Have you ever asked the question -- Why Healthcare Facilities cannot be profitable? Maybe it is in the way they are designed. It is time for a change. We can make the difference.

1. HOSPITAL DESIGN GUIDELINES
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2. HOSPITAL DESIGN GUIDELINES
The art and science behind the designing of a healthcare facility is
certainly complex. Beyond the technical requirements that modern
medicine demands and rigid functional relationships, designers must
cope with a host of issues to ensure the wellbeing of patient, reduction
of stress in the staff, and overall need for designing for sustainability is
critical. The question is –
How do you turn…
VISIONAL
DEMANDS
REALITYinto

3. HOSPITAL DESIGN GUIDELINES
Most Architects and Design Engineers are generally eager to put pencil to paper based on
commonly accepted practices (Best Practices / Lean Design / Reduction of Carbon
Footprints). Square footage requirements are typically a formula:
Although these equations will address traditional standards, each facility is unique;
therefore, should never be approached based on a cookie-cutter-methodology. It takes an
analysis that looks at:
• Interaction between departments
• Material flow to support functions
• Designs impact patient experience
• Flexibility to meet future demands
Staying within Project
Budget Limitations
Departmental Gross Square Foot (DGSF) = Dept. Net Square Feet (DNSF) x Dept. Net-To-Gross Factor
Total Building Gross Feet (BFSF) = Sum Dept Gross Square Feet x Building Net-To-Gross Factor
Total Building Net Square Feet (BNSF) = Sum of All Dept Net Square Feet
Building Net to Gross Ratio = Total BGSF / BNSF = X.XX

4. HOSPITAL DESIGN GUIDELINES
Hospital functions are interconnected – critical departmental space cohesion must be
consider; especially with reverence to inventory movement. Most owners consider
inventory management as Back-of-house-operations, and simply do not discuss
conditions based on budget limitations throughout project phasing, thus accept common
practices. This oversight jeopardizes functional support and patient satisfaction levels
once doors open. Four primary areas need to be reviewed.

5. HOSPITAL DESIGN GUIDELINES
PLANNING AREAS
Supply Chain consists of all the elements, activities,
and processes required to deliver materials to the
patient in the timely fashion. Collaboration and
cooperation, along with information shared
(upstream and down) affect the Supply and Demand.
Healthcare providers focus on providing high quality of care regardless of
cost; therefore, inventory is typically stored onsite in limited qualities
(small central supply, central sterile supply, pharmacy, and laboratory). As
Supply Demands fluctuation costs to maintain levels increase. We don’t
live in a perfect world!
a. Emergencies (a rise in demand during natural disaster events or
extreme conditions that cause a slowing of supply deliveries)
b. Cost inefficiencies (dependency with suppliers)
c. Inability to project replacement points (inventory awareness)
d. Inherent or faulty designs (bogus design phasing policies)
e. Human error / operating error (inventory accuracy limits)

6. HOSPITAL DESIGN GUIDELINES
PLANNING AREAS
Most facilities use Group Purchasing Organizations
(GPOs) to control inventory, do to staff training,
equipment, and space. GPOs typically manage and
control PAR Values and only offering replacement
supplies based material outages. Benefits and
drawbacks of using GPOs over in house staff.
Pros:
a. Increased purchasing power (based on facility size for discounts)
b. Increased menu variety and quality (choices / preferences by staff)
c. Decreased labor cost to manage (less control over functions)
Cons:
a. Membership agreements (added cost to join or annual fees)
b. Deliver and storage capacity (scheduling and site capabilities)
c. Minimum case orders (less qualities and higher cost)

7. HOSPITAL DESIGN GUIDELINES
PLANNING AREAS
On-site storage is designed based on departmental
functions and space availability. Cost per square foot
on-site is higher than remote (warehouses)
Inadequate storage results in:
a. limited assessment to meet special situations
b. Reduced planning objectives and vision for the future
c. Lack of functional adjacencies to support various departments
d. Increased adjustments in operational and staffing time
Remote site storage – make the primary facility “forward-pick”
a. Forward-pick locations can be smaller, because a warehouse
receives bulk items with redistribution as required
b. Security is higher / support multiple locations / inventory
accuracy to control – LOT / Expiration Dates / inventory turns
c. Inventory can be purchased at a great volume / reduce cost per
unit / remove GPOs as management
d. JIT replenishments to areas quicker

