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Capital Project Solutions – June 2011

Conducting a Transition Readiness Assessment to Ensure a Successful Facility Transition Ray Walker Principal Consultant One of the biggest traps healthcare organizations fall into is the belief that planning for a new facility is complete once the structural design is finalized. In fact, the opposite is true. A new facility provides an organization the ideal opportunity to reevaluate and update their operational strategies and processes. However, to truly capitalize on this opportunity, this must be taken into account during design – prior to the start of construction. Given today’s economy, when planning a new facility, there is tremendous pressure to quickly complete the design process and start construction. Unfortunately, more often than not, construction begins before the design is completed. Following this path makes it virtually impossible to carefully and thoughtfully map out the operational impacts of the new environment. Many of the more complex operational issues to be implemented in the new facility are only discussed at a high level during this initial phase. Particulars are not discussed and it is merely assumed that operational process flow changes will mesh with how the new facility is constructed. Without careful planning and coordination, the results can be a significant disconnect between what is built and what is necessary to support operational strategies. In an effort to manage the coordination between operational planning and the physical environment, we encourage healthcare organizations to begin Transition Planning as early in the project schedule as possible, preferably beginning as soon as the design is complete. Transition Readiness Assessment Per Webster’s Dictionary, Transition is defined as: “passage from one state, PLACE, stage or subject to another”. A successful transition from one facility to another is realized when the completed facility and operational readiness merge, optimizing 1


Capital Project Solutions – June 2011

functional patient care activities. So how does a healthcare organization know that they are ready to transition from one building to another? What assurances do the executive leaders of a hospital have that the plans to date are still in sync with how the building is actually being constructed? These questions are often answered during the Transition Planning process. To initiate this phase, we recommend that healthcare organizations conduct a Transition Readiness Assessment (TRA). TRA is a gap analysis of the transition planning completed to date. It also identifies items that remain to be completed and ultimately results in a comprehensive plan to address all elements. The phases of the assessment are quite similar to a physician treating a patient. They are: Discovery (History and Physical) – What information is currently available relative to the proposed transition? This involves initial data and information gathering along with pre-session interviews. Gap Analysis (Diagnosis) – Where are the gaps in what is known and not known? What has already been done? What still needs to be done? Implementation Plan (Treatment Plan) – How can we bridge the gaps in order to ensure everyone’s expectations are aligned and we’re heading down the same path together? Five Steps to Complete TRA Conduct Stakeholder/ Staff Interviews

Evaluate Data, Tools & Systems

Develop Team Structure

Develop Budget & Schedule

Transition Implementation Plan

1. Conduct Stakeholder/Staff Interviews: Key stakeholders should be interviewed to gauge their current understanding of the transition process, i.e.: Will the location of the ancillary services change how service is provided?

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Capital Project Solutions – June 2011

2.

3.

4.

5.

What model of care changes will take place in the new space? Is the staff prepared for these changes? How will supplies be distributed in the new space? Is this different from the current model? Evaluate Data, Tools & Systems Review contracts for services, furniture, equipment, signage, etc. Review inventory tracking logs. Conduct way finding analysis and map traffic patterns. Review regulatory information and approvals. Review Communication and Public Relations Plan. Develop Transition Team Structure Create the Transition Steering Committee. Create the Operational Readiness Assessment Team. Create the Facility Readiness Assessment Team. Ensure multi-disciplinary participation. Establish clear expectations, roles and responsibilities. Ensure Integration of the transition teams with the project delivery teams. Develop Transition Budget & Schedule The transition budget should include - move company expenses, warehousing charges, training expenses, marketing expenses, public relations expenses, etc. The transition schedule should be integrated with the Project Delivery Team’s Construction Schedule. The transition schedule should include staff training, furniture and equipment coordination, stocking of supplies, programming and testing of technology systems, final cleaning, etc. Transition Implementation Plan Based on the information gathered in the previous steps, a Transition Implementation Plan can be prepared that addresses the identified gaps. 3


Capital Project Solutions – June 2011

Will clearly state goals and objectives for the project. Will clearly state team member responsibilities. Conclusion Again, the first step in a successful transition plan is to recognize that planning does not end with a complete design. If the Transition Readiness Assessment process is followed, chances for a successful transition will be significantly increased. In addition to streamlining the move, the functionality of the new space will be greatly improved which will provide substantial longterm benefits and enable the leadership team to achieve the staff and patient satisfaction that they originally sought at the onset of the project.

