF High MTTR Hostile Environment High Cost of Failure Frequent Network Distributors Failure Analysis Repair Analysis Condition Monitoring Impact Analysis Maintenance and Device Replacement Frequency Low MTTR Low Risk Environment Low Cost of Failure Less Frequent End point devices Consumables Low MTBF This approach enables the system components to be maintained and upgraded as required, represents less risk of catastrophic failure and ensures the Hospital is always operating at a known and supported state. jakeman.com.au T + 61 2 6162 1149 19
  20. 20. Traditional and Emerging Integration Base Building Services Include IT Patient Management • System HR and Payroll Pharmacy Infrastructure System CCTV Surveillance system System PKI Service Clinical Scanning Systems • Intrusion alarm system • Building and Car Park Access Control RFID Tracking System Integrated • Contactless/Dual Technology Identity Card Services • Building environment management Duress System • Fire detection system Surveillance System jakeman.com.au T + 61 2 6162 1149 Nurse Call System Alarm System Building Access Control Security Monitor Dual Contactless Technology Identity Card Identity Card Building Monitor Building Environment Management Fire Detection
  21. 21. System and Process Integration IT Services Patient Admin HR & Payroll Clinical Systems Building Management Air Systems Water Systems Network Services Usually operate in Isolation to each other; but share common information Fire Systems Hotel/Admin Services Catering Laundry T + 61 2 6162 1149 Access Control Surveillance Alarms Buildings jakeman.com.au Security Systems Administration
  22. 22. Why Public Private Partnering? jakeman.com.au T + 61 2 6162 1149
  23. 23. PPP’s the Competing Environment Stakeholders   State Consortium      jakeman.com.au T + 61 2 6162 1149 Special Vehicle Architects Construction Company FM Services Providers Multitude of Vendors
  24. 24. Aligning Expectations  State – Briefs Technical, Functional Services  Clinical Outcomes  Functional  Efficient to manage  Consortium     Cost Efficient to Construct Delivering an Integrated Solution that is complex Profitable Minimise Changes [these cost money in a fixed priced arrangement]    jakeman.com.au T + 61 2 6162 1149 Architects – Re Draw & Design $$$ Vendors – Squeezed for price FM Providers – 28+ Years Life Cycle – Whole of Life Costs – Abatements - Design Risk
  25. 25. Risk Management Likelihood and Exposure Threat Assessment Systematic assessment of the threats facing the Facility including identification, analysis using a repeatable process. Risk Assessment Plan of the Control measures identified to mitigate the risks. Risk Profile Risk Management Plan Summary of the Risks facing the Facility Consequence Risk Register Statement of residual or accepted level of risk jakeman.com.au T + 61 2 6162 1149
  26. 26. The Big Picture jakeman.com.au T + 61 2 6162 1149
  27. 27. Design Evolution Best Practice Experience Legislation and Standards Project Brief Technical and Functional Design Compliance Security Master Plan Implementation Objectives & Solution Definition Risk Assessment Policies Operation Performance Indicators Construct Area Risk Assessment Risk Action Plan Implementation Operational Objectives Technical Standards Application of Solutions jakeman.com.au T + 61 2 6162 1149 Standing Orders Operational Procedures
  28. 28. Overarching Objectives – Analyse of the risks facing the hospital, patients and staff to establish an integrated management strategy; – Develop a holistic design to better manage hospital risks; – Identify suitable security technology to support security services; – Improve integration with other Hospital systems to make effective use of information and improve the staff and patient experience. – Define procedures and underpinning training for all staff members (security, clinical and administrative); – Define a comprehensive maintenance strategy to optimise the use of equipment; jakeman.com.au T + 61 2 6162 1149
  29. 29. Linkage  Early and continued identification of risks and treatments is integral to an appropriate, proportionate, effective and sustainable security solution – one that underpins;  Wider Health Sector Aspirations - meeting the emerging issues & challenges,  Organisational objectives – cost effective and sustainable service delivery,  Effective Clinical and Functional Objectives – Efficiencies, Safe and Secure Operating Environment jakeman.com.au T + 61 2 6162 1149
  30. 30. Closing Thoughts There is an intrinsic link between Safety and Security Security can become an enabler, improving business efficiency and provide benefit, however this will require:  A clear understanding of the business objectives  An informed capability – i.e what really matters  Defined risk based strategies  Clear articulation and communication during implementation Managing Risk: Maximising Opportunity jakeman.com.au T + 61 2 6162 1149
  31. 31. Questions jakeman.com.au T + 61 2 6162 1149

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