8. HOSPITAL DESIGN GUIDELINES
PLANNING AREAS
Logistics – The art and science of obtaining and
distribution of materials in the proper place and
proper quantities in a timely fashion.
Control movement within:
a. Transportation – air / rail / truck / ship
b. Warehousing – receiving / sorting / storing / distribution / waste
c. Third Party Logistics – reflect remote warehouses / management
d. Reverse Logistics – returns / re-use / recycling / disposal
Logistics Value Proposition – achieving patient satisfaction at the lowest
total cost, but not jeopardize quality of service. (6-Goals)

9. HOSPITAL DESIGN GUIDELINES
POORLY PLANNED AREAS RESULT IN
1. Failure of one or more of these areas will force future
modifications to the facility; block projected expansions,
disrupt inventory flows to existing departments, increase
operational costs, and limit patient service applications
2. Achieve balance within an ever changing environment
3. Disrupt original visions, thus limiting life-usable-levels of
equipment, services, and patient capacity levels
4. Increase existing staff stress, increase required manpower
levels to continue services, and inability to meet demands in
times of extreme conditions
5. Lessen opportunities to remain affective as a modern facility
IT IS TIME TO THINK ABOUT A BETTER APPROACH!

10. HOSPITAL DESIGN GUIDELINES
As hospitals strive to reduce costs - to bulk-storage of inventory is
the key to acquire large qualities at reduced cost. Streamlining the
hospital supply chain will decrease operational costs.
Advances of Warehouse Operations to Reduce Costs:
a. Meet inventory level to maintain real-time inventory counts and set up
parameters for automatic recording goals during all conditions through
better forecasting, thus eliminate waste and product shortages
b. Decrease GPO involvement through in-house staff training
c. Maximize provider time efforts; allowing Nurses to spend more time with
patients verses monitoring PAR Levels
d. Ability to track medical equipment, supplies, and devices in real-time (RFID)
e. Manage recalls and reduce expirations to maximize usage
f. Use analytics to make better decisions as to replenishment true needs and
to reduce overage in purchases
Process, policy change, and proper analysis will be required!

11. HOSPITAL DESIGN GUIDELINES
According to research conduced by SMI, some
hospitals will see supply chain costs overtake the
cost of labor by 2022. The question is whether to
outsource or in-house a warehouse operation?
Outsourcing:
a. Trusting third-party for security and accuracy for JIT needs
b. No warehouse Health & Safety Compliance issues
c. Ideal distribution location to ensure timely inbound deliveries
d. Reduce capital investments
e. Shift the risk associated with staffing for management and training
f. No ancillary equipment purchases to ensure inventory accuracy
g. Securing inventory from theft and pilferage (bonded warehouse)
Operating In-house:
a. Control of processes, physical inventory, and data
b. Based on type of operations to determine equipment needs
c. Size of Operations (space utilization) allowing for future growth
d. Number of SKUs Carried to maintain proper inventory flow
e. Type of Materials Carried (generic or specific)

12. HOSPITAL DESIGN GUIDELINES
If you determine In-house is right for you – focus on:
a. Engage outside experts – to properly develop warehouse layout
b. Dock Operations – trends in cross docking, storage, sortation, waste removal,
linens, and process gases – as to access points for loading dock positions
c. Inventory Flow – product zoning, loading and unloading, etc
d. Process Improvement – to reclaim and adjust usable storage space
e. Pick locations – based on ABC (Pareto Analysis) of inventory turns
f. Warehouse future expansion needs – room to expand
g. Ensuring the health and safety of workers – controlled environment
h. Software – (WMS) for controlling inventory levels
i. Automation and equipment – to determine capabilities / layout locations
j. Communications – between primary facility to remote in real time
k. Work Stations – based dispatch operational areas

13. HOSPITAL DESIGN GUIDELINES
WAREHOUSE PRODUCT FLOW
KEY – when designing consider the following
F = FLOW (process of inventory movement)
A = ACCESSIBILITY (ease of storage and retrieval)
S = SPACE (optimization of area)
T = THROUGHPUT (quickest possible / min steps)
Bulk, rack, carousel, conveyors, etc could
be used (check with the experts as to
throughput requirements)

14. HOSPITAL DESIGN GUIDELINES
Decisions need to be made – are you going to meet the demands of the future
or continue as before. Why not make the right decision. Allow us to work with
you during Pre-schematic Phase Design. Don’t rely of Best Practices to turn your
Visions into Reality! It is time to step out to what the future demands.
Albert Einstein suggests:
“Logic will get you from A to Z; imagination will get you everywhere”
“The world as we have created it is a process of our thinking. It cannot be
changed without changing our thinking”
We are here to help you in that change!
RemTecH Associates LLC
Box 341, Van Texas 75790
remtechassociates@gmail.com
https://www.remtechassociates.com/
972-467-7829