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Capital Project Solutions – July 2011

The Components of Transition Planning- Operational Readiness Stevie McFadden – Associate Consultant Patrick E. Duke – Vice President

Last month we centered our discussion on the starting point for the transition planning process – Transition Readiness Assessment (TRA). The TRA sets the tone for the successful relocation of staff, assets, supplies and patients from an existing space to a new space. This month, and for the next two months, we will focus on the three components of the transition planning effort after completion of a TRA – Operational Readiness, Facility Readiness, and Move Management.

What is Operational Readiness? Operational Readiness involves planning for new processes and practices that define the way an organization will conduct business in a new facility. It requires an emphasis on review and design of clinical and business operations to allow their future state to be in harmony with the changed physical environment, thereby enabling the organization to achieve desired outcomes. The effort to achieve true Operational Readiness will involve education, training, and orientation that must be effectively coordinated and balanced with the Facility Readiness and Move Management components of the overall transition planning work. If the future state of operations was well defined and integrated into the design effort from the onset of the project, achieving Operational Readiness will be the result of more implementation planning and less process redesign work later on. There is often a perception that patient satisfaction and outcomes will improve by virtue of facility improvements and the eventual relocation into a new space. The reality is that without integrating desired process improvement into the design and then educating staff members on the benefits of adopting it, the new facility becomes no more than an empty suit. While you may conduct a successful move, you will not achieve true Operational Readiness


Capital Project Solutions – July 2011

and defeat the most likely primary driver for the new space – to deliver more efficient patient care and improve outcomes.

When Should Readiness?

We Start Preparing for Operational

It is important that leaders in healthcare organizations and project delivery teams understand the perspective of all staff members as they are challenged to “think outside of the box” when developing improved workflows in a new space. Staff members are prone to becoming overwhelmed on projects because of the amount of changes that must occur to their daily workflows in addition to the changes in how they do everything from park to clock in and out each day. The looming question is - How will I function in the new facility given the changes it will bring? To answer this question and reduce anxiety that can be associated with any change, we advocate launching your transition planning effort after the Architect completes their Design Development phase. Traditionally, user groups made up of staff members are heavily involved in the planning of the new facility from project inception and through the Design Development phase. It is during this time that interest and engagement is extremely high. Team members are actively involved in discussions and meetings to plan what the new facility will look like, identify how they can best move through the space, and develop strategies to improve patient care. However, typically a one to two year lull occurs after Design Development ends and when transition planning begins where there is no followup with the user groups. During this lull everyone returns to their day jobs, and valuable knowledge of the why and how is lost. Therefore, the previous alignment and buy-in around design and workflow decisions is at risk. The typical result is a reeducation process that results in decreased morale and changes on the project that were not anticipated in the budget or schedule. Changes later in the project are more costly and the schedule impacts much harder to mitigate, as depicted in the figure.

How Do I Organize and Facilitate the Effort to Achieve Operational Readiness?


Capital Project Solutions – July 2011

As you launch the transition planning process, it is important to first establish an organizational structure that will support the critical balance of the Facility Readiness, Operational Readiness and Move Management components. While the user groups that were integral to the design process can remain intact, they will need to do so within the framework of an organizational structure that promotes cross collaboration necessary to complete preparations for relocating and operating in the new space. Once an organizational structure is set-up the following steps are necessary to begin the journey towards achieving and sustaining Operational Readiness: Determine Resource Loading Required to Complete Planning Priorities – Healthcare organizations often struggle to manage the day to day requirements and must maintain a lean staffing model to be profitable. In order to prepare for relocation and operation in a new facility, there will be many resources that must go above and beyond their day to day duties. To avoid a strain on resources and impact on current operations, it is important to properly resource the transition planning effort. Team Alignment Session – Initial alignment meetings with the Team’s should be scheduled and facilitated. These sessions allow for shared goals to be developed for the planning effort as a whole. There also is consensus developed around expectations, roles, and methods of planning effort. The decision making process and how those decisions are communicated will also be agreed upon. Development of a Baseline Activity Schedule – It is important to develop a schedule of activities with each Team in coordination with the overall Master Program Schedule for the facility’s design, construction and installation of all furniture, fixtures, equipment and technology systems. We believe sessions that feature interactive and collaborative thought from key stakeholders and members of focused teams are the most productive. It is imperative that the “silo effect” is avoided during the entire planning process and all events encourage collaboration and group thought. Development of a baseline activity schedule will set a timeline for key activities and tasks that must occur prior to the targeted move sequence. The development of this work product will also highlight key synergies between different teams. Develop and Analyze Constraints – The development of a baseline activity schedule will provide a more detailed path for each focus team, but we find it necessary to go a step further and


Capital Project Solutions – July 2011

evaluate all constraints to meeting the milestone dates that were agreed upon. There is a distinct difference in being organized for presentation versus being organized for implementation. You must utilize communication and tracking tools that allow for ease of identifying and analyzing constraints and track where commitments are being met by each team member being held accountable. Complete Implementation Plans for Each Focus Team – Each focus team should use the information from the Alignment Session and Baseline Schedule Development Sessions to develop a detailed Implementation Plan for their effort. The Implementation Plan should feature a detailed team activity schedule, constraints analysis, resource allocation and budget. Considering there are typically a multitude of synergies between each transition team, it is essential to have a process in place to update key milestones. Present an Integrated Implementation Plan to Leadership for Approval – We suggest that each Team Leader present their Implementation Plan to Leadership for final approval. It is important to do this work as early as possible to identify one-time operational costs associated with the planning and implementation work in addition to the year one operating budgets for the new facility. Execute, Communicate, Adapt and Achieve – Each Team should execute its plan and the Team Leader’s should ensure that there is cross collaboration and communication as required. The Transition Steering Committee meetings will provide an excellent forum to identify any points of connectivity and clarification required. The teams should be prepared to adapt to changes in the field and stick to the structured process in place so they can eventually achieve Operational Readiness. Understand the Move is Not the End – Early in the planning process it is important to not only plan to achieve Operational Readiness for opening day, but have a process in place to help sustain the positive changes you have made and identify areas for improvement as well. Many organizations shut down their transition planning organization after opening day, when in fact there are still elements of transition going. We believe the transition planning structure should remain in effect six (6) months to a year after opening day. This provides a means to continuously assess and evaluate the effectiveness of implementation and provide support to all staff that are working to acclimate to their new physical environment.


Capital Project Solutions – July 2011

Critical Success Readiness

Factors

in

Achieving

Operational

Operational Readiness is a critical component to the overall success of the transition planning process. It must be achieved in balance with Facility Readiness and Move Management to ensure a smooth transition. The following are critical success factors in achieving Operational Readiness: Begin the Project with the End in Mind – From the onset of the project integrate operational planning into the design effort to avoid more work later. Avoid the Dangerous “Lull Period” – We recommend beginning your transition planning effort after Design Development. This will avoid a lull in action and participation by staff that oftentimes plagues projects through cost overruns, schedule delays and decreasing morale. Set a Structured Process and Stick to It – A structured process for transition planning and Operational Readiness needs to be set early and you need to have alignment achieved around that prior to developing implementation plans and continuing with your planning efforts. Plan for Beyond the Move – The move does not signify the end of transition. This is often an enterprise wide event that affects all systems, structures and staff members. Oftentimes, they need more support in the days and months following the move than prior to and during the move, keeping a structure in place to address issues and communicate decisions and changes throughout the organization. Conclusion We believe focusing on the factors above is an excellent start from a macro level as you launch your transition planning effort and work towards achieving true Operational Readiness. Next month, we will discuss Facility Readiness.


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Capital Project Solutions – August 2011

Facility Readiness- Is Your Team Ready For The Move? Gary P. Wilkinson Senior Consultant

The “Three Legged Stool� It is not a hyperbole to say that a well defined and executed Relocation Plan resembles that of a three legged stool. Last month, we discussed that Operational Readiness involves planning for new processes and practices that define the way an organization will conduct business in a new facility. It requires an emphasis on review and design of clinical and business operations to allow their future state to be in harmony with the changed physical environment, thereby enabling the organization to achieve desired outcomes. The effort to achieve true Operational Readiness will involve education, training, and orientation that must be effectively coordinated and balanced with the Facility Readiness and Move Management components of the overall relocation planning work. If the future state of operations was well defined and integrated into the design effort from the onset of the project, achieving Operational Readiness will be the result of more implementation planning and less process redesign work later on in the project delivery process. Running parallel to planning and coordinating the operational components of the relocation strategy is the Facility Readiness piece. There is an abundant amount of preparation that must be done in order for the facility to be completed in time for the patient move. The absence of a well defined Facility Readiness Plan will pose the biggest risk of any activity associated with relocating into a new facility. Facility Readiness Plan The development of a Facility Readiness Plan centers on preparing the building and/or facility to accept patients and

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Capital Project Solutions – August 2011

hospital operations. It is well understood at the most basic level that in order to begin operations, construction will be complete and all building systems will be installed. To make that happen it is important to understand many of the more detailed components that must be completed to ensure a successful transition. Equipment Procurement Process: Throughout the course of the design and into construction, numerous planning and coordination meetings will be held with almost every stake holder in the hospital to review needs and requirements for medical equipment. Careful planning as to architectural parameters as well as mechanical, electrical, and plumbing details is needed to ensure that the equipment will be installed correctly and prevent costly change orders later down the road. One planning element that cannot be avoided is the detailed coordination of the procurement process associated with equipment. To guarantee the successful distribution of the medical equipment there are many key decisions that must be made: Equipment Delivery Model - Will the medical equipment be shipped “Just in Time� (JIT) or will an offsite warehouse be used? Often times with larger projects, the JIT method is extremely difficult due to loading dock constraints, the size of the equipment and number of pieces being delivered. Hospital Receiving Methods - Once the medical equipment is received at the facility there are numerous hospital protocols that must be followed. How will the following be coordinated? o Asset tagging o Biomedical checks o Delivery of equipment to end point location o Assembly of equipment o Hanging and placement of equipment A definitive equipment procurement process must be developed to ensure that these questions do not become problems during this chaotic phase of the project. It is recommended that a mover/logistics firm be engaged after you complete the Design Development phase to coordinate these activities. By hiring a firm of this nature prior to the issuance of the purchase orders, a 2


Capital Project Solutions – August 2011

streamlined procurement and delivery process can be established; thus eliminating chaos when the equipment is delivered. IT Systems: Often in capital healthcare projects, the Information and Technology budget is second only to that of construction. For many healthcare facilities, the race to keep up with the ever changing and advancing technologies is almost unwinnable. With the vast amount of systems and applications that are being installed and constructed in facilities today, it is crucial to coordinate the following to prepare the facility for a timely move. Training, Training, and More Training - Prior to moving into any facility and “Going Live”, the most difficult and cumbersome aspect is getting all of the end users trained and indoctrinated on all of the new IT applications and systems. These systems not only affect the clinicians; but registration, accounting, and medical records applications as well. The most critical element concerning training is to allow enough time between the issuance of the Certificate of Occupancy to the actual “Go Live” date. Far too often, healthcare organization do not allow sufficient time to properly train staff on new systems which results in total chaos and confusion in the new facility. Proper training is achieved when specific systems training is combined with a comprehensive macro level education on how each system works together to influence workflows and operations. It is not enough just to have the vendors come and train on each system independently. Develop and IT Implementation Team - The best way to keep your project on schedule and prepared for Move Day is to make sure that there is a dedicated team to lead and coordinate all of the IT related items. In most cases, there is a “Technology Consultant” or “Low Voltage” planner that assists in the design of the IT systems. However, to assume that they will be there to follow through on the installation, certification, testing, and training of the systems is a mistake made by too many hospital 3


Capital Project Solutions – August 2011

leaders. The IT Team should be responsible for identifying gaps in this process as well providing solutions for the gaps. We recommend that you look at options for contracting all technology systems through a Technology Integrator rather than having multiple systems installed by multiple parties that are managed by multiple individuals. Schedule and Accountability: There is no doubt that by the time the project is coming to a close and the Facility Readiness planning is in full swing, the owner has seen his/her fair share of schedules. Information such as Overall Project Schedules, Near Term Schedules, and Milestone Schedules have all made their way across his/her desk more than a time or two. However, in the case of planning the “Go Live” date and preparing the facility for the event, it is necessary to develop the Relocation Schedule so that dates and durations that are critical can be successfully managed. One helpful way to track the Relocation Schedule is to form a Facility Relocation Committee. This Committee should be composed of key stakeholders from the hospital Facility and Operational Team, IT and Medical Equipment Representatives, Construction Team, and hospital administration. This Committee will hold teams accountable as well as monitor and track the Relocation Schedule to ensure that deadlines are being met. Conclusion There are many moving parts associated with preparing for Facility Readiness. Success in this phase of the project is dependent upon the attention given to detail in the implementation of the building plan. Streamlining all medical equipment and IT functions is just one step in the right direction for a smooth relocation. Combined with oversight by the Facility Relocation Committee of key stake holders and one can begin to build a Facility Readiness Plan that is achievable and easily implemented. 4


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Capital Project Solutions – September 2011

Move Management - The "Big Move Day" Is Here Patrick E. Duke, Senior Vice President Gary Wilkinson, Senior Consultant

It All Comes Down to "The Big Move" The day-to-day activities that are associated with delivering a major healthcare capital project can be overwhelming. During construction, it is easy to lose site of the goals that were established at the onset of the project. Often times, these goals are replaced with the single minded notion of “just finishing” and “getting it complete”. The pressure to stay on schedule and within budget, combined with change orders and patient and staff disruptions often overshadow the need to properly plan the physical move into the new facility. The cliché that “people only remember the last three months of the project” is only too true. All of the praise for proper programming, design, and construction can be lost in an instance if the team fails to properly plan the move. Over the past three months, we have discussed the importance of conducting a Transition Readiness Assessment as well as Operational Readiness and Facility Readiness. These three critical planning elements can ensure a smooth transition into the new building. The time for planning will inevitably come to an end and you must make "The Big Move" into your new facility. In this edition of Capital Project Solutions, we will focus on: Setting the date for the "The Big Move" Setting up a command and communication structure Recommended support after "The Big Move"

Setting a Date for "The Big Move" Setting the date for “The Big Move” can often times become one of the most discussed, debated and misunderstood issues during Transition Planning efforts. The primary reasons are as follows: 1


Capital Project Solutions – September 2011

Lack of Clarity Around the Definition of Contractor Completion - The Owner's project management team should clearly define “Contractor Completion” in the Construction Management Agreement. We often see confusion because contracts can use the terms Substantial Completion and Certificate of Occupancy separately. It is preferred to link the two and define Contractor Completion as the date that the Owner can legally take control of the building after receiving a Certificate of Occupancy (CO). A Contractor that achieves Substantial Completion typically has punchlist work and commissioning activities remaining before CO can be achieved. Therefore, Owner activation activities such as stocking and training cannot begin until after CO and this should be the date defined as Contractor Completion. Lack of Clarity Around Inspection Process to Determine Clinical Readiness - You are probably well versed in routine or surprise inspections that occur from your local, state and sometimes national health officials and accrediting bodies. While some elements of these inspections are similar to the inspection process to determine clinical readiness, there are also some differences. Because of the variability from state to state and inspector to inspector, we recommend that communication between the project delivery team and inspection agency occur prior to project launch. This communication should continue throughout the life of the project in order to thoroughly understand all of the requirements for clinical readiness inspections. The date of "The Big Move" cannot be set with any accuracy until you fully understand all of the requirements of clinical readiness inspections. Lack of Understanding of Time Required for Activation Activities – By their very nature, healthcare organizations are flexible and quite skilled at quickly adapting to their environment so as to remain focused on delivering quality patient care. As expected, they are well versed in emergency preparedness. This trait, while extremely positive when related to patient care, can actually work against the need to provide adequate time 2


Capital Project Solutions – September 2011

to complete all activation activities. There is no doubt, that given a deadline, the staff in a healthcare organization will meet it and ensure that proper patient care is delivered. Unfortunately, the amount of time that is required for appropriate staff training and process retooling is typically way underestimated. The result is often an increase in cost and a decrease in efficient early in the new facility's life cycle. In our experience, there cannot be too much time allotted for activation activities. While construction is never an exact science it behooves the Owner to set a date for "The Big Move" as early as possible. Once this date has been established, a cascade of decisions can be made. For example, if new services that require additional FTE's will be added, recruiting must be factored into the schedule. In addition, procuring a Relocation Specialist (the physical mover) should happen sooner rather than later. There are only a handful of companies that specialize in large hospital moves and their calendars are booked well in advance. Considering all these factors and based on our experience over the years, we recommend that a date be set for the "The Big Move" that is no less than 60-90 days from Certificate of Occupancy for smaller projects or those that are in ambulatory settings. For larger and more complex projects, we recommend that the date be a minimum of 90-120 days from Certificate of Occupancy. Setting Up a Command and Communication Structure Given the complexities and risks surrounding the move to a new facility, it is recommended that this task be approached in a manner similar to an Emergency Preparedness situation. Many hospitals utilize principles of the Hospital Emergency Incident Command System (HEICS) and set up the requisite Incident Command Center (ICC). Since healthcare staff is familiar with these terms and procedures, it will be beneficial to closely mimic this set-up for the command and communication structure to

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support "The Big Move". should be as follows:

Some considerations in your plan

Timing of Command Center Activation - The physical move of contents may take place the weekend prior to first clinical visit or for larger facilities it could begin two to four weeks ahead. Typically, patient moves occur in one day over a weekend. However, depending on your volume, it may be best for your organization to phase your patient moves. Regardless, we recommend activating the Command Center to support the beginning of the physical move. Obviously, there is a ramp up period from the early days of your Command Center operations to when you complete the move. Keeping The Clutter Out - Especially on patient move days, it is vital to include only essential Command Center personnel who have a defined role in the process. Setting a "Contractor & Vendor Support Room" that is linked by communications with the Command Center is critical to coordinate all activities. Should staff require systems support during the patient move, contractors and vendors can easily be dispatched from this area to the trouble spot. Also, separate rooms for media, volunteers and patient's families should be set up in a similar fashion. Leverage Technology - The best Command Centers we have encountered have been those that utilize the facility technology to allow for enhanced monitoring and communication. With proper planning, temporary measures can allow for effective use of the facility communication and monitoring systems even if the Command Structure location is not part of a permanent Central Command in the hospital. The Command Center should be able to access all camera locations to view activity, view bed management and have its own unique phone number with an extension that is easy to remember such as x6683 or "MOVE".

The Command Center is the epicenter of "The Big Move" and should be activated when the physical move begins. Roles and 4


Capital Project Solutions – September 2011

responsibilities for all staff supporting "The Big Move" should be well defined and only those essential to the Command Center operations should occupy it. Other separate areas for groups like contractors, vendors, media, volunteers and patient's families should be designated and linked through the communications systems to the Command Center to maintain a stable environment during the patient move. A Command Center that leverages technology systems in the new facility most effectively allows for closer monitoring and better response time to any issues that may arise. Recommended Support After "The Big Move" A common mistake in approach to transition planning is to close the planning window at the conclusion of "The Big Move". The reality is that transition does not stop at that point. It continues past "The Big Move" and depending on the scope of the project, can last months, even years longer. Failure to plan and support staff post "The Big Move" can lead to low morale, low patient satisfaction scores, increased operating costs and lower margins. In looking beyond "The Big Move" you should consider the following: Command Center Operations Post Move – A proven best practice is to keep the Command Center open at least one week post "The Big Move". The hours and staffing model should be discussed and adjusted based on agreed need. Using the Command Center in this time period to address issues provides a safety net to staff and allows the organization to respond quickly to any issues that may arise. Maintain Transition Planning Structure Post Move - The Transition Planning structure should be maintained up to a year post "The Big Move". For the first 3 months following the move, the Transition Steering Committee should meet on a bi-monthly basis and address ongoing issues related to the transition. Allowing these issues to filter through existing management processes and systems can lead to delays in response times and may strain relationships with staff, patients and visitors. 5


Capital Project Solutions – September 2011

Gear Up Your Lean Team - Lean or Performance Improvement teams, inside healthcare organizations, should be integrally involved in the transition planning effort and should be maintained post "The Big Move". Modeling and development of processes and workflows that aligned with your facility design prior to transition need close evaluation and optimization in the near term after the move. This level of support and monitoring will address any bottlenecks that occur and provide yet another critical support element to the staff. It is easy to quickly return to operations as usual once "The Big Move" is completed. Avoiding this scenario is highly recommended. Staff, patients and visitors need time to adjust to the new environment and new processes. Despite their unique ability to adapt and adjust to new environments while maintaining focus on patient care, staff involved in the transition are experiencing change in a way that most have never experienced before. This change needs to be recognized and a bridging process should be developed post "The Big Move" to provide critical support before returning to normal operating procedures. Conclusion The last thing anyone remembers about the project is "The Big Move". In order to finish strong, it is imperative that adequate time for all of the Owner's activation tasks be built into the schedule initially. While you may begin with more time than you think is necessary between Certificate of Occupancy and "The Big Move", construction is never an exact science and contingency time should be allocated. Given the dramatic change that many staff will experience for the first time in their careers, providing a support network dedicated to the move, and more importantly post move, will be welcomed. Proper planning, flexibility and team work will ensure that your new facility achieves your goals and fulfills your vision.

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